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					University of California




            Your Group
            Insurance Plans


                           2008
Table of Contents

  Introduction ................................................................................................................................................................................. 1
  General Information
  Eligibility ............................................................................................................................................................................................3
  Benefits Overview .............................................................................................................................................................................4
  When to Enroll ..................................................................................................................................................................................7
  When Coverage Begins ....................................................................................................................................................................9
  After You Have Enrolled .................................................................................................................................................................10
  When Coverage Ends ..................................................................................................................................................................... 11
  Benefits Assistance .........................................................................................................................................................................12
  Participation Terms and Conditions .............................................................................................................................................13

  Health Care Plans
  Medical .............................................................................................................................................................................................15
  Dental ...............................................................................................................................................................................................19
  Vision ............................................................................................................................................................................................... 22

  Disability Insurance
  Short-Term Disability and Supplemental Disability .................................................................................................................. 23

  Life and Accident Insurance
  University-Paid Life Insurance ..................................................................................................................................................... 29
  Supplemental Life Insurance .........................................................................................................................................................31
  Dependent Life Insurance............................................................................................................................................................. 33
  Accidental Death and Dismemberment (AD&D) ........................................................................................................................ 35
  Business Travel Accident Insurance............................................................................................................................................ 36

  Other Insurance
  Legal Plan ........................................................................................................................................................................................37

  Tax-Savings Programs
  Health Care Reimbursement Account (HCRA).............................................................................................................................41
  Dependent Care Reimbursement Account (DepCare) ............................................................................................................... 43
  Tax Savings on Insurance Premiums (TIP) ................................................................................................................................. 45
Introduction

  The University of California is one of   As one of the largest employers in      handy resource for future reference
  the top academic institutions in the     California with employees in a wide     when you have questions about your
  world and takes pride in the caliber     range of job and careers, UC strives    benefits or want to make changes.
  of its faculty and staff who carry out   to provide a high-quality, affordable
                                                                                   Please also visit the At Your Service
  its mission of education, research and   and flexible benefits program to its
                                                                                   website (atyourservice.ucop.edu) for
  public service.                          diverse and unique workforce.
                                                                                   UC benefits news and detailed ben-
  Accordingly, the University offers to    Please take some time to read this      efits information. For questions, you
  its employees a top-notch total com-     booklet, which provides informa-        may also contact the Benefits Office
  pensation package, which includes        tion about the UC-sponsored health      at your location. (See page 12.)
  not only salary and a generous           and welfare plans, to help you make
  retirement plan, but also comprehen-     important choices for you and your
  sive health and welfare benefits.        family. Then, keep this booklet as a




    Subject to plan amendments,
    the benefits information in
    this edition of Your Group
    Insurance Plans is effec-
    tive January 1, 2008 through
    December 31, 2008.




                                                                                               atyourservice.ucop.edu      1
2
General Information




                                                                                                                                      Eligibility
  Eligibility

  The benefits for which you are           Core Benefits                             if applicable to you. Your local Benefits
  eligible depend on your appoint-                                                   Office can also provide you with
                                           You are eligible for Core Benefits if
  ment type, percentage and duration                                                 information on your benefits plans.
                                           you are appointed to work at least
  and your membership in the Uni-          43.75 percent time.
  versity of California Retirement Plan
  (or another defined benefit plan to
                                                                                     No Duplicate Coverage
  which UC contributes).                   Eligible Family Members                   UC’s rules do not allow duplicate
                                                                                     coverage. That is, you may not be
  UC offers three benefit packages—        Eligible Adult                            covered in UC-sponsored plans as an
  Full, Mid-level, and Core. The initial   You may enroll an eligible adult in       employee and as an eligible family
  requirements are listed below. See       the health and welfare plans shown        member of a UC employee or retiree
  the chart on pages 4 and 5 for a list-   in the chart on page 6. Eligibility is    at the same time. If you are covered
  ing of the various benefits included     based upon your benefit package.          as an eligible family member and
  in each of these packages and infor-     The eligible adult must be enrolled in    then become eligible for UC coverage
  mation on when you may enroll.           the same plans as you.                    yourself, you have two options:
  You must be appointed to a posi-         In addition to yourself, you may          • You can either opt out of the auto-
  tion eligible for health and welfare     enroll only one eligible adult family       matic employee coverage, or
  benefits.                                member in your UC-sponsored plans:
                                                                                     • Make sure the UC employee or
                                           • A legal spouse, or                        retiree who has been covering you
  Initial Requirements                                                                 de-enrolls you from his or her UC-
                                           • A domestic partner.
                                                                                       sponsored plans before you enroll
  Full Benefits                            Note: an adult dependent relative           yourself.
  You are eligible for Full Benefits if    enrolled by 12/31/03 may continue
  you are a member of a UC-sponsored                                                 Family members of UC employees
                                           their coverage until ineligible.
  retirement plan1.                                                                  may not be covered by more than
                                                                                     one UC employee’s plan coverage.
  There are two ways to qualify for        Eligible Child
                                                                                     For example, if a husband and wife
  UCRP membership:                         You may enroll your eligible chil-
                                                                                     both work for UC, their children
                                           dren in the health and welfare plans
  1) You are appointed to work in an                                                 cannot be covered by both parents.
                                           shown in the chart on page 6. Your
     eligible position at least 50 per-
                                           eligible children must be enrolled in     If duplicate enrollment occurs, UC will
     cent time for a year or more²—or
                                           the same plans as you.                    cancel the later enrollment. UC and
  2) You have worked 1,000 hours in a                                                the plans reserve the right to collect
                                           Note that your disabled child may
     continuous 12-month period in an                                                repayment for any duplicate premium
                                           be covered past age 23, subject to
     eligible position³.                                                             payments and you may be liable for
                                           carrier approval.
                                                                                     services under the duplicate plan.
  Mid-level Benefits                       You may enroll your domestic
                                                                                     1 A UC-sponsored retirement plan means
  You are eligible for Mid-level           partner’s child or grandchild even if       UCRP or another defined benefit plan to
  Benefits if:                             you do not enroll your partner; how-        which UC contributes, such as CalPERS.
                                           ever, your partner must be eligible       2 Or your appointment form shows that your
  • You are not a member of a                                                          ending date is for funding purposes only
                                           for UC-sponsored coverage.
    UC-sponsored defined benefit                                                       and that your employment is intended to
    retirement plan, and                   For additional eligibility information,     continue for more than a year.
                                           refer to the UC Group Insurance           3 If you are a member of the Non-Senate
  • You are appointed to work at                                                       Instructional Unit, you qualify for UCRP
                                           Eligibility Factsheet for Employees
    least 50 percent time for a year or                                                membership if you are appointed to work in
                                           and Eligible Family Members, avail-         an eligible position for at least 50 percent
    more², or
                                           able on the At Your Service website         time for a year or more or after you work
                                           (atyourservice.ucop.edu). Refer to the      750 hours in a continuous 12-month period
  • You are appointed to work 100 per-
                                                                                       in an eligible position.
    cent time for at least three months.   Benefits for Domestic Partners booklet,
                                                                                                   atyourservice.ucop.edu         3
Benefits Overview


                    Benefits Overview

                    This overview lists all the benefit                          in the benefits package for which             The UC/employer contribution
                    plans included in the three benefits                         you are eligible (see “Initial Require-       toward the monthly cost of the cov-
                    packages that UC offers. You may                             ments” on page 3).                            erage is determined by UC and may
                    enroll in the plans that are included                                                                      change or stop altogether.



                        Health and Welfare Benefits Packages

                        See pages 7 and 8 for more enrollment information.
                        Benefits                                                                                                                     When You May
                        Packages                                                                                                                     Enroll




                                                                                                                                                                              90-day Wait1
                                                                                                                                                     During PIE
                                                                                                                                                                  During OE


                                                                                                                                                                                             Automatic
                               Mid-level




                                                                                                                                                                                                         With SOH
                                                                                                                                          Premiuns
                                                                                                                                          Paid By
                                           Core
                        Full




                                                  Health Care
                        • •                       Medical² Choice of various options depending on your address, including health         You and     • • •
                                                  maintenance organization (HMO), point-of-service (POS), preferred provider               UC
                                                  organization (PPO), exclusive provider organization (EPO) or a Health Reimbursement
                                                  Account. See page 15.

                        • • •                     Medical—Core Fee-for-service plan with a high deductible. See page 16.                   UC        • • •
                        •                         Dental² Choice of two plans: Delta Dental PPO, a fee-for-service plan, or                UC        • •
                                                  DeltaCare® USA a prepaid plan (network available in California only). Both cover
                                                  preventive, basic, and prosthetic dentistry, as well as orthodontics. See page 19.

                        •                         Vision² Plan covers a variety of vision care services including eye exams,               UC        • •
                                                  corrective lenses, and frames. See page 22.

                                                  Disability Insurance
                        •                         Short-Term Disability Provides basic coverage for inability to work due to preg-         UC                                                •
                                                  nancy/childbirth, disabling injury, or illness. Pays 55% of eligible earnings for up
                                                  to six months ($800 monthly maximum), after a waiting period. Injuries and illness
                                                  must not be work-related. See page 23.
                        •                         Supplemental Disability³ Provides extended coverage for work and nonwork-               You        •                                                   •
                                                  related disabilities due to pregnancy/childbirth, injury, or illness. Supplements
                                                  Short-Term Disability/other income to pay up to 70% of eligible earnings ($10,000
                                                  monthly maximum). Choice of waiting periods. See page 23.

                        • • •                     Workers’ Compensation Provides state-mandated coverage for work-related                  UC                                                •
                                                  injuries.


                        Key: PIE—Period of Initial Eligibility OE—Open Enrollment               SOH—Statement of Health                   (Chart continued on next page)
                        1
                            The 90-day waiting period is available when the PIE is missed. See page 8. You may need to pay part of your premiums on an after-tax
                            basis.
                        ² When you enroll in any UC-sponsored medical, dental, or vision plan, you will not be excluded from enrollment based on your health, nor
                          will your premium or level of benefits be based on any pre-existing health conditions. The same applies to your eligible family members.
                        ³ If you have a pre-existing condition which causes you to be disabled in your first year of coverage, benefits will be limited to a total of 12
                          months. For more information, see the insurance carrier’s summary plan description.




                    4
                                                                                                                                                                                             Benefits Overview
Health and Welfare Benefits Packages

See pages 7 and 8 for more enrollment information.
Benefits                                                                                                                      When You May
Packages                                                                                                                      Enroll




                                                                                                                                                       90-day Wait1
                                                                                                                              During PIE
                                                                                                                                           During OE


                                                                                                                                                                      Automatic
       Mid-level




                                                                                                                   Premiums




                                                                                                                                                                                  With SOH
                                                                                                                   Paid By
                   Core
Full




                          Life and Accident Insurance
•                         Basic Life Provides employees eligible for Full Benefits with life insurance equal         UC                                               •
                          to annual base salary, up to $50,000. Coverage is adjusted if appointment is less
                          than 100% time. See page 29.
         • •              Core Life Provides employees eligible for Core or Mid-level Benefits with $5,000           UC                                               •
                          of life insurance. See page 29.
• •                       Supplemental Life Provides employees with additional life insurance at group rates.       You       •                                                   •
                          Coverage up to four times annual salary (to $1,000,000 maximum). See page 31.

• •                       Basic Dependent Life Provides $5,000 of coverage for employee’s spouse or                 You       •                                                   •
                          domestic partner and each child. See page 33.
• •                       Expanded Dependent Life Covers spouse or domestic partner for 50% (up                     You       •                                                   •
                          to $200,000) of employee’s Supplemental Life amount. Covers each child for
                          $10,000. See page 33.
• • •                     Accidental Death & Dismemberment (AD&D) You may enroll at any time.                       You       •
                          Provides up to $500,000 protection for employee and family for accidental death,
                          loss of limb, sight, speech, or hearing, or for complete and irreversible paralysis.
                          See page 35.
• • •                     Business Travel Accident Provides $100,000 of coverage when an employee                    UC
                          travels on official UC business. See page 36 for enrollment instructions.

                          Other Insurance
• • •                     Legal Provides basic legal assistance for preventive, domestic, consumer, and             You       •
                          limited defensive legal services. See page 37.
• •                       Automobile and Homeowner/Renter You may enroll at any time. Individually                  You       •
                          underwritten plan provides coverage for cars, boats, motorcycles, homes, and
                          apartments. Carrier underwriting requirements must also be met. These plans
                          are offered through A+ Auto & Home Insurance. Your premiums are paid through
                          payroll deduction. You are encouraged to obtain quotes from other insurers to help
                          find the policy (and price) that best meets your needs. For information or to receive
                          an individual premium quotation, contact A+ Auto & Home Insurance directly at
                          1-866-680-5142.

                          Tax-Savings Programs
• • •                     Health Care Reimbursement Account (HCRA) Lowers taxable income by allow- Pretax                     • •
                          ing payment for up to $5,000 of eligible out-of-pocket health care expenses on a   salary
                          pretax basis. See page 41.                                                       reduction
• • •                     Dependent Care Reimbursement Account (DepCare) Lowers taxable income by Pretax                      • •
                          allowing payment for up to $5,000 ($2,500 if married and filing a separate income   salary
                          tax return) of eligible dependent care expenses on a pretax basis. See page 43.   reduction
• • •                     Tax Savings on Insurance Premiums (TIP) Lowers taxable income by allowing                 Pretax    • •                                     •
                          payment of health plan premiums (if any) on a pretax basis. See page 45.                  salary
                                                                                                                  reduction
       Key: PIE—Period of Initial Eligibility OE—Open Enrollment           SOH—Statement of Health

                                                                                                                     atyourservice.ucop.edu                                            5
Benefits Overview



                         Eligible Family Members
                                                                                                                                                May enroll in




                                                                                                                                                Dependent Life
                                                                                                                                                Medical
                                                                                                                                                Dental
                                                                                                                                                Vision

                                                                                                                                                AD&D
                                                                                                                                                Legal
                    Family Member                Eligibility   Must be

                    Legal spouse1, 2             Eligible                                                                                        • • • • • •
                    Domestic partner       1     Age 18 or     • if opposite sex, either the employee or the domestic partner must be age        • • • • • •
                    (same-sex/                   older           62 or older and eligible to receive Social Security benefits based on age;
                    opposite-sex)                              • a domestic partnership registered with the State of California or a
                                                                 substantially equivalent partnership established in another jurisdiction
                                                                 (same-sex domestic partnership only) is a domestic partnership for UC
                                                                 HR/Benefits purposes. A domestic partnership that has not been regis-
                                                                 tered with the State of California must meet the following criteria to be
                                                                 a domestic partnership for UC HR/Benefits purposes:
                                                                 – parties must be each other’s sole domestic partner in a long-term,
                                                                    committed relationship and must intend to remain so indefinitely
                                                                 – neither party may be legally married or be a partner in another
                                                                    domestic partnership
                                                                 – parties must not be related to each other by blood to a degree that
                                                                    would prohibit legal marriage in the State of California
                                                                 – both parties must be at least 18 years old and capable of consenting
                                                                    to the relationship
                                                                 – both parties must be financially interdependent
                                                                 – parties must share a common residence
                    Natural or adopted           To age 23     • unmarried                                                                       • • • • • •
                    child
                    Stepchild,                   To age 23     •   unmarried                                                                     • • • • • •
                    grandchild, or                             •   living with you
                    step-grandchild                            •   supported by you or your spouse (50%+)
                                                               •   claimed as a tax dependent by you or your spouse
                    Domestic partner’s           To age 23     •   unmarried                                                                     • • • • • •
                    child or grandchild                        •   living with you
                                                               •   supported by you or your domestic partner (50%+)
                                                               •   claimed as a tax dependent by you or your domestic partner
                    Legal ward                   To age 18     •   unmarried                                                                     • • • • • •
                    enrolled 1/1/95 or                         •   living with you
                    after                                      •   supported by you (50%+)
                                                               •   claimed as your tax dependent
                    Overage disabled             Age 23 or     • unmarried                                                                       • • • • • •
                    child (except a legal        older         • living with you if not your natural or adopted child
                    ward) of employee                          • enrolled in a group medical plan before age 23 with continuous
                                                                 coverage and the incapacity must have begun before age 23;
                                                               • supported by you (50%+) and claimed as your dependent for income
                                                                 tax purposes or eligible for Social Security income or Supplemental
                                                                 Security Income as a disabled person. The overage disabled child may
                                                                 be working in supported employment which may offset the Social
                                                                 Security or Supplemental Security Income;
                                                               • incapable of self-support due to a mental or physical disability incurred
                                                                 prior to age 23
                                                               • must be approved before age 23 or by the carrier during the PIE for
                                                                 newly eligible employees

                        1
                          The surviving family member of a deceased member cannot enroll a spouse or domestic partner (or their children/grandchildren).
                        ² A legally separated or divorced spouse is not eligible for UC-sponsored coverage.

                    6
                                                                                                                                    When to Enroll
When to Enroll

Enrollment in health and welfare            • You are already enrolled in another      (for example, the day you marry or
benefits is optional, and in order to         group or individual medical plan;        your child is born). Enrollment is
be covered you must enroll yourself           or                                       not automatic; you must complete
and your eligible family members in                                                    a form to enroll the new family
                                            • You are already enrolled in another
UC-sponsored plans when you first                                                      member. During this PIE, you may
                                              group dental and/or vision plan
become eligible; most plans have                                                       change medical plans and enroll in
                                              that provides equal coverage; or
an enrollment deadline. Be sure to                                                     or increase your Supplemental Life
complete your enrollment or ben-            • Your religious beliefs prohibit          insurance and Expanded Dependent
efit change transactions within the           you from using the UC-sponsored          Life insurance.
specified time—your 31-day period of          plan’s services.
                                                                                       See the Family Changes Benefits
initial eligibility, for example.
                                                                                       Checklist available on the At Your
                                            Period of Initial Eligibility              Service website (atyourservice.ucop.
Automatic Enrollment                        A period of initial eligibility (PIE)      edu) for more information about
Your enrollment (self-only coverage)        is a time during which you or your         enrolling and de-enrolling family
is automatic in some UC-sponsored           eligible family members may enroll.        members.
plans.                                      Proof of good health is not required.
                                            To be sure you get the coverage you        Involuntary Loss of Other
If eligible, you will be automatically
                                            want, sign up during your PIE. A PIE       Coverage
enrolled in:
                                            starts on the first day of eligibility,    If you decline enrollment in a UC-
• Basic Life (or Core Life, based on        generally your date of hire. For online    sponsored health plan due to
  your appointment),                        enrollments, it ends 31 days later.        coverage in another plan, and you or
                                            For paper form enrollments, it ends        your family member lose the other
• Short-Term Disability,
                                            31 days later or on the last working       coverage, or the other employer stops
• Workers’ Compensation, and                day of that 31-day period, whichever       contributing to the cost of the cover-
                                            comes first. UC defines a working day      age, you may be eligible to enroll
• Tax Savings on Insurance
                                            as a normal business day—Monday            yourself and your eligible family
  Premiums (TIP).
                                            through Friday, excluding holidays—        members in a UC-sponsored plan.
For other plans, enrollment is optional     for your Benefits or Accounting Office.
and you must enroll yourself and                                                       Moving Out of a Medical
your eligible family members. In most
cases, there is an enrollment deadline.
                                            Other Periods of                           Plan or DeltaCare USA® Plan
                                            Initial Eligibility                        Service Area
                                                                                       If you move out of an HMO, Blue
Default Plans                               If you do not enroll during your initial
                                                                                       Cross PLUS, or DeltaCare® USA plan
                                            PIE, you may be eligible to enroll
If you are eligible for the Full Benefits                                              service area, you and/or your eligible
                                            yourself and your eligible family
package but don’t enroll, UC will                                                      family members have a new PIE in
                                            members at other times when you
automatically enroll you for self-only                                                 which to transfer to a plan that pro-
                                            experience a PIE.
coverage in the Core medical plan,                                                     vides service in your new location.
the Delta Dental PPO plan, and the                                                     If you return to the HMO, Blue Cross
                                            Family Changes
vision plan.                                                                           PLUS, or DeltaCare® USA service
                                            When you have a newly eligible
                                                                                       area, you may transfer back.
If you are eligible for the Core Ben-       family member, you may enroll
efits package or the Mid-level Ben-         yourself and him or her in your UC-
                                                                                       New Faculty Member
efits package but don’t enroll, UC will     sponsored plans. If you are already
automatically enroll you for self-only                                                 If you are a newly-appointed
                                            enrolled in a UC-sponsored medical
coverage in the Core medical plan.                                                     faculty member and don’t enroll
                                            plan, you may also transfer into a
                                                                                       when first eligible, a second PIE
                                            different plan. Your PIE to enroll a
You do not have to accept the default                                                  starts on the first day of classes for
                                            newly eligible family member starts
coverage for yourself and/or your                                                      the semester or quarter in which
                                            the day he or she becomes eligible
eligible family members if:                                                            your appointment starts or the



                                                                                                    atyourservice.ucop.edu      7
When to Enroll



                 first day of arrival at the campus,     90-Day Waiting Period                    How to Enroll or Make
                 whichever occurs first.                 (Medical Coverage Only)                  Changes
                 See your Benefits Office for more       If you miss your PIE, you may enroll     UC provides a convenient, secure,
                 information about situations that may   yourself or eligible family members in   and easy way to enroll in UC-
                 result in a new PIE.                    medical coverage at any time by sub-     sponsored plans. When you enroll in
                                                         mitting an enrollment form to your       your benefit plans using the At Your
                 Attainment of Lifetime                  Benefits Office. However, you will       Service website (atyourservice.ucop.
                 Maximum                                 need to complete a waiting period of     edu), your benefit options will be
                 If you decline enrollment in a UC       90 consecutive calendar days from        displayed online. Your local Benefits
                 medical plan due to coverage in         the day you submit your form before      Office can also provide you with
                 another medical plan, and you           your medical coverage is effective.      other enrollment options available
                 or your family member reach the         Your premiums may need to be paid        to you.
                 lifetime maximum for all benefits       on an after-tax basis.
                 under that plan, you may be eligible                                             How to Enroll Online
                 to enroll yourself and your eligible    Statement of Health
                                                                                                  To sign up for your benefits, go
                 family members in a UC medical plan.    You may enroll in Supplemental and       to At Your Service (atyourservice.
                                                         Dependent Life insurance and Sup-        ucop.edu) and select “Sign in to My
                                                         plemental Disability by submitting a
                 Other Enrollment Options                statement of health to the insurance
                                                                                                  Accounts.”
                 If you miss your PIE, you may enroll    company for approval. A statement        New Employees
                 in selected UC-sponsored benefits as    of health is also required to increase   When you access At Your Service to
                 follows:                                life insurance coverage or to reduce     enroll in benefit plans, the benefit
                                                         your waiting period for Supplemental     plans available to you will be
                 Open Enrollment                         Disability.                              automatically displayed.
                 You may enroll in a UC-sponsored
                                                         The insurance company may or may
                 health plan during Open Enrollment                                               Currently Enrolled Employees
                                                         not accept your enrollment based
                 (usually held in November).                                                      For forms and procedures, see the
                                                         on the statement of health. You may
                 In addition, you may enroll in the                                               person in your department who
                                                         cancel your coverage at any time.
                 Health Care Reimbursement Account                                                handles benefits, or the At Your
                 (HCRA), Dependent Care Reimburse-                                                Service website.
                 ment Account (DepCare), and Tax                                                  Employees who have an appointment
                 Savings on Premiums (TIP) plans                                                  status change (for example, a change
                 during Open Enrollment. (Note: the                                               from Core Benefits to Full Benefits—
                 legal plan is not open for new                                                   see page 3) can make certain
                 enrollments every year.)                                                         changes on the At Your Service
                                                                                                  website (select “Sign in to My
                                                                                                  Accounts”).
                                                                                                  Remember that some changes must
                                                                                                  be made within the 31-day PIE that
                                                                                                  begins on the date of your family or
                                                                                                  appointment status change.




                 8
                                                                                                                              Wnen Coverage Begins
When Coverage Begins

Coverage under UC-sponsored plans          • If you are on leave for health           If You Need Services
generally starts on the day you              reasons on the day you become
become eligible, provided you enroll         eligible for coverage, coverage
                                                                                      Right Away
during your period of initial eligibil-      starts the day after your first full     Although you’re covered immediately
ity (PIE). You must also enroll eligible     day at work for these plans:             when you become eligible, it may
family members before the PIE ends.                                                   take 30 to 60 days after you enroll
                                             – Basic Life,                            for the insurance companies to have
If you complete your enrollment                                                       a record of your membership. Be sure
                                             – Supplemental Life,
transactions before you and/or your                                                   to keep a copy of your enrollment
family members are eligible, cover-          – Basic or Expanded Dependent            confirmation and/or enrollment form
age starts on the day you and/or they          Life,                                  for your records. Contact your local
become eligible.                                                                      Benefits Office or the person in your
                                             – Accidental Death and Dismem-
Some UC-sponsored plans also have              berment,                               department who handles benefits if
other stipulations:                                                                   you need to use the services of one
                                             – Short-Term and Supplemental
                                                                                      of your health and welfare plans and
• For the Health Care Reimburse-               Disability, and
                                                                                      your insurance carrier does not have
  ment Account and Dependent                                                          record of your enrollment.
                                             – Legal.
  Care Reimbursement Account,
  the effective date is the first day of   • If you enroll yourself and/or your
  the month following enrollment,            eligible family members in a UC-
  subject to payroll deadlines.              sponsored medical plan outside
                                             of a PIE and complete a 90-day
• For UC-sponsored plans other
                                             waiting period, coverage begins
  than health plans, if you are on
                                             on the 91st consecutive day after
  a leave without pay (for reasons
                                             the enrollment form is received by
  unrelated to health) when you
                                             your local Payroll or Benefits Office.
  become eligible, coverage starts on
  your first day on pay status.            • For Basic/Expanded Dependent
                                             Life, AD&D and/or Legal cover-
                                             age, if you or a family member is
                                             hospitalized on the day coverage
                                             would normally begin, coverage
                                             starts the day after release from the
                                             hospital. (This does not apply to a
                                             newborn or adopted child.)
                                           See the appropriate plan booklet for
                                           more details about when coverage
                                           begins. Plan booklets are available
                                           through the At Your Service website
                                           (atyourservice.ucop.edu).




                                                                                                 atyourservice.ucop.edu   9
After You Have Enrolled


                          After You Have Enrolled

                          Confirm Your Choices                        last day of the month in which a        Verification of Family
                                                                      divorce, legal separation, termina-
                          After you enroll, check the At Your
                                                                      tion of domestic partnership, or
                                                                                                              Member Eligibility
                          Service Online website (select “Sign                                                The University incurs significant costs
                                                                      annulment is final. Your legally
                          in to My Accounts”) to verify your                                                  to provide group insurance coverage
                                                                      separated spouse, former spouse, or
                          coverage for you and your family                                                    for employees and their family
                                                                      former domestic partner is not eli-
                          members. It is your responsibility                                                  members. To ensure that only those
                                                                      gible to participate in UC-sponsored
                          to promptly notify your Benefits or                                                 who are truly eligible for coverage
                                                                      health and welfare plans and may
                          Payroll Office of any errors in your                                                are enrolled and to meet health plan
                                                                      continue under COBRA for some
                          enrollment. The month after you                                                     contract obligations, UC must verify
                                                                      plans, see page 11. If a divorce,
                          enroll, review your payroll checkstub                                               family member eligibility.
                                                                      legal separation settlement or ter-
                          or direct deposit statement to be sure
                                                                      mination of a domestic partnership      The University performs periodic
                          it reflects your benefit choices.
                                                                      requires you to provide such cover-     audits of enrolled family members
                                                                      age, you must do so on your own.        and failure to comply with an audit
                          Keep Your Records                                                                   may result in the de-enrollment
                                                                    • For your child(ren) or grand-
                          Updated                                     child(ren), eligibility stops at the    of the employee and all family
                          Make sure that UC always has your           end of the month in which the           members.
                          current address, email address, and         child reaches age 23 (unless            UC and the insurance carriers reserve
                          phone number to correctly administer        eligible to continue coverage           the right to request documentation
                          your benefits and send you benefits         because of disability) or age 18 for    (marriage or birth certificates,
                          information.                                legal wards, or when the child          verification of domestic partnerships,
                          At Your Service Online (select “Sign in     marries or no longer meets all eligi-   adoption records, tax records, etc.) to
                          to My Accounts”) allows UC employ-          bility requirements to participate in   verify eligibility for your enrolled
                          ees to update personal information,         UC-sponsored benefit plans.             family members. Please do not
                          such as home address, home                • For your domestic partner’s child       submit any documentation unless UC
                          telephone number, and income tax            or grandchild, eligibility stops at     HR/Benefits or your carrier asks you
                          withholding.                                the end of the month in which the       to do so.
                                                                      domestic partnership ends or your       Failing to provide documentation
                          When a Family Member                        family member no longer meets all       when requested will lead to de-
                                                                      eligibility requirements to partici-
                          Loses Eligibility                           pate in UC-sponsored plans.
                                                                                                              enrollment of you and your family
                                                                                                              members and possible legal action. In
                          If an enrolled family member loses
                                                                    You are also required to de-enroll a      addition, employees may be responsi-
                          eligibility during the year, you are
                                                                    deceased family member. You should        ble for any employer contributions to
                          responsible for de-enrolling that
                                                                    contact your Benefits Office for          and benefits paid by the plan for the
                          family member. Don’t wait until Open
                                                                    assistance. Also, remember to change      ineligible coverage. If it is determined
                          Enrollment. You are responsible for
                                                                    the level of coverage (if needed) for     that the plan has been misused, you
                          costs incurred in connection with
                                                                    Expanded Dependent Life and/or            and any eligible family members will
                          the enrollment of ineligible family
                                                                    Accidental Death and Dismember-           be de-enrolled for 12 months.
                          members and you could be subject to
                          penalties associated with the misuse      ment when an ineligible dependent
                          of the plan if you continue coverage      is no longer eligible for your health     Imputed Income
                          for family members who no longer          insurance plans.                          Under IRS rules, your taxable income
                          meet UC’s rules.                          De-enrolling a family member who          may be affected if you have health
                                                                    is no longer eligible to participate in   plan coverage for any person who
                          Family members lose eligibility for
                                                                    UC-sponsored benefit plans does           is not declared as your federal tax
                          the following reasons:
                                                                    not in itself create a new period         dependent except for your legal
                          • For your spouse/domestic                of initial eligibility (PIE) for you to   spouse. Details are online
                            partner, eligibility stops on the       switch plans.                             (atyourservice.ucop.edu).



                          10
                                                                                                                                   When Coverage Ends
When Coverage Ends

Coverage through UC-sponsored            will send you a “Qualifying Event        Benefit Plan You May
plans can end if you separate from       Notice” which explains the procedure     Continue with the Carrier
UC employment or if certain employ-      for continuing your participation.       You may continue coverage with the
ment actions occur. For example, if                                               Automobile Homeowner/Renter plan
                                         For more information about COBRA
your annual average regular paid                                                  on an individual basis after your
                                         continuation privileges, see the At
time is reduced below 17.5 hours a                                                UC-sponsored coverage ends by
                                         Your Service website or contact your
week, you leave UC employment, or                                                 arranging to pay premiums directly to
                                         Benefits Office.
you retire without UC-sponsored                                                   the insurance carrier.
health plan coverage, your coverage
ends. In addition, coverage for your     Converting to an
family members ends when they lose       Individual Policy                        HIPAA Certificate of
eligibility to participate in UC-spon-   Within 31 days after UC-sponsored        Creditable Coverage
sored plans. See “When a Family          coverage ends, you may be able to        When you and/or your eligible family
Member Loses Eligibility” on page 10.    convert your group insurance cover-      members end or change UC-spon-
                                         age to individual policies for these     sored medical coverage, you will
Ineligibility—Less Than                  plans: Medical, Basic Life, Core Life,   receive a Certificate of Creditable Cov-
                                                                                  erage from your former medical plan.
17.5 Hours Per Week                      Supplemental Life,4 Basic Depen-
                                         dent Life, Expanded Dependent Life,      This certificate provides evidence of
If your annual average regular paid
                                         AD&D, and Legal.                         your previous medical plan coverage.
time drops below 17.5 hours a week,
you become ineligible for medical        For medical coverage, you have 31        Your new insurance carrier may need
(including Core), dental, vision and     days after COBRA continuation cover-     this certificate if the plan/policy
Basic Life insurance as well as Short-   age ends to apply for conversion.        would otherwise exclude coverage or
Term and Supplemental Disability                                                  impose a waiting period for certain
                                         You and/or your family members may
coverage. You may still be eligible                                               pre-existing medical conditions.
                                         be eligible to convert UC-sponsored
for Supplemental Life, AD&D, HCRA,                                                Contact your medical plan directly if
                                         life insurance coverage to individual
DepCare, Legal, and Auto and                                                      you do not receive a certificate.
                                         policies. If not converted, cover-
Homeowner/Renter coverage.                                                        Enrolled family members who live at
                                         age ends on the last day of the last
                                                                                  a different address from you should
                                         period for which premiums are paid.
                                                                                  contact the plan to send a certificate
COBRA Continuation                       Note that conversion options are         to their addresses.
If you or any family member(s) lose      generally more costly and may
eligibility for UC-sponsored medical     provide fewer benefits than UC-
(including wellness), dental, vision,    sponsored plans. See the appropriate
and/or HCRA coverage, you may            plan booklet or call the insurance
be able to continue group coverage       carrier directly for more information.
through the Consolidated Omnibus
Budget Reconciliation Act of 1985        Benefit Plans You May
(COBRA), as amended.                     Not Continue
If you are enrolled in the Health Care   For these plans, your UC-sponsored
Reimbursement Account (HCRA) and         coverage stops on your last day
you leave UC employment during the       actively at work: DepCare, TIP, Short-
plan year, you may be able to            Term and Supplemental Disability,
continue your participation under        Business Travel Accident Insurance,
COBRA through the end of the             and Workers’ Compensation.
                                                                                  4 Those enrolled in Supplemental Life benefits
current plan year (December 31) by
                                         You may not continue or convert any        may also have the option of participating
making direct, after-tax payments to                                                in the Prudential Group Term Life Portabil-
                                         of these plans.
your account. The plan administrator                                                ity benefit. See “Conversion and Portability
                                                                                    Privileges” on page 31.




                                                                                               atyourservice.ucop.edu        11
Benefits Assistance


                      Benefits Assistance

                      At Your Service                          Local Benefits Offices
                      (atyourservice.ucop.edu)                 The person in your department who
                      At Your Service is UC’s systemwide       handles benefits as well as the staff
                      Human Resources and Benefits             in your Benefits Office are available
                      website. You’ll find complete infor-     to help you with benefits questions.
                      mation on all UC-sponsored benefits      They can tell you if any special
                      including:                               presentations are scheduled for your
                      • links to carriers’ websites and        location, provide forms you may
                        phone numbers;                         need, or give you additional informa-
                                                               tion about all of UC’s plans.
                      • tools to help you choose benefits,
                        calculate premiums, and estimate
                                                               Location                                Phone Number
                        retirement benefits;
                                                               Berkeley                                510-642-7053
                      • links to forms, publications, plan
                                                               Davis                                   530-752-1774
                        descriptions and evidence of
                                                               UCD Medical Center                      916-734-8099
                        coverage booklets;
                                                               Irvine                                  949-824-5210
                      • a link to online actions and person-   UCI Medical Center                      714-456-5736
                        alized information through At Your     UCLA                                    310-794-0830
                        Service Online (select “Sign in to     UCLA Medical Center                     310-794-0500
                        My Accounts”);                         Merced                                  209-228-8247
                      • current news about your benefits,      Riverside                               951-827-4766
                        including an online benefits           San Diego                               858-534-2816
                        newsletter (HR/B Briefing).            UCSD Medical Center                     619-543-8244
                                                               San Francisco                           415-476-1400
                      The Always At Your Service brochure      UCSF Medical Center                     415-353-4545
                      provides a summary of features           Santa Barbara                           805-893-2489
                      and online actions available on the      Santa Cruz                              831-459-2013
                      website. You can download it from
                      the “Forms and Publications” sec-        Associated Students UCLA (ASUCLA)       310-825-7055
                      tion of the At Your Service website or   Hastings College of the Law             415-565-4703
                      request one from your local Benefits     Lawrence Berkeley National Laboratory   510-486-6403
                      Office.                                  Office of the President                 510-987-0123




                      12
                                                                                                                                       Participation Terms and Conditions
Participation Terms
and Conditions

                                              or birth certificates, adoption papers,   7. Actions you take during Open
  Your Social Security number will            tax records, and the like may be             Enrollment will be effective the
  be requested only when needed               requested. You agree to provide              following January 1, unless
  by benefit plan administration              such documentation upon request.             otherwise stated.
  for financial reporting or to verify
  your identity, in compliance with         4. If you enroll your eligible domestic     8. You certify that all enrolled family
  state and federal law.                       partner and/or your partner’s eligi-        members are eligible for cover-
                                               ble child(ren) or grandchild(ren), or       age based on the definitions and
As a participant in UC-sponsored               if you enroll or have enrolled your         rules specified in the UC Group
plans, you agree to the following              natural or adopted child who is not         Insurance Eligibility Factsheet for
terms and conditions:                          claimed as your tax dependent, you          Employees and Eligible Family
                                               acknowledge that the UC/employer            Members and Group Insurance
1. Most of the medical plans that UC           contribution for their medical and/         Eligiblity Factsheet for Retirees and
   offers (including the medical por-          or dental and/or vision coverage            Eligible Family Members. You agree
   tion of Blue Cross PLUS and Blue            may be reported as income to you,           that you will de-enroll them within
   Cross PPO (offered by Blue Cross            subject to FICA (Social Security and        31 days if they lose eligibility. You
   of California®5, Health Net and             Medicare) and federal and Califor-          further certify that all the informa-
   Western Health Advantage, Core–             nia state income tax withholding.           tion you provide is true to the best
   CA (offered by BC Life and Health                                                       of your knowledge, under penalty
   Insurance Company)5, High Option         5. If you specifically ask UC represen-
                                                                                           of perjury.
   Supplement to Medicare (offered by          tatives to intercede on your behalf
   BC Life and Health Insurance Com-           with your insurance plan, Univer-        9. Making false statements about
   pany)5, Kaiser Permanente, and              sity representatives will request           satisfying eligibility criteria, failing
   CIGNA Choice Fund require resolu-           minimum necessary health infor-             to notify the University of loss of
   tion of medical malpractice and             mation required to assist you with          eligibility within 31 days, or failing
   other disputes through binding              your problem. If protected health           to provide documentation when
   arbitration. For more information           information is needed to solve your         requested will lead to de-enroll-
   about each plan’s arbitration provi-        problem, in compliance with state           ment of the family members and
   sion, please see the appropriate            privacy laws and federal laws,              possible legal action. In addition,
   plan booklet or call the plan. When         including HIPAA (Health Insurance           employees/retirees may be sub-
   you enroll in these plans, you              Portability and Accountability Act          ject to disciplinary action (e.g.,
   agree that any dispute between              of 1996), you may be required to            loss of health benefits for up to 12
   you (and/or your enrolled family            sign an authorization allowing UC           months) and will be responsible for
   members) and the medical plan               to provide the insurance plan with          any employer contributions to and
   must be submitted to binding                relevant personal health informa-           benefits paid by the plan for the
   arbitration. You agree to waive             tion or authorizing the insurance           ineligible coverage.
   your right to a jury or court trial         plan to release such information to
                                                                                        If a conflict exists between this book
   to resolve these disputes.                  the University representative.
                                                                                        and UC’s Group Insurance Regula-
2. You acknowledge and accept all           6. By making an election with your          tions, the regulations govern.
   terms and conditions of the UC-             written or your electronic signature
   sponsored plans in which you                you are authorizing the Univer-
   are enrolled as stated in the plan          sity to take deductions from your
   booklets and UC’s Group Insurance           earnings (employees)/monthly
   Regulations.                                Retirement Plan income (retirees)
                                                                                        5 Blue Cross of California® and BC Life &
                                               to cover your monthly costs, if any,       Health Insurance Company are indepen-
3. If you enroll family members, the           for the plans you have chosen for          dent licensees of Blue Cross Association
   University and/or carrier may               yourself and your eligible family          (BCA). The Blue Cross name and symbol are
   require proof of eligibility. Marriage      members.                                   registered service marks of the Blue Cross
                                                                                          Association.



                                                                                                     atyourservice.ucop.edu       13
14
Health Care Plans




                                                                                                                                              Medical
  Medical
                                             Your Medical Plan Choices

                                             For 2008, UC offers the following medical plans. You may select any
  Medical coverage is one of the most
                                             medical plan for which you are eligible.
  important benefits that UC offers you
  and your eligible family members. UC       Plan                       Notes
  offers a wide range of medical plans       Blue Cross PLUS*           Must live or work in plan’s service area within California
  so you can choose the coverage that
  best meets your needs.                     Blue Cross PPO*            No service area requirement

  This is only an overview of your           CIGNA Choice Fund          Not available if you live in Hawaii or outside the U.S.
  medical benefits. You should to            Core*                      No service area requirement
  evaluate carefully your family
                                             Health Net HMO             Must live or work in plan’s service area within California
  circumstances and plan costs before
  selecting medical plan coverage. If        Health Net Primary EPO Available if you live in Imperial or San Luis Obispo counties
  you need more information about
                                             Kaiser CA North            Must live or work in plan’s service area in No. California
  a particular UC-sponsored medical
  plan, such as coverage for specific        Kaiser CA South            Must live or work in plan’s service area in So. California
  condition, service areas, or provider      Kaiser Mid-Atlantic        Must live or work in plan’s service area in MD, VA, or DC
  information, please refer to the At
  Your Service website (atyourservice.       Western Health             Must live or work in plan’s service area: Sacramento, Yolo,
  ucop.edu) for a link to the plan.          Advantage                  Solano, Placer, El Dorado, and Colusa counties
  At Your Service also contains the          Please note that plan service areas are established by home (or work,
  Medical Plan Chooser (select “Health       depending on the plan) ZIP codes. If you want to know whether your ZIP
  & Welfare Benefits” and “Medical           code is in a plan’s service area, check the plan provider directory or call
  Plans”) which lets you compare UC-         the plan directly (see page 18 for toll-free numbers). You may also use the
  sponsored medical plan costs, quality,     At Your Service website (under “Health & Welfare Benefits,” select
  services and participating doctors.        “Medical Plans,” then select “Medical Benefits Summary” at top right).
                                             You cannot use a P.O. Box to establish your eligibility for a medical plan.
  Behavioral Health                          * Blue Cross of California® and BC Life & Health Insurance Company are independent
  Benefits (Mental Health                      licensees of Blue Cross Association (BCA). The Blue Cross name and symbol are registered
                                               service marks of the Blue Cross Association.
  and Substance Abuse)
  Behavioral health benefits for
  employees are provided by United         UC Wellness Program6                            program. The new program includes
  Behavioral Health (UBH) for Health                                                       a health assessment taken online or
                                           The University is committed to invest-
  Net, CIGNA Choice Fund, Western                                                          via paper and a $75 gift certificate for
                                           ing in the well being of employees,
  Health Advantage, Blue Cross PLUS                                                        completing the assessment. The gift
                                           retirees, and their family members. In
  and Blue Cross PPO health plans. An
                                           2008, the University is launching UC
  out-of-network benefit provided by                                                       6 The leadership of the following unions at
                                           Living Well, a new, voluntary, health             UC have notified the University that they are
  UBH will be available only to those
                                           management program for employees,                 choosing not to participate in the StayWell
  enrolled in the Blue Cross PPO health                                                      Health Management benefits program on
                                           retirees, and their family members
  plan. Kaiser members will continue                                                         behalf of their UC bargaining unit members:
                                           age 18 and older enrolled in all                  AFSCME 3299 on behalf of SX (Service
  to have access to Kaiser’s integrated
                                           medical plans except Kaiser. Kaiser               Unit), EX (Patient Care Technical), and K7
  behavioral health services and also
                                           currently provides fully integrated               (Skilled Crafts at UC Santa Cruz); CNA on
  have the option to access the UBH                                                          behalf of NX (Nurse Unit); CUE on behalf of
                                           wellness resources to its members.
  services (except the out-of-network                                                        CX (Clerical Unit); UAW 2863 on behalf of
                                           StayWell Health Management, a lead-               BX (Academic Student Employees Unit); and
  provision).
                                                                                             UPTE-CWA on behalf of RX (Research
                                           ing provider of health promotion pro-             Support Professionals Unit), TX (Technical
  The first three in-network outpatient
                                           grams and services, administers the               Unit) and HX (Health Care Professionals Unit).
  mental health visits will be covered
  with no copayment.
                                                                                                        atyourservice.ucop.edu         15
Medical



               Types of Medical Plans
               Plan                                                          Highlights

               Health Maintenance Organization (HMO) Plans                   • Available to employees who live (or work, depending on the
               Health Net, Kaiser, Western Health Advantage                    plan’s rules) in the plan’s service area.

               HMOs will give you a list of doctors from which to            • Most services are prepaid; no annual deductible.
               choose a primary care doctor (PCP). A PCP coordinates         • You share cost by paying a copayment for some products and
               your care, which means that generally you must contact          services.
               him or her to be referred to a specialist within your         • Generally, there is no lifetime maximum benefit.
               designated medical group. If you belong to an HMO,
               the plan only covers the cost of charges for services         • Behavioral health services must be preauthorized by United
               authorized by your PCP. HMOs only provide coverage              Behavioral Health.
               for services outside of your medical group in cases of        • Kaiser members may use either Kaiser or United Behavioral
               emergency.                                                      Health.

               Preferred Provider Organization (PPO)                         • Available to employees worldwide.
               Blue Cross PPO                                                • Separate annual deductibles apply at the in-network and
               A PPO generally offers a broader network than an                out-of-network level.
               HMO. This plan model has arrangements with doctors,           • After paying an annual deductible, you share a percentage of
               hospitals, and other providers of care who have agreed          the cost of services. Physicians may join or leave the PPO net-
               to accept lower fees from the Plan for their services and       work at any time and you may not transfer to another medical
               participate in the network of physicians. If you need or        plan mid-year.
               want health care from outside the network you have            • There is a lifetime maximum benefit limit per member for this plan.
               access, but you should expect to pay a higher copayment
               than if the provider were from within the PPO network.        • Behavioral health services must be preauthorized by United
                                                                               Behavioral Health.

               Point-of-Service (POS) Plan                                   • Available to employees who live or work in the plan’s service
               Blue Cross PLUS                                                 area.

               This plan combines characteristics of the HMO and the         • No annual deductible when you obtain services at the
               PPO. The in-network level of this plan functions like an        in-network-level.
               HMO and you must choose a primary care physician who          • When you access out-of-network services, you share a
               is responsible for all referrals within the POS network. If     percentage of the cost of services, but you pay less if you use
               you choose to go outside the network for healthcare, the        PPO providers.
               plan functions more like a PPO.                               • Generally, there is no lifetime maximum limit at the in-network-
                                                                               level.
                                                                             • Behavioral health services must be preauthorized by United
                                                                               Behavioral Health.

               Fee-for-Service Plan                                          • Available to employees worldwide.
               Core Plan                                                     • High annual deductible applies and has to be met before the
               This plan allows you choose the doctor, the hospital,           plan pays for services.
               the clinic, or the behavioral health provider and the         • Once the plan starts paying benefits, you and the insurance
               insurance pays for part or all of the cost according to a       company share the cost of the services. Generally, the insurance
               schedule laid out in the policy after you have met your         company pays the larger part of the cost.
               plan’s deductible. Under this plan, you pay for a services    • There is a lifetime maximum benefit limit per member for this plan.
               up front and submit a claim to the insurance company,
               and, if the service is covered in the policy, you receive
               reimbursement.




          16
                                                                                                                                      Medical
  Plan                                                      Highlights

  HRA/PPO Plan                                              • Available to employees nationwide except residents of Hawaii.
  CIGNA Choice Fund                                         • Annual deductible applies and must be met before the plan
  CIGNA Choice Fund is a PPO plan with a Health               pays. Amounts paid out-of-pocket to meet the deductible do not
  Reimbursement Account (HRA). The HRA—funded by              count towards the plan’s out-of-pocket maximum.
  UC—pays first to help satisfy a member’s annual deduct-   • Services can be obtained from any provider; however the cost
  ible. Once the HRA is exhausted and the deductible is       is less for services obtained from a provider in the CIGNA (Open
  met, this plan works like a PPO—the cost of services is     Access Plus) Network.
  shared between the plan and the member. All in-net-       • Unused HRA funds at the end of the plan year can be rolled over
  work preventive care, as defined by the plan is covered     and accumulate in the member’s account for the following plan
  at 100 percent.                                             year.
                                                            • The HRA account is subject to monthly proration for new hired
                                                              employees. The deductible remains the same.
                                                            • Behavioral Health Services for CIGNA members are provided under
                                                              a separate benefit administered by United Behavioral Health.


certificates can be redeemed through       “Health & Welfare Benefits” and             If you change or cancel your medi-
Hallmark Insights at more than 350         “Medical Plans” for information about       cal coverage during your PIE, during
merchants, including most of the           doctors, or call the plan to confirm        Open Enrollment, or when your
UC Recreational Sports Facilities (for     that the doctor is in their network.        family or employment status changes,
eligible services).                                                                    the amount of your salary reduction
Additional program features include        Cost of Medical                             under TIP automatically increases or
                                                                                       decreases to reflect the change.
access to extensive online health          Coverage
resources and interactive tools, and       Your medical plan monthly cost
health improvement programs with a         depends on:
                                                                                       General Information
health coach by telephone.
                                           • The plan you choose,                      Confirmation
More details are on the At Your                                                        Approximately 10 days after you
Service website.                           • The level of coverage, and
                                                                                       have enrolled, you may view/verify
                                           • Your annual full-time equivalent          your enrollments on At Your Service
Choosing a PCP                               salary. The monthly amount will be        Online by selecting “Sign in to My
Some medical plans require you to            automatically deducted from your          Accounts.” You may also check
select a primary care physician (PCP).       paycheck.                                 your paystubs to confirm that your
You may choose a different PCP for                                                     enrollment is correct.
                                           Under the Tax Savings on Insurance
each family member or the same PCP         Premiums (TIP) program, UC auto-
for the entire family. If you are using    matically deducts from your pay, on
                                                                                       ID Cards
your work address to qualify for the       a pretax basis, any monthly cost for        Medical plan identification cards are
plan, you must pick PCPs with the          your health premiums. You do not            sent to members. Although you’re
service area of your work address.         pay federal, state, or FICA taxes on        covered immediately when you
                                           this amount. The pretax deductions          become eligible, it may take 30 to 60
If you or your eligible family members
                                           from your pay are not counted as            days after you enroll for the insur-
do not select a PCP, your medical
                                           wages for unemployment insurance            ance companies to have a record of
plan will assign one to you.
                                           or Social Security benefits.                your membership. Be sure to keep
You may change your PCP during the                                                     a copy of your enrollment confirma-
year by calling the plan directly. See     TIP enrollment is automatic. If you         tion and/or enrollment form for your
page 18 for telephone numbers.             wish, you may cancel TIP enrollment         records. Contact your local Benefits
                                           either during your period of initial        Office or the person in your depart-
If you are interested in receiving care    eligibility (PIE: see page 7) or during     ment who handles benefits if you
from a particular doctor, you should       Open Enrollment. Ask the appropriate        need to use the services of one of
find out if that doctor is in the plan’s   person in your department or your           your health and welfare plans and
network. On At Your Service, select        Benefits Office for a form.



                                                                                                   atyourservice.ucop.edu        17
Medical



          your insurance carrier does not have      In addition, if you have a newly         • you acquire a newly eligible family
          a record of your enrollment.              eligible family member as a result of      member; or
                                                    marriage, domestic partnership, birth,
                                                                                             • your eligible family member loses
          Medical Plan Enrollment                   adoption, or placement for adoption,
                                                                                               other coverage.
          Options                                   you may be eligible to enroll yourself
                                                    and your eligible family members.        In either case, you must request
          HIPAA Notification of Medical
                                                    You must request enrollment within       enrollment within 31 days of the
          Program Eligibility (Health Insur-
                                                    31 days after the marriage/partner-      occurrence.
          ance Portability and Accountability
                                                    ship, birth, adoption, or placement
          Act of 1996)
          If you are declining enrollment for
                                                    for adoption.                            For More Information
          yourself or your eligible family          If you do not enroll yourself and/       and Assistance
          members because of other medical          or your family member(s) within the      Medical plan Evidence of Coverage
          insurance or group medical plan           31 days when first eligible, you may     booklets are available on the At Your
          coverage, you may be able to enroll       enroll at a later date; however, each    Service website under “Forms and
          yourself and your eligible family         member will need to complete a           Publications.”
          members7 in a UC-sponsored medical        waiting period of 90 consecutive cal-
                                                    endar days before medical coverage       If you have other questions, call the
          plan if you or your eligible7 family
                                                    becomes effective. You/they can also     medical plan directly using the
          members lose eligibility for that other
                                                    enroll during the next Open Enroll-      toll-free numbers shown below or
          coverage (or if the employer stops
                                                    ment period.                             contact your Benefits Office (see
          contributing toward the other cover-
                                                                                             page 12).
          age for you or your family members).      To request special enrollment or
                                                    obtain more information, contact your    Once you are enrolled in a UC-
          You must request enrollment within
                                                    local Benefits Office.                   sponsored plan, if you have ques-
          31 days after your or your family
                                                                                             tions about your benefits (including
          members’ other medical coverage           Note: If you are enrolled in a UC
          ends (or after the employer stops con-                                             services, benefits, bills and claims),
                                                    medical plan, you may be able to         you should contact your medical plan
          tributing toward the other coverage).     change medical plans if:                 directly using the phone number on
                                                                                             your medical plan ID card.


          Medical Plan                              Toll-free Number       Website
          Blue Cross PLUS                           1-888-209-7975         bluecrossca.com/uc
          Blue Cross PPO                            1-888-209-7975         bluecrossca.com/uc
          CIGNA Choice Fund (for
            prospective members)                    1-800-401-4041         mycignaplans.com (User ID: UofCA; Password: Choice)
          CIGNA Choice Fund                         1-800-244-6224         mycigna.com
          Core                                      1-888-209-7975         bluecrossca.com/uc
          Health Net                                1-800-539-4072         healthnet.com/uc
          Kaiser Permanente—California              1-800-464-4000         my.kp.org/ca/universityofcalifornia
          Kaiser Permanente Mid-Atlantic
            in Washington D.C. metro area           1-301-468-6000         members.kaiserpermanente.org/kpweb
            outside Washington D.C. metro area      1-800-777-7902         members.kaiserpermanente.org/kpweb
          Western Health Advantage                  1-888-563-2250         westernhealth.com/members
          United Behavioral Health                  1-888-440-8225         liveandworkwell.com
          Special Numbers for Hearing Impaired
          CIGNA Choice Fund                         1-800-321-9545
          Health Net                                1-800-995-0852                           7 To be eligible for plan membership, you and
          Kaiser Permanente—California              1-800-777-1370                             your family members must meet all UC
          Kaiser Permanente—Mid-Atlantic            1-301-816-6344                             eligibility requirements for coverage. All
                                                                                               plan members are subject, as a condition of
          United Behavioral Health                  1-800-842-9489
                                                                                               coverage, to eligibility verification audit by
          Western Health Advantage                  1-888-877-5378                             the University and/or insurance carriers.



          18
                                                                                                                             Dental
Dental

Proper dental care plays an impor-       The plan pays enhanced benefits           When you enroll, you can select a
tant role in your health. That’s why     when you visit a PPO network den-         network dentist to provide all of your
UC provides dental coverage for you      tist, so you pay only 20 percent of       basic dental services or the plan
and your family members, includ-         the PPO dentist’s contracted fee after    will assign you a dentist near your
ing a wide range of services from        your deductible for such services as      home. The DeltaCare® USA network
routine preventive care and fillings     fillings, oral surgery, root canals and   consists of private practice dental
to oral surgery, dentures, bridges,      treatment of gum disease.                 facilities that have been screened by
and braces. The dental plans do not                                                Delta Dental for quality. Throughout
                                         If you choose to visit a non-PPO
have any exclusions for pre-existing                                               the year, you can change your den-
                                         Dental Dental Premier dentist, you’ll
conditions.                                                                        tist at any time by simply calling the
                                         still enjoy user-friendly claims
                                                                                   DeltaCare Customer Service number
                                         administration, cost protections and
Benefits and Services                    other Delta Dental advantages, plus
                                                                                   and requesting the change.
For an outline of benefits and           have access to more than 23,000
services, see the UC Dental Plan Sum-    dentists in the state.                    Cost of Coverage
mary available on the At Your Service                                              All plan members pay a certain
                                         The annual plan maximum is $1,500
website (atyourservice.ucop.edu).                                                  percentage or copayment for some
                                         for the Premier network and $1,700
Please remember that if you need         when visiting a PPO dentist. If you go    services. See the Dental Plan
major dental work (a crown, den-         to a dentist not affiliated with Delta    Summary.
tures, a bridge, or oral surgery), you   Dental, Delta cannot assure you what      UC pays 100 percent of your monthly
should read the complete explanation     percentage of the charged fees may        dental plan premium. UC’s contri-
of benefits, limitations, and exclu-     be covered.                               bution toward the monthly cost of
sions in your Delta Dental PPO or                                                  coverage is determined by UC and
                                         There are over 16,000 PPO dentists
DeltaCare® USA Evidence of Cover-                                                  may change or stop altogether.
                                         in California and 105,000 nation-
age (EOC) booklet. You and/or your
                                         wide. To see a list of Delta and Delta-
dentist should contact your plan
before you begin treatment to confirm
                                         Care® USA dentists, go to the At Your     For More Information
                                         Service website for a link to the Delta   For questions or more information,
a dental procedure will be covered.
                                         and DeltaCare websites.                   call Delta Dental PPO or DeltaCare®
                                                                                   USA. Call your Benefits Office or
Delta Dental PPO                         DeltaCare® USA                            the person in your department who
(available worldwide)                    DeltaCare® USA (your dental HMO           handles benefits, for questions or
The Dental Dental PPO plan provides      option; formerly PMI) provides you        publications.
you and your family with the flexibil-   and your family with comprehensive        Delta Dental PPO: 1-800-777-5854
ity to choose any licensed dentist or    benefits and easy referrals to special-   DeltaCare® USA: 1-800-422-4234
specialist. Under this plan, you may     ists and even has a benefit for teeth
choose a PPO network provider, or                                                  For UC forms or publications, and
                                         bleaching. You must be a resident
if you choose a Delta dentist outside                                              links to the dental plan websites,
                                         of California to enroll. The plan
the PPO network, such as a dentist                                                 visit the HR/Benefits website
                                         emphasizes preventive care, so many
in Delta Dental’s Premier network,                                                 (atyourservice.ucop.edu). To see a list
                                         services are provided at no cost (see
you will be eligible for benefits, as                                              of Delta or DeltaCare® USA dentists,
                                         pages 20 and 21). There is no annual
outlined on pages 20 and 21. How-                                                  visit their websites.
                                         plan maximum for DeltaCare®
ever, when you choose to visit a PPO     USA. Other services are provided at
network provider, your out-of-pocket     modest copayments to you and there
costs may be lower because PPO           are no deductibles, making this plan
dentists have agreed to charge Delta     a very affordable option to members.
Dental PPO patients reduced fees.




                                                                                              atyourservice.ucop.edu   19
Dental


         January through December 2008            Delta Dental PPO Plan                         DeltaCare® USA Plan (Services are only
                                                                                                covered when you use your DeltaCare® USA
                                                                                                provider.)
         SERVICE AREA                             Worldwide1                                    California only
         PREVENTIVE DENTISTRY                     No deductible                                 Copayments apply as noted
         Cleaning of teeth—Prophylaxis            You are covered at 100% (up to 2 times in     100% up to 2 times in any 12-month period.
         cleanings                                a calendar year; additional cleanings by      Additional cleanings when necessary: $45
                                                  report)                                       copayment for adults, $35 copayment for
                                                                                                children.
         Oral examinations                        100% (1 routine and 2 non-routine exams       100%
                                                  per calendar year)
         Emergency office visit for pain relief   100%                                          100%
         Topical fluoride treatment               100% (includes cleaning; up to 2 times in a   100% (up to 2 times in any 12-month period
                                                  calendar year through age 13)                 through age 18)
         Space maintainers                        100% (through age 12)                         100%
         X-rays (full mouth, bitewings, other     100% (full mouth x-rays limited to 1 set in   100% (full mouth x-rays limited to 1 set in
         films)                                   5 years unless necessary)                     any 12-month period)
         Pit and fissure sealants (under age 16   80% PPO/75% Premier for first permanent       100% for first permanent molars through
         only)                                    molars through age 9 and second perma-        age 9 and second permanent molars through
                                                  nent molars through age 15                    age 15
         BASIC DENTISTRY                          Deductible applies                            Copayments apply as noted
         Fillings                                 80% PPO/75% Premier                           100% for standard benefit
         Anesthesia    2
                                                  80% PPO/75% Premier                           Local—100%. General and intravenous
                                                  (general anesthesia for                       sedation—100%; limited to medically
                                                  covered oral surgery)                         necessary extractions
         Prosthetic appliance repair              80% PPO/75% Premier                           100%
         Extractions                              80% PPO/75% Premier                           100% if uncomplicated (not covered if done
                                                                                                only for orthodontics)
         Oral surgery                             80% PPO/75% Premier                           $15 copayment for impactions; other covered
                                                                                                services at 100%
         Endodontics                              80% PPO/75% Premier                           $20 copayment for each canal; other covered
                                                                                                services at 100%
         Periodontics                             80% PPO/75% Premier                           $100 copayment per quadrant for surgery
                                                                                                (mucogingival and osseous gingival); $150
                                                                                                copayment for soft tissue graft procedures;
                                                                                                periodontal maintenance: 100% for 1 in each
                                                                                     After an   6-month period; additional maintenance when
                                                                                     annual     necessary: $55 copayment
                                                                                     deductible
         Denture relining and rebase              80% PPO/75% Premier                of $50 per Relining—100% (limited to 1 in any 12-month
                                                                                     person3    period). Rebase—$20 copay.
         MAJOR DENTISTRY                          Deductible applies                            Copayments apply as noted
         Crowns                                   50%                                           $50 per unit copayment ($100 extra charge
                                                                                                for precious metals)
         Inlays/onlays                            50%                                           100% for standard benefit
         TMJ DISORDER BENEFITS                    50% up to $500 for all ben-                   100%
         Temporomandibular joint (TMJ)            efits in a lifetime (not applied
         dysfunction: occlusal devices/occlusal   to calendar year maximum).
         guards (night guards)                    Deductible applies.
         PROSTHETIC DENTISTRY                     Deductible applies                            Copayments apply as noted
         Standard, full, or partial dentures      50%                                           Upper—$65 copayment per denture
                                                                                                Lower—$65 copayment per denture (extra
                                                                                                charge for precious metals) Removable partial
                                                                                                denture with flexible base—$115
         Bridges                                  50%                                           $50 per unit copayment (extra charge for
                                                                                                precious metals)



         20
                                                                                                                                                      Dental
January through December 2008                  Delta Dental PPO Plan                             DeltaCare® USA Plan
TOTAL BENEFIT                                 $1,500 per person per calendar year ($1,700        No maximum
                                              if a Delta Dental PPO dentist is used)
(Total benefit for preventive, basic, and major dentistry; and prosthetic dentistry.)
ORTHODONTICS                                   No deductible                                     Copayments apply as noted
Who is eligible for service                    All covered family members                        All covered family members
Benefit                                        50% up to $1,500 in a lifetime for depen-         $1,000 copayment (plan covers 36 months of
                                               dent children as defined in eligibility provi-    usual and customary treatment—a monthly
                                               sions; up to $500 in a lifetime for adults (not   office visit fee of $75 applies after the 36
                                               applied to calendar year maximum)                 months)
SPECIAL PROVISIONS, LIMITATIONS,
EXCLUSIONS
Work in progress when you join                 Only services that you receive on or after        Only services received from a DeltaCare®
                                               your effective date of coverage are covered.      USA provider on or after your effective date of
                                                                                                 coverage are covered.4
Predetermination of benefits                   If services are expected to be $400 or more,      Before any work is done, ask your Delta-
                                               your dentist files a treatment plan first;        Care® USA dentist what the charges will be.
                                               Delta reviews it and notifies you and your        If you have any questions about what will be
                                               dentist of the benefits payable.                  covered, call DeltaCare® USA.
Alternate treatment provision                  If more than one professionally acceptable        If you select a treatment plan different from
                                               and appropriate treatment can be used,            that customarily provided by DeltaCare® USA,
                                               Delta benefits will be based on the least         you will pay the applicable copayment, plus
                                               expensive method.                                 the additional cost of the alternate treatment.
Replacement of crowns, dentures,               Not covered if crown or prosthetic                Not covered if crown or prosthetic appliance
partial dentures, and bridges                  appliance is less than 5 years old                is less than 3 years old
Out-of-area emergencies                        Coverage applies worldwide.                       Plan pays up to $100 in 12-month period for
                                                                                                 pain relief when you are more than 25 miles
                                                                                                 from your dentist’s office.
Teeth Bleaching                                Not covered                                       $125 copayment per arch. External bleach-
                                                                                                 ing is limited to one bleaching tray per arch
                                                                                                 per 36-month period; bleaching gel for two
                                                                                                 weeks of patient self treatment.

NOTE: Other limitations and exclusions may apply. See the Delta Dental or DeltaCare® USA booklet.
1
    Nationwide—Delta Dental PPO, Delta Dental Premier and non-Delta dentists (licensed); Worldwide—Coverage available only from non-Delta
    dentists (licensed).
2
    Disabled members may receive anesthesia for any covered dental service if needed to receive treatment. Preauthorization is required.
3
    Combined for basic and major dentistry, TMJ disorder benefits, and prosthetic dentistry.
4
    Exception: DeltaCare® USA may cover orthondontia treatment in progress for new enrollees/family members if treatment meets specific
    DeltaCare® USA criteria.




                                                                                                                  atyourservice.ucop.edu         21
Vision‚


          Vision

          Regular eye exams and good vision         glasses, or have some conditions of     The VSP doctor will obtain the nec-
          are important to everyone. To enable      anisometropia or keratoconus.           essary authorization and information
          you and your family to get the care                                               about your eligibility and coverage
                                                    Members may purchase annual
          you need, UC provides a vision plan.                                              directly from VSP.
                                                    supplies of select contact lenses at
          Vision Service Plan (VSP)—a pre-
                                                    a reduced cost. For additional          By using a VSP provider, you pay
          ferred-provider organization with
                                                    details see the VSP website             only the required deductibles for
          over 4,000 providers in California
                                                    (vsp.com) or call VSP or your VSP       covered services and costs for items
          and over 22,000 nationwide—offers
                                                    provider.                               and services not covered. In addition,
          the benefits described here. The
                                                                                            the following discounts—for services
          vision plan does not have any exclu-    VSP offers discounted laser
                                                                                            not covered by the plan—are avail-
          sions for pre-existing conditions.      corrective vision surgery through
                                                                                            able within 12 months following the
                                                  VSP-contracted laser centers. Call
                                                                                            last covered eye examination from
                                                  VSP for more information.
          What the Plan Covers                                                              the VSP doctor who provided the
          The plan’s benefits include:            For plan limitations, refer to the plan   examination.
                                                  booklet available on atyourservice.
          • One vision examination per                                                      • 20 percent discount for additional
                                                  ucop.edu.
            calendar year                                                                     pairs of prescription glasses; and
            The plan covers testing and analy-
            sis of eye health, as well as any     Cost of Coverage                          • 15 percent discount for contact lens
                                                                                              professional services (for example,
            necessary prescriptions for lenses.   UC pays the entire cost of the              fittings or adjustments).
                                                  monthly vision plan premium. UC’s
          • One set of corrective lenses per                                                You can also use a non-VSP pro-
                                                  contribution toward the monthly cost
            calendar year                                                                   vider. If you do, you should pay the
                                                  of coverage is determined by UC and
            The plan covers single vision,                                                  full amount of the provider’s bill and
                                                  may change or stop altogether.
            bifocal, trifocal, or other complex                                             submit a claim to VSP.
            glass or plastic lenses. Photo-       You pay deductibles—$10 for a vision
            chromatic lenses and tints are also   exam and, if you need glasses, $25
            covered. VSP covers the full cost     for materials. There is no deductible     For More Information
            of polycarbonate lenses when the      for contact lenses. You also pay for      This is only an overview of your
            member uses a VSP provider. For       additional care, services, or products    vision benefits. You can access VSP’s
            those members using a non-VSP         not covered by VSP.                       Evidence of Coverage booklet and
            provider, a single $5 reimburse-                                                the VSP website through the At
            ment is available for tints and       How to Use the Plan                       Your Service website (atyourservice.
            polycarbonate options, if elected.                                              ucop.edu). Under “Quick Links” select
                                                  Once you enroll, VSP will send you        “Health & Welfare Benefits” and the
          • One set of frames every other         information explaining how the plan       “Vision Plan” link for the VSP website
            calendar year                         works. In general, you follow these       and the Evidence of Coverage
            Some frames provided by VSP           simple procedures:                        booklet. You may also call VSP at
            doctors are fully covered.
                                                  • Call the VSP doctor and make an         1-800-877-7195 to request a booklet
          • One set of contact lenses per           appointment,                            or to ask a question.
            calendar year
                                                  • Identify yourself as a VSP member
            Contact lenses are fully covered
                                                    covered under the UC vision plan,
            if they are considered medically
                                                    and
            necessary and a VSP provider is
            used. Generally, they are covered     • Give the VSP doctor either your
            for those who have had cataract         (the UC employee’s) Social Security
            surgery, have extreme acuity prob-      number or alternate I.D. number.
            lems that cannot be corrected with




          22
Disability Insurance




                                                                                                                                  Short-Term Disability & Supplemental Disability
  Short-Term Disability and
  Supplemental Disability

  An unexpected injury or illness that      affect major events in your life. If you    Supplemental Disability
  keeps you out of work can use up          are on leave for health reasons on          Supplemental Disability pays a
  savings rapidly. Making sure you          the day you become eligible for cov-        higher level of benefits for a longer
  have enough disability insurance is       erage, coverage starts the day after        period of time than the Short-Term
  an important part of your personal        your first full day at work.                plan. If you decide to enroll in the
  financial planning. UC’s disability                                                   Supplemental Disability plan, the
  benefits in conjunction with state-
                                            What the Plans Cover                        premium is paid by you. This plan
  mandated Workers’ Compensation                                                        pays benefits if you are unable to
  and Social Security disability benefits   Short-Term Disability                       work due to a pregnancy/childbirth,
  create a comprehensive safety net to      The Short-Term Disability plan              disabling injury, or illness. You must
  provide protection from loss of wages     provides coverage for nonwork-              be under a doctor’s direct and con-
  whether a few months or a lifetime.       related disabilities and pays short-        tinuous care. If your disability is not
  For Workers Compensation claims, UC       term benefits if you are unable to          work-related, benefits from this plan
  is self-insured and contracts with a      work due to a pregnancy/childbirth,         are coordinated with benefits from
  third party administrator to manage       disabling injury, or illness. In order to   Short-Term Disability.
  its claims. For questions about Work-     receive benefits, you must be under a
                                                                                        Supplemental Disability and Short-
  ers’ Compensation, see Business and       doctor’s direct and continuous care
                                                                                        Term Disability benefits, combined
  Finance Bulletin BUS 73—Workers’          and your illness or injury must not be
                                                                                        with all other sources of disability
  Compensation Self-Insurance Pro-          work-related.
                                                                                        or retirement income you receive
  gram, available online through At         The plan pays 55 percent of your eli-       (Workers’ Compensation or Social
  Your Service (under “Forms & Publi-       gible earnings, up to $800 a month          Security for example), pay 70 per-
  cations”) or from your local Workers’     (maximum), for up to six months.            cent of your eligible earnings, up to
  Compensation Manager. You can find        Before benefits begin, you must first       $10,000 a month for up to 12 months
  a list of UC Workers’ Compensation        use up to 22 working days of accrued        of temporary disability.
  Managers online (ucop.edu/riskmgt/        sick leave excluding paid holidays. If
  wcmdir.html).                                                                         If you are still disabled after 12
                                            you have not accumulated that much
                                                                                        months of benefits, the Supplemental
  UC does not participate in the            sick leave, you must use what you
                                                                                        plan has a provision that pays long-
  California State Disability Insurance     have.
                                                                                        term disability benefits to fill in the
  (SDI) program. If you are a new UC        If you are covered only by the              difference between other sources of
  employee and become disabled, you         Short-Term Disability plan, you are         disability or retirement income and
  may have SDI coverage through a           automatically assigned a seven day          70 percent of your eligible earnings.
  former employer. Any SDI income           waiting period. Benefits start after        The Supplemental plan will pay a
  you are eligible to receive based on      your chosen waiting period or after         minimum of $100 a month, even if
  past employment will be deducted          you exhaust a minimum amount of             you are receiving a full 70 percent of
  from your disability benefits payable     your sick leave, whichever occurs           eligible earnings from other sources.
  under the University of California’s      later.                                      Other sources of income include, but
  disability plan benefits.                                                             are not limited to, Workers’ Compen-
  To be sure you get the coverage you         See “Choosing a Waiting Period”           sation, Social Security, and UCRP.
  want, sign up during your PIE and           on page 25 for more on how wait-
                                                                                        If you have no other source of
  make your selections carefully. It is       ing periods and sick leave work.
                                                                                        income, the Supplemental plan alone
  important that you consider your                                                      pays a maximum of 50 percent of
  circumstances and how your choice                                                     your eligible earnings up to $10,000
  of a disability waiting period will                                                   a month.


                                                                                                   atyourservice.ucop.edu    23
Short-Term Disability & Supplemental Disability



                                                  As long as you remain disabled,                    Your Service website (atyourservice.          Plan Limitations
                                                  Supplemental Disability plan benefits              ucop.edu) to calculate your monthly
                                                                                                                                                   • The Short-Term Disability plan does
                                                  are payable until you reach age 65.                premium. Select “Health & Welfare
                                                                                                                                                     not pay for work-related injuries or
                                                  (If you become disabled after reach-               Benefits,” “Disability Insurance” and
                                                                                                                                                     illnesses which cause disability—
                                                  ing age 60, benefits may continue                  then “Insurance Premium Calculator.”
                                                                                                                                                     instead, benefits are provided
                                                  past age 65. See the insurance plan
                                                                                                                                                     by Workers’ Compensation. The
                                                  booklet for more information.)
                                                                                                       Other Disability Plans                        Supplemental Disability plan pays
                                                  As with Short-Term Disability, you                                                                 benefits for a work-related disabil-
                                                                                                       In addition to Short-Term Disabil-
                                                  must use your accrued sick leave (up                                                               ity in coordination with Workers’
                                                                                                       ity and Supplemental Disability,
                                                  to 22 working days—176 hours—not                                                                   Compensation.
                                                                                                       UC employees may be eligible for
                                                  including paid holidays) before
                                                                                                       other disability benefits:                  • Disabilities related to pre-existing
                                                  benefits begin. If you have not
                                                                                                                                                     conditions and which begin in your
                                                  accumulated that much sick leave,                    • Workers’ Compensation, which
                                                                                                                                                     first year of coverage under the
                                                  you must use what you have.                            covers work-related injuries
                                                                                                                                                     Supplemental Disability plan are
                                                                                                         and illnesses;
                                                  The Supplemental Disability plan                                                                   limited to a total of 12 months of
                                                  offers a choice of minimum waiting                   • UCRP disability income, which               benefits.
                                                  periods before benefits begin—7,                       is available for UCRP mem-
                                                                                                                                                   • Disabilities related to mental illness
                                                  30, 90, or 180 days. See “Choosing                     bers with five or more years of
                                                                                                                                                     and/or substance abuse under the
                                                  a Waiting Period” on page 25. If you                   service credit with permanent
                                                                                                                                                     Supplemental plan’s long-term
                                                  enroll in the Supplemental Disability                  or long-term disabilities (12
                                                                                                                                                     benefits are generally limited to a
                                                  plan, you will be asked to choose                      months or longer);
                                                                                                                                                     24-month lifetime maximum bene-
                                                  the length of your waiting period.
                                                                                                       • Social Security disability                  fit, unless you remain continuously
                                                  The waiting period you choose will
                                                                                                         benefits; and                               hospitalized or in an extended
                                                  apply to both the Short-Term and the
                                                                                                                                                     treatment plan.
                                                  Supplemental Disability plans.                       • California State Disability
                                                                                                         Insurance.
                                                  Cost of Coverage                                     Benefits payable by the Short-
                                                                                                                                                   Other Information You
                                                  The Short-Term Disability Plan is                    Term and Supplemental Disability            Should Consider
                                                  currently paid for by the University.                plans will be reduced by most               • If you do not enroll in the Supple-
                                                                                                       other disability benefits for which           mental Disability plan when you
                                                  If you decide to enroll in the Supple-               you are eligible, including but not           are first hired, you must submit
                                                  mental Disability Plan, the premiums                 limited to the above.                         a statement of health and be
                                                  are paid for by you. Use the Insur-                                                                approved by the insurance com-
                                                  ance Premium Calculator on the At                                                                  pany in order to enroll. Previous or
                                                                                                                                                     currently existing medical condi-
                                                                                                                                                     tions may prevent your approval
                                                                                                                                                     if you try to enroll without a PIE.
                                                       Accruing Sick Leave                                                                           You must also submit a statement
                                                                                                                                                     of health for approval in order to
                                                       Waiting period               Minimum sick                      Years of UC                    reduce your waiting period. Gener-
                                                       (calendar days)              leave needed                      employment needed              ally, disability plans are not “open
                                                                                    (working days)                    to earn leave*                 for enrollment” during UC’s annual
                                                            7                       5 (40 hours)                       0.4                           Open Enrollment.
                                                          30                        22 (176 hours)                      1.8                        • Under the Supplemental Disability
                                                          90                        66 (524 hours)                     5.5                           plan, the definition of disability
                                                                                                                                                     changes after 12 months of receiv-
                                                         180                        131 (1,048 hours)                 10.9
                                                                                                                                                     ing benefits, and it becomes more
                                                       * Calculations assume that you work 174 hours a month, earn eight hours of sick leave per
                                                                                                                                                     difficult to meet the insurance
                                                         month, and do not use any earned sick leave.
                                                                                                                                                     carrier’s requirements. During the




                                                  24
                                                                                                                            Short-Term Disability & Supplemental Disability
  first 12 months, disability is defined   if you become disabled, you should      If you have just purchased a new
  as being disabled from your “own         be prepared to cover your expenses      house, you may not want to risk a
  occupation.” After 12 months of          yourself—without income from the        long waiting period, during which
  benefits, disability is defined as       disability plans—until your waiting     you might be without income to pay
  being disabled from “any occupa-         period is complete.                     your mortgage.
  tion” for which you are reasonably
                                           No one waiting period is right for      It is also important to consider other
  suited.
                                           everyone. It is important that you      sources of income you might have.
                                           consider your circumstances and
                                                                                   For instance, if you have a lot of
Choosing a Waiting                         how your selection will affect major
                                                                                   savings, you might choose a longer
Period                                     events in your life.
                                                                                   waiting period and pay a lower pre-
When you enroll in the Supplemen-          For example, consider your choices      mium. On the other hand, if you are
tal Disability plan, you must select a     carefully if you plan to become         a new employee without much sick
waiting period.                            pregnant. Most pregnancy disabilities   leave, you might consider choosing a
                                           last only 6–8 weeks, so the wait-       shorter waiting period.
A waiting period is the time from the
                                           ing period you select will determine
day you are unable to work due to an                                               You can always increase the length
                                           if you will receive any disability
injury, illness, or pregnancy until the                                            of your waiting period later, but a
day disability benefits start. You may     income following the birth of your
                                                                                   statement of health and approval by
elect a 7-, 30-, 90-, or 180-day wait-     child.
                                                                                   the insurance company is required in
ing period. The longer the waiting         Additionally, you should consider       order to shorten your waiting period.
period, the lower the monthly premi-       your major financial obligations
ums you’ll pay. However, when you          when selecting a waiting period.
choose a longer waiting period and




                                                                                              atyourservice.ucop.edu   25
Short-Term Disability & Supplemental Disability




                                                       Short-Term Disability Plan Only
                                                       This is how benefits work if you have Short-Term Disability only. Before benefits begin, you must use up to 22 days
                                                       of sick leave (excluding holidays), if available.

                                                                Accrued
                                                                Sick Leave (If you have no accrued sick leave, benefits begin after the seven-day waiting period.)
                                                       7 DAYS




                                                                      Short-Term Plan
                                                                      (55% of eligible earnings to $800)
                                                                     BENEFITS START

                                                             30 DAYS                           6 MONTHS
                                                   Disability starts the day you become disabled.




                                                       Short-Term and Supplemental Disability Plans

                                                       If you have Supplemental Disability, this is how both plans work together based on the waiting period you choose.
                                                       Remember, the waiting period you choose for the Supplemental Disability plan automatically becomes your wait-
                                                       ing period for the Short-Term Disability plan as well. After you have received 12 months of Supplemental Disability
                                                       benefits, the plan will pay 50% of your eligible earnings to $10,000 per month.

                                                   7-day Waiting Period

                                                   (If you have no accrued sick leave, benefits begin after the seven-day waiting period.)
                                                                Accrued       Supplemental Plan: With other benefits, 70% of eligible earnings to $10,000 per month maximum from this plan
                                                                Sick Leave
                                                   7 DAYS




                                                                      Short-Term Plan                                                                   50% of eligible earnings to
                                                                      (55% of eligible earnings to $800)                                                $10,000 per month from this plan
                                                                     BENEFITS START

                                                             30 DAYS                           6 MONTHS                                           12 MONTHS*                           18 MONTHS
                                                   Disability starts the day you become disabled.


                                                   If you have five days of sick leave or less, you will receive disability benefits up to 70% of your eligible earnings to $10,000 per
                                                   month maximum after your seven-day waiting period. If you have more than five days of sick leave, before benefits begin you
                                                   must use up to 22 days of sick leave, excluding paid holidays, if available. This benefit will be reduced if benefits combined with
                                                   other sources (for example, Social Security and/or UCRP disability) exceed 70% of your eligible earnings.

                                                   30-day Waiting Period

                                                        Accrued     Supplemental Plan: With other benefits, 70% of eligible earnings to $10,000 per month maximum from this plan
                                                        Sick Leave
                                                        30       Short-Term Plan                                                                50% of eligible earnings to
                                                        DAYS     (55% of eligible earnings to $800)                                             $10,000 per month from this plan
                                                                BENEFITS START

                                                             30 DAYS                           6 MONTHS                                           12 MONTHS*                           18 MONTHS
                                                   Disability starts the day you become disabled.

                                                   You must wait 30 calendar days before you receive disability benefits up to 70% of your eligible earnings to $10,000 per month.
                                                   If you have accrued sick leave, you must use up to 22 days of sick leave, excluding paid holidays, before benefits begin. You may
                                                   use sick leave to cover your disability waiting period. If you do not have enough sick leave to cover your waiting period, the bal-
                                                   ance of your waiting period will be unpaid. This benefit will be reduced if benefits combined with other sources (for example,
                                                   Social Security and/or UCRP disability) exceed 70% of your eligible earnings.




                                                  26
                                                                                                                                                        Short-Term Disability & Supplemental Disability
Short-Term and Supplemental Disability Plans

90-day Waiting Period

    Accrued Sick Leave
                         Supplemental Plan: With other benefits, 70% of eligible earnings to $10,000 per month from this plan
    Req.    Optional
                         Short-Term Plan                                                                    50% of eligible earnings to
     90 DAYS
                         (55% of eligible earnings to $800)                                                 $10,000 per month from this plan
                         BENEFITS START

          30 DAYS                           6 MONTHS                                   12 MONTHS*                             18 MONTHS
Disability starts the day you become disabled.

You must wait 90 calendar days before you receive disability benefits up to 70% of your eligible earnings to $10,000 per month.
You must use up to 22 days of sick leave, excluding paid holidays, if available. You may also use additional accrued sick leave, up
to the full waiting period. If you do not have enough sick leave to cover your waiting period, the balance of your waiting period
will be unpaid. This benefit will be reduced if benefits combined with other sources (for example, Social Security and/or UCRP
disability) exceed 70% of your eligible earnings.

180-day Waiting Period

            Accrued Sick Leave               Supplemental Plan: With other benefits, 70% of eligible earnings to $10,000 per month from this plan
    Req.              Optional
                                                                                                                          50% of eligible earnings to
                                             Short-Term Plan                                                              $10,000 per month from
    180 DAYS                                 (55% of eligible earnings to $800)                                           this plan
                                             BENEFITS START

          30 DAYS                           6 MONTHS                                   12 MONTHS*                             18 MONTHS
Disability starts the day you become disabled.

You must wait 180 calendar days before you receive disability benefits up to 70% of your eligible earnings to $10,000 per month.
You must use up to 22 days of sick leave, excluding paid holidays, if available. You may also use additional accrued sick leave, up
to the full waiting period. If you do not have enough sick leave to cover your waiting period, the balance of your waiting period
will be unpaid. This benefit will be reduced if benefits combined with other sources (for example, Social Security and/or UCRP
disability) exceed 70% of your eligible earnings.


      Waiting Period: During this time you do not receive plan benefits; you receive pay for any sick leave that you use.
      Accrued Sick Leave: You are required (Req.) to use accrued sick leave—up to 22 working days. Benefits begin after the concurrent waiting
      period and used sick leave. For the 90- and 180-day waiting periods, you have the option of using additional accrued sick leave, up to the
      full waiting period.
*     After 12 months, if you continue to be eligible, a $100 minimum benefit will be paid regardless of other benefits or payments.




                                                                                                                  atyourservice.ucop.edu         27
28
Life and Accident Insurance




                                                                                                                                      University-Paid Life Insurance
  If the event of your death, financial    UC’s life insurance plans carry no        an eligible employee. Unlike whole
  protection for your dependents can       exclusions based on the cause of          life policies, term life policies don’t
  play an important role in their future   death.                                    accumulate a cash value over time.
  security. UC automatically provides                                                Coverage stops when you are no
                                           UC’s plans are group term life plans
  basic life insurance coverage for                                                  longer eligible.
                                           that provide coverage at special rates
  all eligible employees. And, if you
                                           to group members—in this case, UC         Rates and coverage amounts are
  are eligible, you may buy additional
                                           employees. Term insurance stays in        adjusted each January 1 and usually
  coverage—for both yourself and your
                                           effect only during a set time, or term;   stay the same for the rest of the year.
  family members.
                                           in this case, as long as you remain


  University-Paid
  Life Insurance

  The two University-Paid plans—           If you are on leave for health reasons    paid to the employee. Your life
  Basic Life and Core Life—provide a       on the day you become eligible for        insurance plan booklet has more
  minimum amount of life insurance         coverage, coverage starts the day         information.
  coverage. The amount varies,             after your first full day at work.
  depending on your appointment rate                                                 Insurance Assignment
  and average regular paid time. You       Core Life                                 Employees, such as those diagnosed
  are automatically covered by the plan    This plan provides $5,000 of life         with a terminal illness, may make an
  for which you qualify.                   insurance.9                               absolute assignment for the value of
                                                                                     Supplemental or Basic/Core Life
                                           Benefits are paid to your beneficia-
  What the Plans Cover                     ries (see page 31) if you die while
                                                                                     insurance benefits. Making an
                                                                                     absolute assignment irrevocably
                                           employed or on paid leave, or during
  Basic Life                                                                         transfers ownership of your life
                                           the first four months of approved
  This plan provides life insurance                                                  insurance benefits to someone else.
                                           leave without pay or temporary
  equal to your annual base salary, up                                               For example, a terminally ill person
                                           layoff. Benefits from this plan are
  to $50,000.8 The coverage amount                                                   may consider assigning his or her
                                           payable in addition to any other
  is based on your UC salary and                                                     life insurance to a viatical settlement
                                           death benefits for which you may
  appointment rate as of your date of                                                company—a company that pays a ter-
                                           qualify.
  hire or January 1 of the current year,                                             minally ill person an agreed amount
  whichever comes after.                                                             in exchange for future benefits and
                                           Living Benefit Option
                                                                                     rights to the person’s life insurance.
  Benefits are paid to your beneficia-     The plan also provides a “living ben-
  ries (see page 31) if you die while      efit” option that allows terminally ill   Once coverage has been assigned,
  employed or on paid leave, or during     employees who have been covered           the new “owner” (the viatical settle-
  the first four months of approved        by the plan for at least one year to      ment company) has the right to
  leave without pay or temporary           receive some of their life insurance      designate beneficiaries or convert
  layoff. Benefits from this plan are      benefits before death. The money          the insurance. The employee can
  payable in addition to any other         can be used for any purpose. The
  death benefits for which you may         money—75 percent of the total cover-      8 If you are a member of the California Public
  qualify—for example, from the Sup-       age amount is paid directly to you in       Employees’ Retirement System (CalPERS),
  plemental Life insurance plan (see       a lump sum or in 12 equal monthly           UC provides coverage equal to your annual
                                                                                       base salary multiplied by your appointment
  page 31) or your retirement plan.        installments. The amount that would         rate, less $5,000, up to $45,000. CalPERS
                                           otherwise be payable to beneficiaries       provides $5,000 of coverage.
                                           at death is reduced by the amount         9 This plan does not cover CalPERS members.




                                                                                                  atyourservice.ucop.edu        29
University-Paid Life Insurance



                                 no longer leave a cash payment to       Cost of Coverage                         Use the Insurance Premium Calcula-
                                 beneficiaries and the employee is not                                            tor on the At Your Service website
                                                                         UC pays the entire cost of your cover-
                                 eligible to elect the “living ben-                                               (atyourservice.ucop.edu) to
                                                                         age for Basic or Core Life insurance.
                                 efit” option described on page 32.                                               calculate your monthly premium.
                                                                         UC’s contribution toward the monthly
                                 Because assigning benefits is per-                                               Select “Health & Welfare Benefits,”
                                                                         cost of coverage is determined by UC
                                 manent and involves complex legal                                                “Life Insurance” and then “Insurance
                                                                         and may change or stop altogether.
                                 and tax issues, an attorney should be                                            Premium Calculator.”
                                 consulted before assigning coverage.
                                 Assignment forms can be obtained
                                 from your Benefits Office.




                                 30
                                                                                                                              Supplemental Life Insurance
Supplemental
Life Insurance

Eligible employees may supplement        Waiver of Premium                         Portability unit. The Portability
their Basic Life coverage by enrolling                                             benefit allows you to continue your
                                         If you are covered under Supple-
in this plan and paying monthly                                                    current UC group term-life Supple-
                                         mental Life, become totally disabled
premiums. If you qualify, you can                                                  mental coverage at Prudential’s
                                         before age 65, and your disability
choose the amount of coverage that                                                 Portability group term-life rates. The
                                         continues for six consecutive months,
meets your needs, up to the limits                                                 Portability premium rates are lower
                                         you may qualify for continuance of
noted below.                                                                       than the conversion rates. There are
                                         life insurance protection without
                                                                                   separate Portability rates based upon
                                         paying the premiums. You must pro-
                                                                                   your health status and you will need
What the Plan Covers                     vide written proof of your disability
                                                                                   to submit an additional statement
You may choose one of these              no later than one year after the dis-
                                                                                   of health for the Portability group’s
coverage amounts:                        ability starts and submit proof of your
                                                                                   preferred rate. Since this is term-life
                                         continuing disability each year. Your
• $20,000                                                                          coverage, the benefits will reduce
                                         life insurance will continue until you
                                                                                   to 60 percent at age 65; 50 percent
• One times your annual salary, up to    reach age 70, as long as you remain
                                                                                   at age 70 and terminate at age 80.
  $250,000                               totally disabled. You may need to
                                                                                   Similar to your conversion privileges,
                                         continue your premium payments to
• Two times your annual salary, up                                                 you will also have 31 days from
                                         your Payroll or Benefits Office while
  to $500,000                                                                      which your coverage ends to submit
                                         your application is pending. See your
                                                                                   your application and the appropri-
• Three times your annual salary, up     insurance booklet or call the insur-
                                                                                   ate premiums to Prudential. See your
  to $750,000                            ance carrier for more information.
                                                                                   Benefits Office for more information.
• Four times your annual salary, up
  to $1,000,000                          Cost of Coverage                          Your Beneficiaries
Coverage is based on your UC salary      Your cost for Supplemental Life
                                                                                   You may designate your beneficia-
and appointment rate as of your date     depends on your age and the amount
                                                                                   ries online, on the At Your Service
of hire or the full-time salary rate     of coverage you purchase. Use the
                                                                                   website (atyourservice.ucop.edu), by
for your position as of January 1 of     Insurance Premium Calculator on the
                                                                                   selecting “Sign in to My Accounts.”
the current year (whichever is later),   At Your Service website to figure your
even if you work part time. Coverage     monthly premium. Select “Health &         If you don’t name beneficiaries,
will not be reduced automatically if     Welfare Benefits,” “Life Insurance”       benefits are paid to the first survivor
your full-time salary rate is reduced.   and then “Insurance Premium               in this list:
                                         Calculator.”                              a. Legal spouse or domestic partner of
Benefits are paid to your beneficia-
ries if you die while enrolled.                                                       the member;
Benefits from this plan are payable in   Conversion and                            b. Child or children, including
addition to any other death benefits     Portability Privileges                       adopted child or children of the
for which you may qualify—for            You may be eligible to convert your          member (child or children of a
example, from the Basic Life insur-      group life insurance to an individual        deceased child shall take the share
ance plan or your retirement plan.       policy if your UC-sponsored coverage         of such child by representation);
If you are on leave for health reasons   ends. See ”Converting to an Individ-
                                                                                   c. Parent or parents of the member;
on the day you become eligible for       ual Policy” on page 11 and see your
                                         Benefits Office for more information.     d. Sibling or siblings of the member.
coverage, coverage starts the day
after your first full day at work.       Or, you may instead participate in        If there is no such survivor, any lump
                                         Prudential’s Portability Group            sum death payment shall be paid to
                                         Term-Life Plan by submitting an           the member’s estate.
                                         application to Prudential’s




                                                                                              atyourservice.ucop.edu     31
Supplemental Life Insurance



                              You may change your designated            Insurance Assignment                      For More Information
                              beneficiary at any time by using At
                                                                        Employees, such as those diagnosed        This is an overview of your Univer-
                              Your Service. Once your new desig-
                                                                        with a terminal illness, may make an      sity-Paid Life and Supplemental Life
                              nations are processed, all previous
                                                                        absolute assignment for the value of      insurance benefits. Once you are
                              designations are invalid. You may
                                                                        Supplemental or Basic/Core Life           enrolled, the insurance carrier will
                              complete UC’s Designation of Benefi-
                                                                        insurance benefits. Making an             send you more information. A copy
                              ciary form (UBEN 116) if you do not
                                                                        absolute assignment irrevocably           of the Life Insurance plan booklet
                              have Internet access.
                                                                        transfers ownership of your life          is located on the At Your service
                              Changes in your family situation (e.g.,   insurance benefits to someone else.       website (atyourservice.ucop.edu)
                              marriage, divorce, birth of a child) do   For example, a terminally ill person      under “Forms & Publications” “Life
                              not automatically alter or revoke         may consider assigning his or her         Insurance.”
                              your previous designations. Prior         life insurance to a viatical settlement
                              designations remain valid until you       company—a company that pays a ter-
                              change your designations online.          minally ill person an agreed amount
                              Review your beneficiary designations      in exchange for future benefits and
                              for your insurance plans any time         rights to the person’s life insurance.
                              there is a change in your family
                                                                        Once coverage has been assigned,
                              situation. A will does not supercede
                                                                        the new “owner” (the viatical settle-
                              a beneficiary designation.
                                                                        ment company) has the right to
                                                                        designate beneficiaries or convert
                              Living Benefit Option                     the insurance. The employee can
                              The plan also provides a “living ben-     no longer leave a cash payment to
                              efit” option that allows terminally ill   beneficiaries and the employee is not
                              employees who have been covered           eligible to elect the “living benefit”
                              by the plan for at least one year to      option described at left. Because
                              receive some of their life insurance      assigning benefits is permanent
                              benefits before death. The money          and involves complex legal and tax
                              can be used for any purpose. The          issues, an attorney should be con-
                              money—75 percent of the total             sulted before assigning coverage.
                              coverage amount, up to $250,000—is        Assignment forms can be obtained
                              paid directly to you in a lump sum        from your Benefits Office.
                              or in 12 equal monthly installments.
                              The amount that would otherwise be
                              payable to beneficiaries at death is
                              reduced by the amount paid to the
                              employee. Your life insurance plan
                              booklet has more information.




                              32
                                                                                                                               Dependent Life Insurance
Dependent Life
Insurance

UC offers two plans to employees         covered by Expanded Dependent Life        spouse or domestic partner from the
who are eligible for Full and            for at least one year to receive some     basic plan to the expanded plan, you
Mid-level Benefits for insuring their    of their life insurance benefits before   must submit a statement of health for
eligible family members. The basic       death. The money can be used for          that person.
plan covers each dependent for a         any purpose. The money—50 percent
specific amount; the expanded plan       of the total coverage amount, up to       Basic Dependent Life
provides more coverage.                  $50,000—is paid directly to you in        To cover your eligible family
                                         a lump sum or in 12 equal monthly         members under this plan, you must
If you currently cover other eligible
                                         installments. The amount that would       be eligible for and enrolled in either:
family members through Basic
                                         otherwise be payable to beneficiaries
Dependent Life or have coverage for                                                • The Basic Life plan described on
                                         at death is reduced by the amount
children under Expanded Dependent                                                    page 29, or
                                         paid to the spouse or domestic part-
Life, newly eligible children are
                                         ner. Your life insurance plan booklet     • The Supplemental Life plan
covered automatically at birth (or if
                                         has more information.                       described on page 31.
adopted, the earlier of the date of
physical custody or the date you,                                                  Coverage for your dependents stops
your spouse, or domestic partner has     Who Is Eligible                           if you cancel or lose your life insur-
the legal right to control the child’s   The family members you may cover          ance coverage. However, you may be
health care).                            are the same under both plans. See        able to convert your Dependent Life
If you are on leave for health reasons   page 6 for the eligible family mem-       insurance to an individual policy.
on the day you become eligible for       bers you may enroll.                      Your Benefits Office has more
coverage, coverage starts the day                                                  information.
                                         You may cover your family members
after your first full day at work.       under either the basic or the
                                                                                   Expanded Dependent Life
                                         expanded plan. You may not cover
                                                                                   To cover your eligible family mem-
What the Plans Cover                     them under both plans.
                                                                                   bers under this plan, you must be
                                         If both you and a family member are       eligible for and enrolled in the
Basic Dependent Life
                                         UC employees: You may choose to           Supplemental Life plan described on
This plan covers your spouse or          cover yourself under the Supplemen-       page 31.
domestic partner and/or eligible         tal Life plan or you may be covered
children for $5,000 each.                                                          Coverage for your dependents stops
                                         (if eligible) by your family member’s
                                                                                   if you cancel or lose coverage under
                                         Dependent Life plan. You may not
Expanded Dependent Life                  be covered by both plans (see “No         the Supplemental Life plan. However,
This plan covers your eligible family                                              you may be able to convert your
                                         Duplicate University Coverage” on
members for these amounts:                                                         Dependent Life insurance to an
                                         page 3).
                                                                                   individual policy. Your Benefits Office
• Legal spouse or domestic partner:      When enrolling family members after       has more information.
  An amount equal to 50 percent of       the PIE ends, you must submit a
  your Supplemental Life insurance                                                 Your cost depends on your age and
                                         statement of health for an adult
  amount—$200,000 maximum                                                          on which family members you cover.
                                         member; this is not required for
• Eligible children: $10,000 each        children. The insurance company           You pay nothing for the first month of
                                         may or may not accept your request        coverage. Likewise, if you increase
                                         for enrollment based on the               coverage, you don’t pay the extra
Living Benefit Option                    statement(s) of health. You may           premium for the first month of
The plan also provides a “living         transfer your dependents from the         increased coverage.
benefit” option that allows a termi-     expanded plan to the basic plan at
nally ill spouse or domestic partner                                               Use the At Your Service website
                                         any time. However, to transfer your
                                                                                   (select “Health & Welfare Benefits,”




                                                                                              atyourservice.ucop.edu      33
Dependent Life Insurance



                           “Life Insurance” and then “Insurance    Portability Benefit                      For More Information
                           Premium Calculator”) to calculate the   If you participate in Prudential’s       This is an overview of your Depen-
                           cost of your Expanded Dependent         group term-life Portability benefit      dent Life insurance benefits. Once
                           Life coverage.                          for your Supplemental Life insurance     you enroll, the insurance carrier will
                                                                   (see page 31), you may also continue     send you more information. A copy
                           Cost of Coverage                        dependent life coverage (either the      of the Life Insurance plan booklet
                           Use the Insurance Premium Calcula-      Basic Dependent life or Expanded         is located on the At Your Service
                           tor on the At Your Service website      Dependent life) within the same          website (atyourservice.ucop.edu)
                           (atyourservice.ucop.edu) to calcu-      Portability benefit. See your Benefits   under “Forms & Publications” “Life
                           late your monthly premium. Select       Office for more information.             Insurance”
                           “Health & Welfare Benefits,” “Life
                           Insurance” and then “Insurance          Your Beneficiaries
                           Premium Calculator.”
                                                                   Basic Dependent Life
                                                                   You are the beneficiary if a covered
                           Conversion Privileges
                                                                   dependent dies.
                           You may be eligible to convert your
                           Dependent Life insurance to an indi-    Expanded Dependent Life
                           vidual policy if your UC-sponsored
                                                                   You are the beneficiary if a covered
                           coverage ends. See ”Converting to
                                                                   dependent dies. If you prefer, you
                           an Individual Policy” on page 11 and
                                                                   may designate someone else to
                           see your Benefits Office for more
                                                                   receive benefits if a spouse or
                           information.
                                                                   domestic partner covered under this
                           Also, if you become totally disabled    plan dies. You cannot designate an
                           and you are covered under Supple-       alternate beneficiary to receive
                           mental Life waiver of premium           benefits for covered children. To
                           benefit, your Dependent Life cover-     change your beneficiary, use the
                           age will end and you may be eligible    Designation of Alternate Benefi-
                           to convert to an individual policy.     ciary—Expanded Dependent Life and
                                                                   AD&D Insurance form (UBEN 119),
                                                                   available on the At Your Service
                                                                   website (atyourservice.ucop.edu)
                                                                   under “Forms & Publications.”




                           34
                                                                                                                                     Accidental Death and Dismemberment
Accidental Death and
Dismemberment (AD&D)

The financial impact of an accident              If you or a covered family member        annual amount payable is equal to
can be devastating. To help protect              dies in a car accident while using a     the lesser of:
you and your family from the                     seatbelt and/or an airbag, the plan
                                                                                          • the actual cost of day care
unforeseen financial hardship of an              pays an additional 10 percent.
                                                                                            expenses incurred after the date
accident, UC offers the Accidental
                                                 The plan pays a percentage of the          of the accident causing your (the
Death and Dismemberment (AD&D)
                                                 coverage amount if an accident             employee’s) death,
plan. The plan provides worldwide
                                                 causes irreversible paralysis for you
coverage for you and your enrolled                                                        • 5 percent of the your coverage
                                                 or a covered family member. The
family members.                                                                             amount, or
                                                 percentage payable depends on the
                                                 degree of the paralysis.                 • $5,000.
What the Plan Covers                             It also provides coverage if you are     If an insured person suffers a covered
The plan offers three levels of                  permanently and totally disabled by      accidental dismemberment or
coverage including:                              a covered accident. (Family members      paralysis, the plan will pay covered
• The self-only plan—covers you;                 are not eligible for this benefit.)      rehabilitative expenses resulting
                                                                                          from the covered injury causing the
• The family plan—covers you, your               If you die in a covered accident, the
                                                                                          dismemberment or paralysis for two
  spouse or eligible domestic                    plan provides special educational
                                                                                          years after the date of the accident,
  partner, and your children; and                benefits for your spouse or domestic
                                                                                          to a maximum of $10,000.
                                                 partner and/or children. Your spouse
• The modified family plan—covers                or partner may receive up to $10,000     For more details, see the insurance
  you and your children.                         for the professional or trade training   company’s booklet.
The family plan covers your spouse               needed to become self-supporting.
or partner for 60 percent of your cov-           If you die in a covered accident, the    Cost of Coverage
erage amount. With eligible children,            plan also pays for your covered          Your cost depends on the plan
it covers your spouse or partner for             child’s higher education—either the      option and the coverage amount
50 percent of your amount and each               actual annual tuition or 5 percent of    you choose, which can range from
child for 20 percent. The modified               your coverage amount (up to              $10,000 to $500,000. Use the rate
family plan covers you, and each                 $10,000, but not less than $1,500)       chart on the At Your Service website
eligible child is covered for 20 per-            per school year, whichever is less. To   (atyourservice.ucop.edu) to
cent of your amount. Your spouse or              be eligible, a child must be enrolled    determine your monthly premium.
partner is not covered.                          in an institution of higher education    Select “Health & Welfare Benefits,”
You and your enrolled family                     on the day of the accident. Or, if a     and “Accidental Death and
members are covered worldwide,                   full-time high school student, the       Dismemberment.”
24 hours a day.10                                child must enroll in an institution of
                                                 higher education within one year of
If you are on leave for health reasons
                                                 high school graduation. This benefit
                                                                                          For More Information
on the day you become eligible for                                                        This is only an overview of your
                                                 is paid annually for up to four
coverage, coverage starts the day                                                         AD&D benefits. Once you enroll in
                                                 consecutive years, provided the child
after your first full day at work.                                                        the plan, the insurance carrier will
                                                 continues as a full-time student.
The plan provides coverage for                                                            send you more information. A link to
                                                 The plan will pay for day care           the AD&D plan booklet is located on
accidental death or dismemberment
                                                 expenses for covered children under      the At Your Service website (aty-
or loss of sight, speech, or hearing
                                                 age 13 if you die due to a covered       ourservice.ucop.edu) under “Forms &
caused by an accident.
                                                 accident. This benefit is paid up to     Publications”—Evidence of Coverage
                                                 four years ($20,000 maximum) or          and Plan booklets.
10 If you are in the military, certain wartime
   exclusions may apply. See the insurance       until the child reaches age 13. The
   company’s booklet for more information.




                                                                                                      atyourservice.ucop.edu    35
Business Travel Accident Insurance


                                     Business Travel
                                     Accident Insurance

                                     What’s Covered                            Upon registration, you will receive         transmission, emergency cash
                                                                               confirmation of coverage for your trip      advance, emergency referral to a
                                     When traveling on official University
                                                                               and information to use in an emer-          lawyer, translator or interpreter
                                     business, you will be covered world-
                                                                               gency while traveling on University         access, medical benefits verifica-
                                     wide 24 hours a day for a variety of
                                                                               business both domestically and              tion and medical claims assistance.
                                     accidents and incidents while away
                                                                               abroad. A summary of coverage and
                                     from the workplace. This coverage                                                   • Travel Assistance including secu-
                                                                               claim forms are also available online
                                     includes:                                                                             rity extraction, emergency travel
                                                                               (www.uctrips-insurance.org).
                                                                                                                           arrangements for the return of
                                     • Accidental death,
                                                                               The registration will ensure cover-         your traveling companion or
                                     • Accidental dismemberment,               age for you while traveling on official     dependents, and vehicle return.
                                                                               University business. Your registra-
                                     • Paralysis, and
                                     • Permanent total disability benefits.
                                                                               tion information will serve to verify     Your Beneficiaries
                                                                               eligibility to the insurance company
                                                                               in the event you submit a claim,          For purposes of Accidental Death
                                     Travel Assistance Services (when                                                    benefits, the designated beneficiaries
                                     business traveler is 100+ miles from      use any benefit, or request travel
                                                                                                                         are the same as those named on
                                     home or workplace; security extrac-       assistance services.
                                                                                                                         the University-provided basic group
                                     tion not subject to mileage limitation)                                             life insurance, unless you make a
                                     include:                                  Travel Assistance                         separate beneficiary designation.
                                     • Emergency medical evacuation,           Services Available                        You can change your beneficiary
                                       and repatriation,                       In addition to the insurance pro-         designation on the At Your Service
                                                                               tection provided by the insurance         website (atyourservice.ucop.edu) or
                                     • Repatriation of remains,
                                                                               plan, ACE USA has arranged with           complete and submit UC’s Designa-
                                     • Security extraction,                    Europ Assistance USA to provide you       tion of Beneficiary form (UBEN 116).
                                     • Out-of-country medical,                 with access to its travel assistance      The beneficiary designation remains
                                                                               services around the world which           in effect until it is either changed or
                                     • Loss of personal effects, and           include:                                  revoked. The beneficiary designation
                                     • Other travel assistance services        • Medical Assistance including            does not automatically end with the
                                                                                 referral to a doctor or medical spe-    return from a business trip.
                                     Coverage is also provided to a
                                     spouse/domestic partner and depen-          cialist, medical monitoring when
                                     dent child(ren) when accompanying           you are hospitalized, emergency         For More Information
                                     you on a business trip.                     medical evacuation to an adequate       Additional information including
                                                                                 facility, medically necessary           claim forms, frequently asked
                                                                                 repatriation and return of mortal
                                     How To Register                             remains.
                                                                                                                         questions, and a coverage
                                                                                                                         summary is available online
                                     This insurance coverage is provided
                                                                               • Personal Assistance including           (www.uctrips-insurance.org).
                                     at no cost to you, but you must
                                                                                 pre-trip referral information (such
                                     register to ensure coverage for each
                                                                                 as immunization requirements,
                                     business trip.
                                                                                 appropriate medical exams and
                                     You must register online (www.              treatments, passport and visa
                                     uctrips-insurance.org) all out-of-state     requirements, weather, health
                                     and foreign country business trips to       warnings and travel hazards) and
                                     ensure coverage. Coverage is auto-          while you are on a trip: emergency
                                     matic for business travel within the        medication, embassy and consular
                                     state and registration is not required      information, lost document assis-
                                     for those trips.                            tance, emergency message



                                     36
Other Insurance




                                                                                                                               Legal Plan
  Legal Plan

  Most people need legal advice at one       Court. Nor does it include disputes     • Reduced contingency fees: Capped
  time or another, but high legal fees       over real estate construction             at 25 percent for initial trial/
  often prevent them from getting the        matters for a new home or room            settlement and 30 percent for sub-
  necessary assistance.                      additions to and/or remodeling of         sequent appeal proceedings.
                                             an existing home (four-day trial
  UC offers a legal insurance plan that                                              Benefits are limited to one claim per
                                             limitation).
  gives you access to basic, personal                                                item per year, whether you have
  legal help. The plan provides access     • Limited defensive legal services        individual or family coverage, with
  to a toll-free telephone line and          include misdemeanor defense and         the exception of the attorney office
  covers specific legal services. These      felony charge advice.                   work, estate planning, wills, trust
  services are provided through ARAG                                                 benefits and telephone legal
                                           • Major trial representation includes
  at an annual cost roughly equal to the                                             services.
                                             trial representation beginning on
  average attorney rate of one or two
                                             the fourth day of trial in covered      See the ARAG legal plan booklet for
  hours in an attorney’s office.
                                             proceedings for which indemnity         plan limitations and exclusions.
  The legal insurance plan helps             benefits are being provided ($400
                                             per half day of trial time).
  mainly with routine preventive or                                                  Cost of Coverage
  defensive matters and should cover
                                           • Online law guide and document           Your monthly cost depends on your
  most basic legal needs. The chart
                                             library: The online law guide pro-      enrollment. Use the rate chart on the
  on page 38 explains what the plan
                                             vides comprehensive overviews of        At Your Service website (atyours-
  covers.
                                             the most common legal issues. The       ervice.ucop.edu) to determine your
                                             online document library includes        monthly premium. Select “Health &
  What the Plan Covers                       Do-It-Yourself Legal Documents™,        Welfare Benefits,” and “Legal Plan.”
  The legal plan helps you with pre-         which allow you to create your
                                             own legally valid documents.
  ventive, domestic, consumer, and                                                   How to Use the Plan
  defensive legal services.                • Identity theft services gives you       When you need legal help, your
  • Preventive legal services includes       toll-free access to an Identity Theft   first step is to call ARAG’s toll-free
    general legal advice, negotiation,       Case Manager, who will explain          number. You can also send them an
    document review and preparation,         identity theft and how to prevent       email or visit an attorney in person.
    preparation of wills and durable         it. If you become a victim of iden-     You can visit the ARAG Legal plan
    power of attorney. Often, a few          tity theft, you’ll receive personal     website to access the Law Guide
    minutes of legal advice can prevent      guidance, online guides, printed        and Do-It-Yourself Documents for a
    a small problem from becoming a          workbooks, risk assessment tools        variety of updated educational legal
    major one.                               and more.                               information.
  • Domestic legal services cover          • Reduced fees for non-covered            When you call ARAG, a Customer
    divorces, separations, adoptions,        matters: Receive at least 25 per-       Care Counselor will advise you on
    child support, child visitation, and     cent off an attorney’s normal rate      the services the plan will cover. A
    name changes.                            for most non-covered personal           claim form, a description of coverage,
                                             legal needs when using an attor-        and a current list of the plan’s Net-
  • Consumer services include legal          ney from ARAG’s Reduced Fee
    representation for the enforcement                                               work Attorneys can be sent to you.
                                             Network. Benefit is subject to plan
    of warranties or promises in             exclusions.                             These Network Attorneys have
    connection with the purchase of                                                  met the ARAG’s requirements and
    goods or services. This does not                                                 have agreed to provide the services
    include actions in Small Claims                                                                (continued on page 39)




                                                                                                atyourservice.ucop.edu    37
Legal Plan



                  What the Plan Covers
                  Benefits are limited to one claim per item per year, whether                any attorney you choose. For a list of Network Attorneys, a
                  you have individual or family coverage, with the exception                  claim form or a complete list of limitations and exclusions, log
                  of the attorney office work, estate planning, wills, trust                  on to http://members.araggroup.com/ucop or call an ARAG
                  benefits and telephone legal services. For the following                    Customer Care Counselor at 1-800-828-1395.
                  services, you may use an attorney from ARAG’s Network or

                                                                                                                           Network       Non-Network
                  Worldwide Coverage Per Family Each Calendar Year                                                         Attorney        Attorney
                  Attorney Office Work
                  Advice, negotiation and service for legal matters that are not listed as a covered benefit or          Up to 8 hours1      $560
                  exclusion under the plan. The benefit covers such matters as sale or purchase of a residence,
                  problems with a landlord, administrative hearings (e.g., Social Security, Medicare, and other
                  public benefits).
                  Simple wills and simple trusts (including Power of Attorney)2, 3                                         Fully paid         $175




                                                                                                                                                                              Dollar amounts shown are maximums at $70 per hour.
                  Codicils to wills, living wills 2, 3                                                                     Fully paid         $70
                  Durable Power of Attorney 2                                                                              Fully paid         $70
                  Domestic
                  Uncontested divorce (for self use only)                                                                  Fully paid        $525
                  Contested divorce (for self use only)                                                                    Fully paid        $700
                  Child support, visitation, and/or alimony in conjunction with a modification of divorce decree or        Fully paid        $280
                  a separation or annulment agreement
                  Child custody/child support not in conjunction with a modification of a divorce decree or a
                  separation or annulment agreement
                  • Legal services required for the creation of a child custody, child support, or visitation agreement    Fully paid        $245
                  • Modification/enforcement of an uncontested child custody, child support, or visitation agreement       Fully paid        $294
                  • Modification/enforcement of a contested child custody, child support, or visitation agreement          Fully paid        $490
                  Establishment of guardianship/conservatorship                                                            Fully paid        $420
                  Adoption proceedings4                                                                                    Fully paid        $420
                  Name change                                                                                              Fully paid        $280
                  Defensive
                  Criminal misdemeanor defense (except traffic violations)4                                                Fully paid        $700
                  Habeas Corpus proceedings                                                                                Fully paid        $420
                  Juvenile court hearings—if juvenile is covered dependent                                                 Fully paid        $490
                  Defense of a lawsuit for the collection of a debt based on a contract or other written instrument4       Fully paid        $630
                  Personal bankruptcy                                                                                      Fully paid        $560
                  Defense of traffic matter that will directly result in license suspension4                               Fully paid        $350
                  Defense against civil damage(s) claims: advice, negotiation and office work5                             Fully paid        $280
                  Defense against civil damage(s) claims including legal representation5                                   Fully paid       $3,1006
                  Consumer
                  Consumer protection (except for disputes over real estate/construction matters)4                         Fully paid        $350
                  IRS Coverages
                  IRS Collection Defense prior to trial                                                                     $1,800 7       $1,800 7
                  IRS Collection Defense Court representation at trial as a defendant                                       $1,200  7
                                                                                                                                           $1,200 7
                  IRS Audit Advice, consultation and negotiation                                                             $420 7
                                                                                                                                             $420 7
                  Representation at IRS Audit                                                                                $900 7
                                                                                                                                             $900 7
                  Major Trial Representation
                  Representation at trial beginning on the 4th day of trial ($400 per ½ day of trial time) in            Included with $100,0008
                  covered proceedings for which indemnity benefits are being provided.                                  Covered Benefits
             1
               The eight hours under attorney office work may be used for more involved trust matters and post-dissolution matters as a result of bifurcated dissolution.
             2
               Benefits for estate planning, wills, and trusts are limited to four claims per year.
             3
               In conjunction with this benefit, the eight hours allowed under the attorney office work may be used for more involved trust matters.
             4
               Four-day trial limitation.
             5
               Except claims involving motorized vehicle or claims which are covered by other insurance.
             6
               Trial Indemnity Benefits of $2,400 for up to three days of trial time are included in this amount ($400 per ½ day of trial time).
             7
               This is the annual maximum regardless of whether you are enrolled in self, self plus chid(ren), self plus adult, or self plus adult plus child(ren) coverage
             8
               This coverage is paid at a rate of $400 per ½ day of trial time.
             Insurance products are underwritten by ARAG Insurance Company of De Moines, Iowa: GuideOne™ Mutual Insurance Company of Wes Des
             Moines, Iowa, or GuideOne Specialty Mutual Insurance Company of West Des Moines, Iowa. Additional services may be provided by ARAG LLC or
             Advisory Communication Systems Inc. Some products are only available through membership in the ARAG Association LC.
             38
                                                                                                                             Legal Plan
described on page 38. Attorneys fees      For the services listed on the previ-      It is up to you and the attorney to
for most covered matters are paid         ous page, you may use an ARAG              decide how best to use the time
in full.                                  Network Attorney, or any attorney          available—in personal meetings
                                          you choose. For a list of Network          or by having the attorney review
This document is for illustrative
                                          Attorneys, a claim form, or a              documents or write letters for you.
purposes only and not a contract.
                                          complete list of limitations and           If you exceed the yearly allowance,
Insurance products are underwrit-
                                          exclusions, visit their website            you must arrange with the attorney
ten by ARAG® Insurance Company
                                          (members.araggroup.com/ucop) or            to pay for further services yourself.
of Des Moines, Iowa or GuideOne®
                                          call an ARAG Customer Care Coun-
Mutual Insurance Company of West                                                   • Specific covered services: The plan
                                          selor at 1-800-828-1395.
Des Moines, Iowa or GuideOne                                                         also covers services such as wills,
Specialty Mutual Insurance of West        The plan provides these types of           legal defense, domestic matters,
Des Moines, Iowa. Additional services     legal services:                            and consumer protection. See
may be provided by ARAG LLC, ARAG                                                    the chart on page 38 for a list of
                                          • Telephone legal services: For
Services LLC, or Advisory Communi-                                                   covered services.
                                            simple matters that can be handled
cation Systems Inc. Some products
                                            adequately by telephone, you may
are only available through member-
                                            call a telephone network attorney      For More Information
ship in the ARAG Association LC.
                                            who will either work with you over     This is only an overview of your legal
If you prefer, you may use a non-           the phone or recommend that you        insurance benefits. The insurance
network attorney of your choice,            meet with an attorney in person.       company’s plan booklet is available
anywhere in the world. The plan             Access to telephone network attor-     on the At Your Service website. You
pays at a rate of $70 an hour, up to        neys can help you get the most         may also visit ARAG’s website
the limits shown on page 38.                from the plan. By using this service   (members.araggroup.com/ucop) or
                                            whenever possible, you can keep        call ARAG at 1-800-828-1395,
You may use whatever source of legal
                                            other plan benefits available for      Monday–Friday, 9 a.m.–5 p.m, PT.
assistance is appropriate in a particu-
                                            more serious matters.                  Once you enroll, the insurance carrier
lar situation. You are not restricted
to a specific attorney. For example,      • Attorney office work for advice and    will send you more information.
you can use a Network Attorney for          counseling: The plan pays for up to
one matter, then choose any other           eight hours a year when you use a
attorney for another. The plan does         Network Attorney. If you use a non-
not cover legal work in progress at         network attorney, the plan pays
the time you enroll.                        a rate of $70 an hour, up to $560
                                            a year. Once the attorney begins
Before consulting any attorney, be
                                            working for you, the plan begins to
sure to call ARAG. Doing so is the
                                            pay benefits.
best way to be sure the plan serves
you to your best advantage.




                                                                                             atyourservice.ucop.edu    39
40
Tax-Savings Programs




                                                                                                                              Health Care Reimbursement Account (HCRA)
  Health Care Reimbursement
  Account (HCRA)

  The Health Care Reimbursement             Eligible Expenses                        care expenses are not clearly eligible
  Account (HCRA) allows you to pay                                                   according to the IRC, you will not
                                            Eligible expenses include copay-
  for eligible out-of-pocket health                                                  be reimbursed for these expenses
                                            ments and deductibles (but not
  care expenses on a pretax, salary                                                  and you will be asked to submit
                                            premiums), prescription drugs,
  reduction basis. The program is                                                    additional information. For more
                                            orthodontia, eyeglasses, laser eye
  established under Internal Revenue                                                 information about eligible and
                                            surgery, and other expenses incurred
  Code (IRC) §105.                                                                   ineligible expenses, see UC’s Health
                                            for health care that are not reim-
                                                                                     Care Reimbursement Summary Plan
                                            bursed by your medical, dental, or
  How the Plan Works                        vision plan.
                                                                                     Description or the SHPS website
                                                                                     (myshps.com).
  You determine the annual amount of        You can pay for expenses from the
  your contributions from a minimum                                                  Note: Expenses reimbursed under the
                                            HCRA for yourself, your legal spouse,
  of $180 to a maximum of $5,000.                                                    Health Care Reimbursement Account
                                            or anyone else you claim as a depen-
  Each month, an equal portion of that                                               may not be deducted on your income
                                            dent on your federal income tax
  amount is deducted from your pay-                                                  tax form.
                                            return.
  check and is credited to your account
                                            Health care expenses must meet the
  before federal, state, and Social                                                  Contribution Limits and
  Security (FICA) taxes are taken out.      requirements of IRC §213(d) in order
                                            to be eligible for reimbursement.        Forfeiture Rules
  When you, your legal spouse, or           However, note that while an expense      You may contribute up to $5,000
  eligible dependents have eligible         listed there may be an eligible tax      (minimum of $180) annually to your
  expenses, you pay them from your          deduction, it may not be an eligible     HCRA. If you and your spouse are UC
  account. Your savings are strictly on     expense under HCRA (for example,         employees, you may each contribute
  taxes and depend on your particular       insurance premiums).                     up to $5,000.
  tax situation. See Internal Revenue
  Service (IRS) Publication 502, Medi-      Expenses must be incurred between        Be sure to estimate your expenses
  cal and Dental Expenses (irs.gov), or     January 1, 2008 through March 15,        carefully before enrolling. Once
  consult your tax advisor for additional   2009 in order to be eligible for         elected, you cannot change the
  details. Please note that UC cannot       reimbursement. Expenses incurred         amount of your contribution due
  provide tax advice.                       after your HCRA participation ends       to miscalculating your anticipated
                                            are not eligible for reimbursement. If   expenses, or to misunderstanding
  Participants have a spending account      you enroll mid-year, expenses            what expenses are eligible. The
  card that can be used for eligible        incurred before your effective date      IRS requires that you forfeit any
  health care expenses at approved          are not eligible for reimbursement.      unclaimed funds in your account
  health care merchants. This means         Note: The effective date is the first    after the closing date for the plan
  that you won’t have to pay cash up        of the month following your              year.
  front for those expenses or file claim    enrollment, subject to payroll
  forms for reimbursement from your                                                  SHPS must receive claims for 2008
                                            deadlines.                               eligible expenses by June 15,
  account. Instead, the amounts will
  be automatically deducted from your       Please be aware that expenses            2009, in order to reimburse the
  account. Use of the card is optional;     submitted for reimbursement will         expenses.
  paper form reimbursement is also an       be carefully evaluated against the
  option.                                   IRC requirements for eligible and
                                            ineligible expenses. If your health




                                                                                                atyourservice.ucop.edu   41
Health Care Reimbursement Account (HCRA)



                                           Enrollment and Change                       employment status change during         For More Information
                                                                                       the plan year, the IRC rules require
                                           in Participation                            that your contributions stay the same
                                                                                                                               This is only an overview of the HCRA
                                           You may enroll when you first                                                       program. Be sure to review the
                                                                                       and you cannot cancel participation.
                                           become eligible, during your period                                                 Health Care Reimbursement Account
                                           of initial eligibility (PIE), during Open   If you leave UC, cancel HCRA, or do     Summary Plan Description (available
                                           Enrollment, or when you have an             not re-enroll during Open Enrollment,   on the At Your Service website under
                                           eligible change in family or employ-        you participation terminates at the     “Forms & Publications” and from
                                           ment status. You may also enroll,           end of the pay period in which your     your Benefits Office) for plan details.
                                           change your contribution or cancel          last contribution is deducted from      HCRA information is also available
                                           participation during a new 31-day           your pay. You may use the spending      on the At Your Service website under
                                           PIE caused by an eligible change in         account card or submit claims for       “Health & Welfare Benefits.”
                                           family or employment status. See the        eligible expenses incurred through
                                           Health Care Reimbursement Account           the last day of the pay period for
                                           Summary Plan Description for more           which a contribution was made. See
                                           details. Mid-year changes must be on        the Health Care Reimbursement
                                           account of and consistent with the          Account Summary Plan Description
                                           change in status. Enrollments and           for additional details.
                                           changes in contributions take effect
                                           on the first of the month following         Plan Administration
                                           the action taken, subject to payroll        Claims processing and reimburse-
                                           deadlines.                                  ment are handled exclusively by
                                           Your enrollment is for the current          SHPS. For more information on HCRA
                                           plan year (January 1 through Decem-         administration, contact SHPS
                                           ber 31) only, ending on December            (1-877-270-3915 or myshps.com).
                                           31 of each year. To participate the         The Flexible Spending Account (FSA)
                                           following year, you must re-enroll          Calculator on the SHPS website will
                                           during Open Enrollment. Unless              help you estimate your tax savings
                                           you have an eligible family or              (myshps.com).




                                           42
                                                                                                                            Dependent Care Reimbursement Account (DepCare)
Dependent Care Reimbursement
Account (DepCare)

DepCare allows you to pay for           Dependent care must be necessary          Contribution Limits and
certain dependent care expenses         so that you, or you and your spouse,
on a pretax, salary reduction basis.    can work or look for work (you must
                                                                                  Forfeituture Rules
Dependents can be either children or    have work income during the year).        You determine how much you want
adults (see “Who is Eligible”).                                                   taken from your monthly pay, from a
                                        If care is provided in a day care         minimum of $180 per year up to the
                                        center, the center must charge a fee.     lesser of:
How the Plan Works                      If the center cares for six or more
                                        children who are not residents, it        • $5,000 per plan year ($2,500 if
The amount you specify is taken
                                        must comply with all state and local        you are married and filing a
from your paycheck each month and
                                        licensing laws and applicable               separate income tax return);
deposited in your DepCare account.
                                        regulations.                              • Your total earned income; or
After you incur eligible dependent
care expenses, you submit a claim       Expenses must be incurred between         • Your spouse’s total earned income.
form and receipts for these expenses    January 1, 2008 through March 15,
                                        2009 in order to be eligible for          If your spouse is incapable of self-
to SHPS, the company UC has hired
                                        reimbursement. Expenses incurred          care or is a full-time student, his or
to administer the program. SHPS
                                        after your DepCare participation ends     her earned income is considered to
reimburses you for your expenses
                                        are also not eligible for reimburse-      be at least $250 per month ($3,000
through an automatic deposit to your
                                        ment. If you enroll midyear, expenses     per year) if you claim one dependent
bank or by check.
                                        incurred before your effective date       or at least $500 per month ($6,000
Your savings are strictly on taxes.     are not eligible. Note: The effective     per year) if you claim two or more
DepCare contributions are deducted      date is the first of the month            dependents.
from your paycheck on a tax-free        following your enrollment, subject        If your spouse has no earned
basis—before federal, state, and        to payroll deadlines.                     income, is capable of self-care, and
Social Security (FICA) taxes are
                                        Please be aware that expenses             is not a full-time student, you may
taken out. This reduces your taxable
                                        submitted for reimbursement will be       not contribute to DepCare.
earnings and, therefore, the amount
of taxes you pay. Your savings will     carefully evaluated against the IRC       If your spouse is also eligible to par-
depend on your particular tax           requirements for eligible and ineli-      ticipate in UC’s or another employer’s
situation.                              gible expenses. If your dependent         dependent care assistance plan, your
                                        care expenses are not clearly eligible    combined contributions should not
Your enrollment is for one year at a    according to the IRC, you will not        exceed the above maximums.
time and ends on December 31 of         be reimbursed for these expenses
each year. To participate the follow-                                             Be sure to estimate your DepCare
                                        and you will be asked to submit
ing year, you must re-enroll during                                               expenses carefully. Once elected,
                                        additional information. In some
Open Enrollment.                                                                  you cannot change the amount of
                                        cases, you may need a tax advisor’s
                                                                                  your contribution due to miscalculat-
                                        statement certifying the eligibility of
                                                                                  ing your anticipated expenses, or to
Eligible Expenses                       the expense.
                                                                                  misunderstanding what expenses are
Dependent care expenses must meet       For more details about eligible           eligible. The IRS requires that you
the requirements of Internal Revenue    and ineligible expenses, see UC’s         forfeit any unclaimed funds in your
Code (IRC) §21 and §129 to be           DepCare Summary Plan Description          DepCare account after the closing
eligible for DepCare reimbursement.     and IRS Publication 503, Child and        date for the plan year.
However, note that while an expense     Dependent Care Expenses (available
                                                                                  SHPS must receive claims
listed there may be an eligible tax     on the IRS website at irs.gov).
                                                                                  for 2008 eligible expenses by
deduction, it may not be an eligible                                              June 15, 2009, in order to
expense under DepCare.                                                            reimburse the expenses.




                                                                                             atyourservice.ucop.edu   43
Dependent Care Reimbursement Account (DepCare)



                                                 Any payment from DepCare reduces,             physically or mentally incapable of       Plan Administration
                                                 dollar for dollar, the expenses eligible      self-care, and whom you claim as a
                                                                                                                                         Claims processing and reimburse-
                                                 for the dependent care tax credit.            dependent on your tax return.
                                                                                                                                         ment are handled exclusively by
                                                 Your savings will depend on your            If care is provided outside the home        SHPS. For more information on
                                                 particular tax situation. Please note       for a spouse or a family member             DepCare administration, contact
                                                 that in some situations, you may save       age 13 or older, either of whom is          SHPS (1-877-270-3915 or myshps.
                                                 more money using the dependent              incapable of self-care, the spouse          com).
                                                 care tax credit. See the DepCare            or family member must live in your
                                                 Summary Plan Description for a gen-         home at least eight hours each day.
                                                                                                                                         For More Information
                                                 eral comparison of DepCare versus
                                                                                                                                         This is only an overview of the
                                                 the federal tax credit.                     Enrollment and Change                       DepCare program. Be sure to review
                                                 You should carefully consider your          in Participation                            the DepCare Summary Plan Descrip-
                                                 participation in this program in                                                        tion (available on the At Your Service
                                                                                             You may enroll when you first
                                                 relation to your tax savings and the                                                    website under “Forms & Publications”
                                                                                             become eligible, during your period
                                                 possible effect on your other ben-                                                      and from your Benefits Office) for
                                                                                             of initial eligibility (PIE), during Open
                                                 efits. DepCare contributions may                                                        plan details and penalties. DepCare
                                                                                             Enrollment, or when you have an
                                                 also reduce your earnings for Social        eligible change in family or employ-        information is also available on
                                                 Security and unemployment benefits.         ment status. You may also enroll,           the At Your Service website under
                                                 If you need specific advice about           change your contribution or cancel          “Health & Welfare Benefits.”
                                                 how DepCare applies to your tax             participation during a new 31-day
                                                 situation, please consult a tax             PIE caused by an eligible change in
                                                 advisor.                                    family or employment status. See the
                                                                                             DepCare Summary Plan Description
                                                 Who is Eligible                             for more details. Mid-year changes
                                                 You are eligible to participate in          must be on account of and consistent
                                                 DepCare if:                                 with the change in status. Enroll-
                                                                                             ments and changes in contributions
                                                 • You are eligible for the Full,            take effect on the first of the month
                                                   Mid-level, or Core benefits               following the action taken, subject to
                                                   package (see page 3).                     payroll deadlines.
                                                 • You are married and both you and          Unless you have an eligible family
                                                   your spouse have earned income            or employment status change during
                                                   during the year (unless your spouse       the plan year, the IRC rules require
                                                   is incapable of self-care or is a full-   that your contributions stay the same
                                                   time student).                            and you cannot cancel participation.
                                                                                             See the Dependent Care Reimburse-
                                                 Eligible Dependents                         ment Account Summary Plan
                                                 You may use your DepCare account to         Description for additional details.
                                                 pay for eligible expenses for the fol-
                                                                                             If you leave UC, cancel DepCare or
                                                 lowing eligible family members:
                                                                                             do not re-enroll during Open Enroll-
                                                 • A child under age 13 in your              ment, your participation terminates
                                                   custody whom you claim as a               at the end of the pay period in which
                                                   dependent on your tax return;             your last contribution is deducted
                                                 • A spouse who is physically or men-        from your paycheck. You may submit
                                                   tally incapable of self-care; and         claims for eligible expenses incurred
                                                                                             through the last day of the pay
                                                 • A dependent who lives with                period for which a contribution
                                                   you—such as a child over age 13,          was made.
                                                   parent, sibling, or in-law—who is




                                                 44
                                                                                                                               Tax Savings on Insurance Premiums (TIP)
Tax Savings on Insurance
Premiums (TIP)

The Tax Savings on Insurance               family members who are your               set forth in the Internal Revenue
Premiums (TIP) program allows you          tax dependents: Adult dependent           Code. See the Tax Savings on Insur-
to pay your medical, dental, or vision     relative, Natural or adopted child,       ance Premiums (TIP) Summary Plan
plan employee monthly cost—if any—         Stepchild, Legal ward, Other child,       Description for more details. If you
on a pretax, salary reduction basis.       Disabled child, Grandchild or step-       are participating in TIP and make a
                                           grandchild.                               change to your health plan due to
How the Plan Works                         In general, you may not use TIP
                                                                                     an eligible change in employment
                                                                                     or family status, your TIP amount
If you enroll in a health plan that        to pay the out-of-pocket premium
                                                                                     will adjust automatically. At all other
requires you to pay an employee            cost for medical coverage for your
                                                                                     times, IRC rules require that your
monthly cost, you are automatically        family members who are not your tax
                                                                                     TIP salary reduction amount stay the
enrolled in TIP. Each month your           dependents; for example, a natural or
                                                                                     same despite increases or decreases
taxable earnings are reduced by the        adopted child, domestic partner, your
                                                                                     in your net premiums.
amount of your premium.                    partner’s child/grandchild and/or
                                           your disabled child past age 23.
Your savings are strictly on taxes. TIP
                                           Monthly costs for these individuals       Participation Can End
funds are deducted from your pay on
                                           must be paid on an after-tax basis.       If you want to cancel your TIP par-
a tax-free basis—before federal, state,
                                           Exception: If you have registered         ticipation, IRC rules require you to
and Social Security (FICA) taxes are
                                           your domestic partnership with the        do so during your PIE, during Open
taken out. This reduces your taxable
                                           State of California and have submit-      Enrollment, or during an additional
earnings and, therefore, the amount
                                           ted UC’s form UPAY 850 indicating         PIE caused by an eligible change in
of taxes you pay. Your savings
                                           such registration and the filing date,    employment or family status. If you
will depend on your particular tax
                                           any out-of-pocket premium cost for        cancel at any other time, penalties
situation.
                                           medical coverage for your partner         may apply.
                                           and/or your partner’s child/grand-
Cost of Participation                      child is deducted from pay on a
                                                                                     TIP participation ends if certain
                                                                                     employment actions occur. For
You should carefully consider your         pretax basis for California income        example, if you go on leave without
participation in this program in rela-     tax purposes only. For federal tax        pay or reduce your appointment rate,
tion to your tax savings and the           purposes, the out-of-pocket premium       your participation in TIP automati-
possible effect on your other benefits.    cost must still be paid on an after-tax   cally ends.
TIP contributions may also reduce          basis. If these family members are
your earnings for Social Security and      your tax dependents, any necessary
unemployment benefits. Please con-         adjustments will be made at the end
                                                                                     For More Information
sult a tax advisor about how TIP           of the year when you respond to UC’s      This is only an overview of the TIP
applies to your particular tax             annual tax dependency mailing. You        program. Be sure to review the Tax
situation.                                 may be able to recover excess federal     Savings on Insurance Premiums (TIP)
                                           or California State income tax            Summary Plan Description (available
Who Is Eligible                            withheld when filing tax returns.         on the At Your Service website under
                                                                                     “Forms & Publications” and from your
You are eligible to participate if you                                               Benefits Office) for plan details.
are eligible for the Full, Mid-level, or   Change in Participation
Core benefits package (see page 3).        TIP salary reductions can be changed
In addition to any cost for yourself,      only during your PIE, during Open
you may pay the health plan monthly        Enrollment, or during an additional
costs through TIP for your spouse          PIE caused by an eligible change
and for the following eligible             in employment or family status as




                                                                                                atyourservice.ucop.edu    45
By authority of the Regents, University of California Human Resources and Benefits, located in Oakland, administers all benefit plans
in accordance with applicable plan documents and regulations, custodial agreements, University of California Group Insurance
Regulations, group insurance contracts, and state and federal laws. No person is authorized to provide benefits information not
contained in these source documents, and information not contained in these source documents cannot be relied upon as having
been authorized by the Regents. Source documents are available for inspection upon request (1-800-888-8267). What is written
here does not constitute a guarantee of plan coverage or benefits—particular rules and eligibility requirements must be met before
benefits can be received. The University of California intends to continue the benefits described here indefinitely; however, the
benefits of all employees, retirees, and plan beneficiaries are subject to change or termination at the time of contract renewal or at
any other time by the University or other governing authorities. The University also reserves the right to determine new premiums,
employer contributions and monthly costs at any time. Health and welfare benefits are not accrued or vested benefit entitlements.
UC’s contribution toward the monthly cost of the coverage is determined by UC and may change or stop altogether, and may be
affected by the state of California’s annual budget appropriation. If you belong to an exclusively represented bargaining unit, some
of your benefits may differ from the ones described here. Contact your Human Resources Office for more information.

The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) provides for continued coverage for a certain period of time
at applicable monthly COBRA rates if you, your spouse, or your dependents lose group medical, dental, or vision coverage because
you terminate employment (for reasons other than gross misconduct); your work hours are reduced below the eligible status for
these benefits; you die, divorce, or are legally separated; or a child ceases to be an eligible dependent. Note: The continuation
period is calculated from the earliest of these qualifying events and runs concurrently with any other UC options for continued
coverage. See your Benefits Representative for more information.

In conformance with applicable law and University policy, the University is an affirmative action/equal opportunity employer.
Please send inquiries regarding the University’s affirmative action and equal opportunity policies for staff to Director of Diversity
and Employee Programs, University of California Office of the President, 300 Lakeside Drive, Oakland, CA 94612 and for faculty to
Director of Academic Affirmative Action, University of California Office of the President, 1111 Franklin Street, Oakland, CA 94607.


Website address: atyourservice.ucop.edu


                University of California
                Human Resources and Benefits
                P.O. Box 24570
                Oakland, CA 94623-1570
27M                                                                                                                      2001   W3/20/08
2001   W3/20/08