Benefits

Frequently Asked Questions

Benefit Changes

You have 31 days from the "qualifying event" to add a family member to your benefits. Qualifying events include birth, adoption, marriage, or establishing a domestic partnership. To add a family member login to the UCPath portal: ucpath.universityofcalifornia.edu

Family members become ineligible for UC-sponsored benefits through divorce, the end of a domestic partnership, death, or when children become too old (generally age 26).  Whenever a family member loses eligibility to participate in UC-sponsored plans, it is your responsibility to de-enroll that family member. To make changes login to the UCPath portal: ucpath.universityofcalifornia.edu

 

Health Insurance

Medical - You will find the monthly medical plan costs on UCnet.

Dental - UC pays the entire cost of monthly dental premiums for you and your family members.

Vision - UC pays the entire cost of monthly vision premiums for you and your family members.

Current Enrollments - Login to the UCPath portal to find your current enrollments and monthly deductions.

 

Go to Find a Doctor on UCnet. You will find lists of participating physicians on each insurance plan website. 

HMO medical plans require you to select a Primary Care Physician (PCP) to manage your care. 

  • Each family member may choose a different PCP from the doctors who are contracted with your medical plan.  
  • When you pick your PCP you are also choosing a medical group (e.g. Sansum, Santa Barbara Select IPA, Buenaventura).  HMO physicians are affiliated with a medical group of specialists and hospitals that you may use for non-emergency care. 
  • The PCP you select will oversee your care and authorize visits to specialists in the medical group.

HMO medical plans require you to select a Primary Care Physician (PCP) to manage your care.  You may request a different Primary Care Physician (PCP) at any time.  You do not have to wait until Open Enrollment to change your PCP.  Be sure to confirm the “effective date” of the new PCP when you make the change.

  1. Call your medical plan’s customer service number to request the change. You can find the number on your medical ID card.
  2. Ask the insurance representative when the PCP change will be effective. If you call the medical plan before the 15th of a month, the change will be effective the first of the next month. If the change is made after the 15th, it will be effective the first of the next month
  3. Use your medical plan’s website to search for a PCP.  Your PCP must be located within a 30-mile radius of your primary residence or workplace and in your medical plan’s service area.
  4. Each family member may choose a different PCP from the doctors who are contracted with your medical plan.

When you pick your PCP you are also choosing a medical group (e.g. Sansum, Santa Barbara Select IPA, Buenaventura).  HMO physicians are affiliated with a medical group of specialists and hospitals that you may use for non-emergency care.  The PCP you select will oversee your care and authorize visits to specialists in the medical group. 

Your medical plan's mail order pharmacy is the most cost effective way to purchase medication that you take over a long period of time. When you order your maintanance medication by mail, you get a 90 day supply for the cost of 60 days at a retail pharmacy.

  • Go to your medical plan's website to find a Prescription Mail Order Form or call the Member Services number on your medical plan ID card.
  • You will need a new prescription to send with the mail order form.  Ask your physician for a 90-day mail order prescription with refills, if medically appropriate.

 

California law allows for a second opinion consultation when you have questions about a diagnosis, want more information about a treatment plan or if you are not satisfied with the results of treatment you have received. 

If you’ve seen a specialist in your medical group (e.g. Sansum Clinic, Santa Barbara Select IPA, Seaview IPA), you may request a second opinion consultation with a physician outside of your medical group from your insurance plan (e.g. Health Net, Kaiser, Anthem Blue Cross).  See the requirements by plan listed below.

The consulting physician must be a provider for your insurance plan.  The approval will go faster if you know which specialist you wish to consult for the second opinion.

Second opinion referrals are for consultation ONLY.  The consulting physician will not be able to order tests or provide any treatment unless that level of care is pre-approved in the referral authorization. You should provide the second opinion specialist with all relevant medical records and test results for review - take them with you or send them to the specialist prior to your appointment. (Make sure you request your records well in advance of the appointment.)

You pay your normal office visit copay.

Call your insurance plan to request a second opinion consultation. 

  • The member services representative will ask you a few questions to clarify your situation:
    • what is your diagnosis
    • the name of the specialist you consulted in your medical group
    • the name of the physician you wish to see for the second opinion consultation
  • The insurance will confirm the consulting physician is in the HMO network.
  • Once the consultation is approved, the insurance will send both you and the consulting physician a written authorization explaining the limits of the consultation.

1-800-539-4072          Health Net Member Services

1-800-464-4000          Kaiser Member Services

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Requirements by Plan:

Health Net HMO

The second opinion physician MUST be in the SAME specialty as that of the specialist seen within the medical group.  You may select from Health Net and Health Net Blue & Gold physicians.

Call the Member Services number on your medical ID card.  They can authorize a “vacation override” so you can get a 30 day supply of medication to take with you. 

If you need more than a one month supply, please contact the Health Care Facilitator.

If you have lost your insurance ID card you can request a replacement card by:
1) calling the plan's member services number or 
2) sign-in to the insurance plan's member website.  You can also print a temporary medical ID card from the insurance plan's member website.
 

Not all insurance plans issue ID cards:

  • Medical, DeltaCare dental and ARAG legal plan mail ID cards to members.
  • Delta Dental PPO ID cards are available on the Delta member website.
  • VSP does not issue ID cards. Participating VSP providers will confirm your eligibility directly with VSP.

You can find insurance contacts on the UCnet website.  

You may initiate, change or end a Health Savings Account (HSA) pre-tax payroll deduction. To make changes login in to the UCPath portal.

New Employees

For most plans, you’re covered on your first day at work (hire date) or eligibility date, but it can take 30-60 days after you enroll for the insurance companies to have a record of your enrollment. So if you need immediate services, check with your insurance carriers first to see if they have a record of your enrollment.

Insurance plan contacts on UCnet.

Health and welfare benefits begin on your date of hire, but it can take up to 30 -60 days before the medical, dental, vision and/or legal plans will have your new eligibility added to the insurance membership systems.

If you have an urgent health situation or need to fill a prescription, you can speed up your enrollment by calling the insurance member services. 

Please complete the following steps to speed-up your enrollment in the insurance membership system:

  1. Login to the UCPath portal to enroll/update/view benefits enrollments
  2. Call the health plan's member services and identify yourself as a new member who is calling to verify eligibility.
  • Ask if you are “active” in the insurance membership system.
  • If you are not, complete the following steps:
  1. Ask to speak with the membership unit or a member services representative who is authorized to use the University of California Carrier Eligibility Website.   
  2. Ask the representative to manually enter your enrollment into the insurance membership system.
  3. Ask the representative for your Member ID and Group Number.
  4. If you need a prescription, ask the representative to inform the pharmacy unit of your new eligibility.
  5. Ask how long it will be before your pharmacist/doctor’s office can access your new member information (it should be no more than one or two days).
  6. When that time frame has elapsed, you can pick up prescriptions or visit your doctor.
  1. Print a Temporary ID Card

You can print a temporary ID card on the following insurance websites after your membership has been activated.  Register as a new member using your Member ID and Group Number.

  • Health Net:  Select “Print a Temporary ID”
  • Delta PPO:  Select “Eligibility and Benefits”

Medical - You and each family member you enroll will receive a medical plan ID card.  The cards are mailed to your address in the UCPath portal after your enrollment is processed by the medical plan.  It can take 30 - 60 days for the medical plan to process new enrollments. 

Delta Dental PPO - Delta does not issue ID cards.   You can print an ID card from your Delta Dental member website.

DeltaCare USA - You and each family member you enroll will receive a DeltaCare ID card.  The cards are mailed to your address in the UCPath portal after your enrollment is processed by the medical plan.  It can take 30 - 60 days for the medical plan to process new enrollments.

Vision Services Plan (VSP) - VSP does not issue ID cards.  Participating VSP providers will confirm your eligibility with VSP.

Print an ID card

You can print an ID cards for medical and dental insurance after your membership has been activated by the insurance plan. Go to the  insurance website.   Register as a new member on the site using your Member ID and Group Number.