Benefits Frequently Asked Questions

How much do I pay for my benefits?

Medical - You will find the monthly medical plan costs on At Your Service.

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.

Flexible Spending Accounts - The Flexible Spending Accounts (FSA) allow you to pay eligible expenses on a pretax, salary reduction basis. Dependent Care FSA (DepCare FSA) is for eligible dependent care expenses and Health FSA is for eligible health care expenses not covered by your medical, dental, or vision plans. You decide how much to contribute to your Flexible Spending Accounts.

Life Insurance – You pay for supplemental life insurance for yourself and your eligible family members. Premium is based on your age and annual salary. Use the Insurance Premium Calculator to estimate your premiums based on your salary.

Supplemental Disability Insurance - You pay for supplemental disability insurance for yourself. Premium is based on your age, your annual salary, and the waiting period you select. Use the Insurance Premium Calculator to estimate your premiums based on your salary.

Accidental Death & Dismemberment Insurance – You pay for the cost of this insurance for yourself and your eligible family members. See the Cost Chart for coverage and pricing options.

Legal Insurance – You pay for the cost of this plan for yourself and your eligible family members. Click on Plan Costs to find the monthly premium for legal insurance.

Family Care - UC pays the fee that gives you access to the SelectPlus website with its networks of pre-screened providers. You make all the arrangements including hiring and payment to the provider you choose. Click here to find more about the services provided by SelectPlus.

Auto/Renter/Homeowner Insurance - UC employees have access to group rates for auto, renter and homeowners insurance through California Casualty. Employees deal directly with the insurer, and premiums may be paid through payroll deduction. For more information, contact California Casualty.

Business Travel Accident Insurance - When traveling on official University business you will be covered by ACE USA at no cost to you, but you must register to ensure coverage for each business trip. The coverage is worldwide, 24 hours a day, for a wide variety of accidents and incidents while away from the workplace.

Long Term Care – UC does not offer a long-term care plan.

Current Enrollments - Sign-in to At Your Service Online to find your current enrollments and monthly deductions.

Total Compensation - The value of your UC employment goes beyond your salary. As a UC employee, you enjoy a full range of benefits, services and programs. Use the Total Compensation Calculator to estimate the value of your total UC compensation.

When will my insurance start?

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.

How do I rush my enrollment if I need immediate medical, drug or dental services?

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:

Complete your UC new employee enrollment on At Your Service Online.
The next day, verify that your enrollment is in the UC system by checking “Health and Welfare - Current Enrollments” on At Your Service Online.
Call the health plan’s member services and identify yourself as a new member who is calling to verify eligibility.
1. Ask if you are “active” in the insurance membership system.
2. 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.
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
- Anthem: Select “Customer Care” tab
- Health Net: Select “Print a Temporary ID”
- Delta PPO: Select “Eligibility and Benefits”

If you are having trouble enrolling with your carrier, or have questions about this process, please contact your Health Care Facilitator.

Will I receive ID cards for my health insurance plans; if so, when?

Medical - You and each family member you enroll will receive a medical plan ID card. The cards are mailed to your address in the UC personnel system 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 UC personnel system 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 by using your social security number.

Print an ID card

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

Anthem: Select “Customer Care” tab
Health Net: Select “Print a Temporary ID”
Delta PPO: Select “Eligibility and Benefits”

How do I order medication by mail to save money?

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 maintenance medication by mail, you get a 90 day supply for the cost of 60 days at a retail pharmacy.

Go to your 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.

How do I get a second opinion outside of my HMO medical group?

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. Mercy Medical Center), 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

1-888-209-7975 Anthem Blue Cross Plus Member Services

Requirements by Plan:

Blue Cross Plus – In-Network (HMO):
Blue Cross Plus members must FIRST ask their HMO physician for an authorization to see a physician outside of their HMO medical group for the second opinion. If that request is denied by the physician or the medical group, the member can call Anthem member services to request a second opinion consultation.

Tell Anthem Member Services that you wish to use your in-network benefits for the consultation. Ask Member Services to refer the request to the Transition Department for review. You can select from Anthem Plus and Anthem PPO providers for the second opinion.

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.

When can I change my Primary Care Physician (PCP)?

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.

How do I change my Primary Care Physician (PCP)?

Call your medical plan’s customer service number to request the change. You can find the number on your medical ID card.
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.
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.
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. Mercy Medical Center). 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.

Can each family member have a different Primary Care Physician (PCP)?

Yes. Each family member may choose a different PCP from the doctors who are contracted with your medical plan.

How do I find a doctor in my medical plan?

Go to Find a Doctor on At Your Service. 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. When you pick your PCP you are also choosing a medical group (e.g. Mercy Medical Center). 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.

I’m going on vacation, how can I get my prescription drug refilled early?

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.

How do I change my address?

Sign-in to At Your Service Online to change your address in the UC personnel system. UC will send this information to your insurance carriers.

Or, you can ask your department administrative office to change your address.

How do I add a family member to my benefits?

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.

You will find chart with eligibility information and instruction for how to enroll on At Your Service.

How do I remove a family member from my insurance?

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.

Go to At Your Service for information about eligibility and instructions on how to de-enroll a family member.

How do I opt-out of or cancel an insurance plan?

New employee within 31 days from your hire date: Create your account profile on At Your Service Online. Once you are logged in and are at the “Main Menu”, look for the words “Benefits Enrollment” and follow the directions given.

Current employee beyond 31 days from your hire date: Complete Benefits Enrollment/Change Form (UPAY 850) and submit it to the Benefits Office:

Email: benefits@ucmerced.edu
Physical Address: The Promenade, 767 E Yosemite Ave Suite A/B Merced, CA 95340
Mailing Address: 5200 North Lake Road, Merced, CA 95343
Fax: 209-228-8586

How do I enroll in or make changes to my life insurance coverage?

Supplemental Life Insurance

If you did not enroll in Supplemental Life Insurance when you were first eligible for benefits, there are other opportunities to enroll without proof of good health.

Marriage or establishing a Domestic Partnership
Birth or adoption of a child, or date a stepchild, grandchild or legal ward meets UC requirements
Involuntary loss of other UC-sponsored life insurance

These events create a new Period of Initial Eligibility (PIE) to enroll. The PIE begins on the date of the qualifying event and ends 31 calendar-days later, or the last business day of that 31 day period if earlier. If you are already enrolled in the Supplement Life Insurance plan, these life events also provide a new PIE to increase your coverage amount.

See the Family Changes Benefits Checklist for complete details on enrollment criteria & deadlines.

To enroll at any other time, you may apply through the Statement of Health process (see below). Your application is subject to review by the insurance carrier and may be approved or denied.

Enroll in or increase your coverage during a new Period of Initial Eligibility (PIE):

Complete a UPAY 850 form and submit it to the Benefits Office by email or fax (209-228-8586)

Section 1: complete all requested information
Section 2: check "Other" box and write event description and event date under Comments
Section 4 Supplemental Life: check appropriate action box and check box for new coverage amount
Sign and date form at the bottom

Decrease existing coverage (may be done at any time):

Complete a UPAY 850 form and submit it to the Benefits Office by email or fax (209-228-8586)

Section 1: complete all requested information
Section 2: write "Decrease life insurance coverage" in Comments
Section 4 Supplemental Life: check "Change" action box, and check box for desired coverage amount
Sign and date form at the bottom

Cancel existing coverage (may be done at any time):

Complete a UPAY 850 form and submit it to the Benefits Office by email or fax (209-228-8586)

Section 1: complete all requested information
Section 2: check the cancel coverage box
Section 4: check the Cancel box under the Supplemental and/or Dependent Life plan as appropriate
Sign and date form at the bottom

Dependent Life Insurance

If you did not enroll in Dependent Life Insurance when you were first eligible for benefits, there may be other opportunities to enroll without proof of good health. You have a 31 day PIE to enroll from the date of the qualifying event:

Marriage or establishing a Domestic Partnership
Birth or adoption of a child, or date a stepchild, grandchild or legal ward meets UC requirements
Involuntary loss of other UC-sponsored life insurance

Restrictions may apply if the newly eligible spouse or domestic partner is not the first eligible family member. If that is the case, please contact the Benefits Office for more information.

To enroll a spouse or domestic partner at any other time, you may apply through the Statement of Health process (see below). The application is subject to review by the insurance carrier and may be approved or denied.

Dependent children may be enrolled at any time. No Statement of Health is required even if the PIE has expired.

Enroll in Dependent Life during a new Period of Initial Eligibility (PIE):

Complete a UPAY 850 form and submit it to the Benefits Office by email or fax (209-228-8586)

Section 1: complete all requested information
Section 2: check "Other" box and write event description and event date under Comments
Section 4 Dependent Life: check appropriate action box and check box for new coverage type
Sign and date form at the bottom

Statement of Health (SOH) Process for Life Insurance
To initiate the SOH process, complete a UPAY 850 and submit it to the Benefits Office.

Section 1: complete all requested information
Section 2: check Statement of Health box.
Section 4: Check appropriate boxes for Supplemental and/or Dependent life, including coverage amount
Sign and date form at the bottom

Upon receipt of the completed UPAY 850 form, the Benefits Office will send you an Evidence of Insurability form for you to complete and submit directly to the life insurance carrier. After completing their review (generally 4-6 weeks) the carrier will notify you and the Benefits Office of their decision. If your request is approved, the Benefits Office will process the enrollment/change upon receipt of the carrier approval.

How do I enroll in or make changes to disability coverage?

To enroll or move to a shorter waiting period
If you did not enroll in Supplemental Disability when you were first eligible, you may apply to enroll through the Statement of Health process (see below). Your application is subject to review by the insurance carrier and may be approved or denied.

The cost of coverage is based on your age, salary rate and the waiting period you choose. The insurance premium calculator on the At Your Service website can help you calculate the monthly cost for the different waiting periods.

If you are already enrolled in Supplemental Disability and wish to shorten your waiting period, you must also apply through the Statement of Health process, which the carrier can approve or deny. If you wish to lengthen your waiting period, you may do so at any time.

Statement of Health (SOH) Process for Disability Insurance (to enroll outside of Period of Initial Eligibility (PIE) or to shorten your waiting period)

To initiate the SOH process, complete a UPAY 850 and submit it to the Benefits Office.

Section 1: complete all requested information
Section 2: check the box for Statement of Health
Section 4 Supplemental Disability: check whether the action is to enroll or change waiting period, and check the box for your chosen waiting period
Sign and date form

Upon receipt of a completed UPAY 850 form, the Benefits Office will send you an Evidence of Insurability form for you to complete and submit directly to the disability insurance carrier. After completing their review (generally 4-6 weeks), the carrier will notify you and the Benefits Office of their decision. If your request is approved, the Benefits Office will process the enrollment/change upon receipt of the carrier approval.

To move to a longer waiting period
If you are already enrolled and wish to move to a longer waiting period, you may do so at any time. complete a UPAY 850 and submit it to the Benefits Office.

Section 1: complete all requested information
Section 2: write "Change waiting period" in Comments
Section 4 Supplemental Disability: check action box for "Change Waiting Period", and check box for your chosen waiting period.
Sign and date form

Please be aware that Supplemental Disability premiums are paid at the end of the month (arrears), so approved changes will generally not appear until the month following the enrollment or change.

Resources

Disability and Life Insurance Premium Calculator

Health and Welfare Benefits Information

Life Insurance Information

Checklists and Factsheets