Open Enrollment

2019 Rates

Medical and Dental Premium Rates

User Guide

How to access and complete open enrollment on eCampus

Holidays

2019 University Holidays

Open Enrollment At A Glance:

In carefully analyzing our medical plans, their costs and the competitive options that were available to us, the University has eliminated a Kaiser plan offering and is adding Blue Shield as our Non-Kaiser HMO and PPO option.  While acknowledging that some of these changes might cause some employees to change plan providers or physician groups, we believe that these changes will help the University maintain choice while insuring a competitive cost.

Kaiser HMO 

  • The Kaiser Silver HMO plan will no longer be offered.
  • The Kaiser HMO for 2019 will match the current Gold HMO plan design. 

Anthem Blue Cross 

  • The Anthem HMO plans will be replaced by two Blue Shield plans - Blue Shield Trio and Blue Shield Access Plus.
  • Both the Blue Shield Trio and Blue Shield Access Plus will match the plan design for the current Blue Cross Gold design. 

Anthem PPO Health Savings Account (HSA) Plan 

  • The Anthem PPO Health Savings plan will be replaced with a Blue Shield PPO HSA Plan. 
  • The University will contribute $50/employee/month to the HSA account for any employee enrolling in this plan in 2019. 
  • The Blue Shield PPO HSA plan benefits will closely match the current PPO HSA plan.

Other Coverages:

There are no plan design changes or increases in premium costs for Delta and Anthem Blue Vision. 

  • If you are currently enrolled in Kaiser Silver or any of the Anthem Blue Cross plans, you must make a new medical plan election.
  • Complete open enrollment benefit changes by November 28, 2018, (extended deadline).
  • Review your benefits information on eCampus.
  • Review and update your contact/address information on eCampus.
  • If you are currently participating and would like to continue your FSA plan, you MUST re-enroll in the plan during open enrollment.
  • Open Enrollment period ends on November 28, 2018, (extended deadline)
  • All open enrollment changes must be completed online by 11:59 pm on November 28, 2018
  • NO late enrollment or changes will be accepted 
  • Recently added benefits / Vendors
    • Health Advocate - New Vendor
    • Concern - Employee Assistance Program (EAP Vendor)
  • Register online for Benefit Information Sessions:
    • Benefit Overview Presentations
    • Drop-in Sessions
    • 1:1 Sessions
  • 2019 Annual Amounts (pending confirmation from IRS):
    • HSA contribution Self only $3,500; Family $7,000.
    • FSA Medical contribution limit $2,700.
    • 403b contribution limit $18,500
  • Monthly MassTransit contribution limit $265.

Kaiser Gold Members

You may remain with Kaiser or enroll in a Blue Shield Plan.

There are no changes to the plan design as the Kaiser Plan is the same as Kaiser Gold from last year.

Premium for EE only remains the same with a slight increase if you are covering dependents on this plan.

Kaiser Silver Plan Members

You may enroll in the Kaiser HMO plan or enroll in a Blue Shield Plan.

The Kaiser HMO plan for 2019 has improved benefits and a higher cost.

The Blue Shield TRIO HMO plan is the lowest cost option and closely matches the benefits of the Kaiser HMO and the Blue Shield Access+ HMO.

Santa Clara County Independent Physician Association (SCCIPA) is the most prominent medical group in the TRIO plan.

The Blue Shield Access+ HMO Option has the largest network of Doctors and Physicians.

Anthem Blue Cross Gold & Silver HMO Members

You must enroll in a new medical plan.

The Blue Shield Access+ HMO Option:

  • Is the same plan design as the current Anthem Gold HMO
  • Has the largest network of Doctors and Physicians and
  • Is offered in 2019 at a lower monthly cost than the current Anthem Gold HMO

The Blue Shield TRIO HMO Option

  • Has the same plan design as the current Anthem Gold HMO
  • Is the lowest cost option for 2019
  • The Santa Clara County Physician Association (SCCIPA) is the most prominent medical group in the Blue Shield TRIO HMO.

Anthem Blue Cross Lumenos Health Savings Account PPO Members 

You must enroll in a new medical plan.

The Blue Shield HSA PPO plan will replace the Anthem HSA PPO plan.

The new Blue Shield plan is the same monthly cost as the current Anthem HSA PPO plan.

New! SCU will begin contributing $50 per month ($600 annually) into your Health Savings Account effective January 1, 2019.

HealthEquity will be the new Health Savings Account Bank that integrates with Blue Shield.  Members may want to consider consolidating Health Savings Accounts into a single account.

Open Forums:

After many years with Anthem, we anticipate that many of you will be concerned about how these changes will impact you and your family. With this in mind, we have planned a series of open forums and other opportunities for you to utilize so that you can better understand the new plans and make the best selection.  Here are the dates, times and locations of the four Benefits Open Enrollment Forums being offered by HR.  These Benefits Open Enrollment Forums will be facilitated by HR Benefits Staff.   Representatives from Blue Shield, Kaiser, Santa Clara County Independent Physicians Group as well as the Benefits Committee will also be present for the Open Forums.

  • Friday, October 19 from 9 AM – 11 AM in the California Mission Room
  • Wednesday, October 24 from 12:30 PM – 2:30 PM in the California Mission Room
  • Monday, November 12 from 12:30 PM – 2:30 PM in HR’s Manresa Learning Center
  • Tuesday, November 27 from 2:00 PM – 4:00 PM in HR's Manresa Learning Center

Download Benefits Open Enrollment Forum Presentation 

Workshops:

A series of workshops are also being offered on a variety of topics and can answer many of your questions. Here are the dates, times locations, and topics which will be covered:

  • Tuesday, October 30, 10:30 – 11:30 AM in Manresa Learning Center – Understanding the Advantages of a Health Savings Account Plan
  • Tuesday, October 30, 1:00 – 2:00 PM in Manresa Learning Center – How Blue Shield Can Make Your Medical Healthcare Plan Transition Seamless
  • Thursday, November 8, 3:00 – 4:00 PM in Manresa Learning Center - How Blue Shield Can Make Your Medical Healthcare Plan Transition Seamless
  • Monday, November 12, 4:00 – 5:00 PM in Manresa Learning Center - – How Blue Shield Can Make Your Medical Healthcare Plan Transition Seamless (Note: session changed)

 Drop-In Sessions:

 Members of the Benefits Staff in HR are also available on the following dates and times for drop-in sessions.

  • 11/6 4:00 – 5:00 PM – Manresa Learning Center
  • 11/9 11:00 AM-1:30 PM Jesuit School of Theology Berkeley Campus
  • 11/16 9:00 – 10:00 AM – Barcelona Conference Room
  • 11/26 9:00-10:00 AM – Manresa Learning Center

Appointment Times:

The Benefits Staff is also available for schedules appointment times.  Please visit the Benefits Calendar for dates and times and to sign up.


Blue Shield Information:

Blue Shield’s customer service representatives are available to support and assist Santa Clara University employees with general questions, provider searches and benefit information on the three Blue Shield medical plans.

  • Trio HMO plan - (855) 829-3566
  • Access + HMO plan - (855) 599-2650
  • PPO Savings plan - (855) 599-2650

The How To Find a Network Provider guide provides information on how to look up a primary care provider on Blue Shield's portal.

Blue Shield Trio Plan:

Provider name Main County Served
Hill Physicians Medical Group Inc. Alameda
John Muir Physician Network Contra Costa
Meritage Medical Network Marin
Hill Physicians Sacramento Primed Inc. Sacramento
Mercy Medical Group Sacramento
Hill Physicians San Francisco, Inc. San Francisco
Hill Physicians San Joaquin San Joaquin
Sequoia Physicians Network San Mateo
Santa Clara County IPA Santa Clara
Physicians Medical Group of Santa Cruz County Santa Cruz
Hill Physicians Medical Group, Solano Solano
AllCare IPA - Stanislaus ACO Stanislaus

Blue Shield Access+ Plan:

Provider name Main County Served
Affinity Bay Valley Region Alameda
Affinity Medical Group Alameda
Alta Bates Medical Group Alameda
Hill Physicians Medical Group Inc. Alameda
Sutter East Bay Medical Foundation Alameda
Hills Physicians Contra Costa County Contra Costa
John Muir Physician Network Contra Costa
Sutter East Bay Medical Foundation Diablo Division Contra Costa
Saint Agnes Medical Group Madera Madera
Meritage Medical Network Marin
Allcare IPA Merced Merced
Merced County - BSC Administered Merced
Hill Physicians Sacramento Primed Inc. Sacramento
Mercy Medical Group Sacramento
Sutter Independent Physician Sutter Connect Sacramento
Sutter Medical Group Sac Placer Division Sacramento
UC Davis Health System Sacramento
Asian American Medical Group San Francisco
Brown And Toland Physcians Medical Group San Francisco
Hill Physicians San Francisco, Inc. San Francisco
Hill Physicians San Joaquin San Joaquin
PAMF Mills Peninsula Division San Mateo
Sequoia Physicians Network San Mateo
Affinity Medical Group - South Bay Santa Clara
Palo Alto Medical Foundation Santa Clara
Palo Alto Medical Foundation Camino Santa Clara
Physicians Medical Group of San Jose Santa Clara
Santa Clara County IPA Santa Clara
Verity Medical Foundation Santa Clara
Palo Alto Medical Foundation Santa Cruz Santa Cruz
Physicians Medical Group of Santa Cruz County Santa Cruz
Hill Physicians Medical Group, Solano Solano
Sutter Medical Group Solano Division Solano
AllCare IPA - Stanislaus ACO Stanislaus
Sutter Gould Medical Foundation Stanislaus

 


Medical Plan Comparisons:

2019 MEDICAL PLANS 

Kaiser

HMO

Blue Shield

Trio Network

HMO

Blue Shield

Access+ Network

HMO

Blue Shield

HDHP PPO HSA

PPO/Non-PPO

Annual Deductible        
Individual None None None $2,000 / $4,000
Individual with Dependent(s) None None None $2,700 / $5,200
Family None None None $4,000 / $8,000
Annual Out of Pocket Maximum        
Individual & Individual with Dependent(s) $1,500 $2,000 $2,000 $3,425 / $12,000
Family $3,000 $4,000 $4,000 $6,850 / $24,000

Medical Services

Primary Care Visit $20 copay $20 copay $20 copay 90% / 70%
Specialist Office Visit $20 copay $20 copay $40 copay
$20 with PCP referral
90% / 70%
Basic X-ray and Laboratory No charge No charge No charge 90% / 70%
Inpatient Hospital $250 copay per admission $250 copay per admission $250 copay per admission 90% / 70%
Emergency Room $50 copay $100 copay $100 copay 90% / 90%
Urgent Care $20 copay $20 copay $20 copay 90% / 70%
Chiropractic $15 copay per visit to
30 visits per year
$15 copay per visit to
20 visits per year
$15 copay per visit to
20 visits per year
90% / 70%
Hearing Aid $2,500 per device, 2 devices every 3 years $2,000 every 2 years $2,000 every 2 years 80% / 80%
Prescription Drugs       After Deductible
Generic / Tier 1 $10 copay $10 copay $10 copay $10 copay / $10+25%
Formulary / Tier 2 $25 copay $25 copay $25 copay $40 copay / $40+25%
Non-Formulary / Tier 3 $25 copay $50 copay $50 copay $60 copay / $60+25%
Monthly Employee Contribution    
Employee Only $51.32 $11.12 $77.81 $113.92
Employee + 1 $301.63 $152.20 $351.93 $421.64
Employee + Family $455.80 $290.94 $536.13 $677.60
  2018 2019
 MEDICAL PLANS Anthem Blue Cross
HMO
Gold Plan
Blue Shield
HMO
Trio Network
Blue Shield
HMO
Access+ Network
Deductible - Individual / Family None None None
Out of Pocket Maximum - Individual / Family $2,000 / $4,000 $2,000 / $4,000 $2,000 / $4,000
Medical Services      
Primary Care Visit $20 copay $20 copay $20 copay
Specialist Office Visit $40 copay $20 copay $40 copay
$20 copay with PCP referral
Basic X-ray and Laboratory No copay No copay No copay
Inpatient Hospital $250 copay per admit $250 copay per admit $250 copay per admit
Emergency Room (copay waived if admitted) $100 copay $100 copay $100 copay
Urgent Care $20 copay $20 copay $20 copay
Chiropractic $15 copay per visit to 20 visits per year $15 copay per visit to 20 visits per year $15 copay per visit to 20 visits per year
Hearing Aid 80% $2,000 every 2 years $2,000 every 2 years
Prescription Drugs      
Generic / Tier 1 $10 $10 $10
Formulary / Tier 2 $25 $25 $25
Non-Formulary / Tier 3 $50 $50 $50
Specialty / Tier 4 20% up to $250 per prescription 20% up to $200 per prescription 20% up to $200 per prescription
  2018 2019
 MEDICAL PLANS Anthem Blue Cross
High Deductible PPO HSA
Blue Shield
High Deductible PPO HSA
  PPO Non-PPO In Network Out of Network
  Member pays Member pays
Annual Deductible      
Individual $2,000 $4,000 $2,000 $4,000
Individual with Dependent(s) $2,700 $5,200 $2,700 $5,200
Family $4,000 $8,000 $4,000 $8,000
Out of Pocket Maximum      
Individual & Individual with Dependent(s) $3,425 $12,000 $3,425 $12,000
Family $6,850 $24,000 $6,850 $24,000
Medical Services    
Primary Care Visit 10% 30% 10% 30%
Specialist Office Visit 10% 30% 10% 30%
Basic X-ray and Laboratory 10% 30% 10% 30%
Inpatient Hospital 10% 30% 10% 30%
Emergency Room (copay waived if admitted) 10% 10% 10% 10%
Urgent Care 10% 30% 10% 30%
Chiropractic 10% 30% 10% 30%
Hearing Aid 20% 20% 20% 20%
Prescription Drugs    
Generic / Tier 1 $10 copay 30% up to $250 per prescription $10 copay $10 + 25%
Formulary / Tier 2 $40 copay 30% up to $250 per prescription $40 copay $40 + 25%
Non-Formulary / Tier 3 $60 copay 30% up to $250 per prescription $60 copay $60 + 25%
Specialty / Tier 4 30% up to $250 per prescription 30% up to $250 per prescription 30% up to $200 per prescription Not covered

 

Open Enrollment Period Ends on November 28

Open Enrollment Period Is Now Closed

Upcoming Benefits Seminars