To meet the varied needs of its employees, the University offers a
comprehensive and competitive health and welfare benefits program that includes medical,
dental, vision, life and accident, disability and legal insurance.
UC Group Insurance Regulations DO NOT permit dual coverage. An employee may be covered as an employee or annuitant OR as an eligible family member of a UC employee or annuitant. They may NOT be covered as both. If the employee has medical, dental, or vision coverage as an eligible family member and then becomes eligible for UC coverage as an employee, there are two options:
If both parents are UC employees or annuitants, only ONE parent may cover the children.
Family members (EFM’s) are eligible for coverage on UC group insurance plans as long as they meet the requirements shown on Chart 4.C.
Below are the two screens in the Benefits Bundle: BENE.
PPEINS0-E1440 EDB Entry/Update 12/18/YY 11:41:09
12/13/YY 23:41:35 Insurance Enrollment Userid: ABCDE
ID: 121212121 Name: EXAMPLE,IMA Pri Pay: MO
Assigned BELI: Derived BELI: Effective Date:
BELI Status Qualifiers: Primary: Date: Secondary: Date:
CURRENT ENROLLMENTS
Plan Cov Eff Date End Date Opt Out BRSC
Medical HN UA 0701YY
Dental D1 UA 0701YY
Vision VI UA 0701YY
Legal
Future Enrollment Pending: NO State Dom Part Dec: Contribution Base: 42
Cov Eff Date BRSC
AD&D Prin Sum: 100 Coverage : S 0715YY
Disability Wait Per: 030 Salary Base: 3179 0401YY
Supplemental Life : 1 Salary Base: 39 0701YY
Dependent Life Plan:
Basic Life : Salary Base: 039 0701YY
Insurance Reduction Code :
Next Func: ID: Name: SSN:
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The EINS - Insurance Enrollment Screen (above) is used to enroll, change, or cancel an eligible employee in University benefits.
The EDEP - Dependent Data Screen (below) is used to enroll, change, or cancel an eligible dependent's benefits.
PPEDEP0-E1281 EDB Entry/Update 07/02/YY 12:01:44
07/01/YY 23:42:39 Dependent Data Userid: ABCDE
ID: 121212121 Name: EXAMPLE,IMA Pri Pay: MO
Pg 1 of 1
Dependent Name Deenrol Birth Coverage Effective/End Dates
No Relationship Sex SSN CTL Date Medical Dental Vision Legal
51 EXAMPLE,ASA N 081260 0701YY 0701YY 0701YY
S SPOUSE M 212121212
Next Func: ID: Name: SSN:
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E 5.1 (a) How to Enroll Employee in Health and Welfare
Plans
All enrollments have to be processed during the PIE - Period of Initial Eligibility, which is the first 31 days from the Eligibility date.
Encourage employees to use the website http://atyourservice.ucop.edu for enrollment!
*Any Level of coverage is available during PIE ONLY. Enrollment outside of PIE requires a ‘Statement Of Health’ approval from the insurance carrier. Such enrollment is processed in the Central Benefits Office.
**Salary Base - EDB should have already derived the monthly and annual salary base from information on the appointment screen. If this base does not appear, or if it is incorrect, please contact your Central Benefits Office.
E5.1 (b) How to Cancel Health and Welfare Coverage
*COBRA Packet & UBEN 102 available at: http://atyourservice.ucop.edu/forms_pubs/subject/cobra.html
E5.1(c) How to Enroll Dependents
For example: =,Michael E
E 5.1(d) How to Cancel Health & Welfare Coverage for Dependents
*COBRA Packet & UBEN 102 available at : http://atyourservice.ucop.edu/forms_pubs/subject/cobra.html
E5.2 New Hire Enrollment Procedure
To enroll in benefit plans, the newly hired employee should go to the UCOP website at http://atyourservice.ucop.edu.
E5.2(a) Initial Hire Data
EDB preparers must do the following before the employee can use the website to enroll:
E5.2(b) Steps in the New Hire Website Enrollment Process
NOTE: The website is available seven days a week, 24 hours a day.
Tasks for the Departmental EDB Preparer:
The employee’s choices are automatically registered, and the information downloaded into the Personnel/Payroll System (PPS). However, the insurance carriers will not receive the enrollment information until 30 days from the date of enrollment. Employees should allow 30 days before making an appointment to see a doctor. If a visit to a doctor is necessary before the 30 day period is completed, contact the appropriate Central Benefits Office to expedite the update.
E5.2(c) Documents to Employees
The EDB preparer should give the Employee three IDOC’s:
NOTE: The PIE end date is 31 days from the date of hire (calculated from the most recent hire date).
E5.2(d) Limitations
E5.2(e) New Hire Enrollments Requiring a Form and EDB Update by Preparers
The following transactions should be entered on the EDB directly by the department representative/EDB preparer. The UPAY850 On-line Enrollment, Change & Cancellation form should be completed, signed, and sent to the appropriate Central Benefits Office within PIE (Period of Initial Eligibility).
E5.2(f) Enrollments Requiring a Form and EDB update by the Central Benefits Office
The Central Benefits Office will process enrollment in the EDB for:
The employees should submit the UPAY850 enrollment form attached to the required documentation to the appropriate Central Benefits Office during the PIE.
The UC offers eligible employees a choice of one fee-for-service plan -- Core, three health maintenance organizations (HMOs) -- Kaiser, Health Net, PacifiCare, one point-of-service plan -- Blue Cross Plus, and one Preferred Provider Plan - Blue Cross PPO.
| For MEDICAL eligibility and enrollment criteria,
please refer to
Chart 4.A. For PIE criteria, please refer to Chart 4.B. |
The medical Plan Code is a two-character field that identifies the
medical plans offered by UC. Use this code in the "Plan" field along with
an entry in "Coverage Effective Date" (see below) for enrollments:
CM Core Medical HN Health Net KS Kaiser Permanente (South) FP PacifiCare KN Kaiser Permanente (North) BC Blue Cross Plus KU Kaiser Umbrella (Out of California) BP Blue Cross PPO KW Kaiser Mid Atlantic BH High Option* *HIGH OPTION (BH) IS NOT AVAILABLE TO NEW HIRES.
The University provides a choice of two dental plans for its eligible employees. Delta Dental provides worldwide coverage from any dentist. Delta will pay a maximum of $1,500 per person in a calendar year.
The PMI Dental Health Plan is a prepaid dental service requiring members to use a PMI dentist.
| For
DENTAL eligibility and enrollment criteria,
please refer to
Chart 4.A. For PIE criteria, please refer to Chart 4.B. |
The Dental Plan code is a two-character field that indicates the dental
plans offered by UC in which employees, and any eligible family members, may be
enrolled:
D1 Delta Dental Service D3 PMI
UC provides a comprehensive Vision Services Plan (VSP). Benefits include one vision examination and one set of corrective lenses or contact lenses every calendar year, one set of frames every two years. There are limitations on the amount that can be spent on each of these items.
| For
VISION eligibility and enrollment criteria,
please refer to
Chart 4.A. For PIE criteria, please refer to Chart 4.B. |
This is a two-character code that identifies the Vision plan that UC
offers:
VI Vision Service Plan
E5.6 Coverage Levels for Medical, Dental and Vision Plans
The coverage level is identified by a system-derived code of up to three characters based on the number of dependents (if any) who will be entered on the EDEP screen. The codes are:
U Employee only UA Employee and another Adult UC Employee and child/children UAC Employee and Family
E5.6(a) Coverage Effective Date
The "COV EFF DATE" is a six-digit number that indicates the effective date for the current insurance plan and coverage level.
NOTE: This date is normally derived from the EAPP screen based on the appointment or change in status date (the BELI effective date).
E5.7 Default Plan Enrollment for Medical, Dental and Vision ONLY
By assigning a BELI 1, 2, 3, or 4, the department is automatically enrolling employee in the following default coverage (s):
| ASSIGNED BELI # | DEFAULT COVERAGE |
| 1 | Core Medical, Delta Dental, Vision Plan – Employee ONLY |
| 2 | Core Medical – Employee ONLY |
| 3 | Core Medical – Employee ONLY |
| 4 | Core Medical – Employee ONLY |
Due to Consolidated billing, premiums for the default coverage are charged to
the department ledger automatically. Consequently, the department will be
responsible for premium payments even if they make a mistake with the assigned
BELI. (No refunds for payments incurred beyond 60 days). To prevent unnecessary
charges to the department, it is imperative to find out if the employee wants to
keep the default coverage. If:
YES - ask: are there eligible family members? If so, have the employee enroll on the web or follow instructions in Section 5.1(c): ‘How to Enroll Dependant Coverage’.
NO - ask the employee to Opt out on the web or Opt him/her out manually following the instructions below (Again: this will save money to your department)!!
E5.8 How to Opt Out of Default Coverage
NOTE: The Opt out function should be used during the first 31-day Period of Initial Eligibility – PIE ONLY. If it’s passed the first 31-day PIE, refer to Section E5.1(b): ‘How to Cancel Health & Welfare Coverage’.
E5.9 Cancellation of Previous Opt-Out Function
To cancel a previous "Opt Out" the employee must show an involuntary loss of coverage within 31 days of when the coverage is lost (e.g.: an employee was covered by a spouse’s medical, dental, or vision plan and the spouse involuntarily loses coverage, the employee has 31 days from the date the coverage ends to cancel the "Opt Out" and to enroll in University-sponsored plans.)
To Opt Back In (refer to Section E5.1(a) for more information) :
NOTE: If the 31 day period from the qualifying event date is missed, the next opportunity to enroll in Medical, Dental, and Vision plans is during Open Enrollment in November with coverage effective January 1 of the following year. Or, request 90-day late enrollment for Medical only.
The University offers a prepaid legal expense insurance plan that gives employees access to basic, personal legal assistance. The plan provides unlimited access to a toll-free telephone line and covers specific legal services. These services are provided through ARAG at an annual cost roughly equal to one or two hours in an attorney’s office.
| For
LEGAL
eligibility and enrollment criteria,
please refer to
Chart 4.A. For PIE criteria, please refer to Chart 4.B. |
E5.10(a) Legal Plan
This is a two-character code that identifies the Legal plan that UC offers:
J2 ARAG Legal Plan
E5.10(b) Coverage Levels for Legal Plan
The coverage level is identified by a system-derived code of up to three characters based on the number of enrolled dependents (if any) who will be entered on the EDEP screen. The codes are:
U Employee only UA Employee and another Adult UC Employee and child/children UAC Employee and Family
NOTE: There is no "Employee and Another Adult" or "Employee and Child/Children" category for Legal coverage. If Employee and just another member, the system will derive "UAC"=Family coverage.
E5.10(c) Coverage Effective Date
The "COV EFF DATE" is a six-digit number that indicates the effective date for the current coverage level. Enter as MMDDYY.
E5.11 Accidental Death and Dismemberment (AD&D) Plan
The University offers the accidental death and dismemberment (AD&D) plan to help protect employees and their families from the unforeseen financial hardship of an accident. The plan is administered by American Home Assurance.
For Beneficiary forms see Section E2.13.
| For AD&D eligibility and enrollment criteria, please refer to Chart 4.A. |
E5.11(a) Principal Sum
The "Prin Sum" is a three-digit code that indicates the amount of Accidental Death and Dismemberment (AD&D) insurance coverage that the employee has selected.
Code Dollar
AmountCode Dollar
AmountCode Dollar
Amount010 $ 10,000 070 $ 70,000 150 $ 150,000 020 20,000 080 80,000 175 175,000 030 30,000 090 90,000 200 200,000 040 40,000 100 100,000 300 300,000 050 50,000 125 125,000 400 400,000 060 60,000 500 500,000
E5.11(b) AD&D Coverage Code
This is a one-character code for the AD&D coverage level selected by the employee:
S Single-party coverage -- employee only F Family coverage -- employee and spouse OR employee, spouse and children M Modified family coverage -- employee and eligible child(ren)
NOTE: If both the husband and wife are eligible employees of the University, only one employee may elect to cover the eligible children. (Coverage is offered at a modified rate under these circumstances.)
E5.11(c) Coverage Effective Date
This is a six-digit number that indicates the effective date of AD&D coverage. The effective date of coverage is the date the information is keyed into the system (e.g., if the data entry date is 3/3/05, the effective date is 3/3/05).
E5.12 Supplemental Disability Plan
| For
SUPPLEMENTAL DISABILITY
eligibility and enrollment criteria,
please refer to
Chart 4.A. For PIE criteria, please refer to Chart 4.B. |
E5.12(a) Disability Waiting Period
This is a three-digit code that indicates the number of calendar days the employee has chosen as the waiting period after the disability begins, but before Supplemental Disability benefits kick in:
007 Seven Days 030 Thirty Days 090 Ninety Days 180 One Hundred Eighty Days
Note: The Short Term and Supplemental Disability insurance plans require that participants use their sick hours up to 176 hours or 22 work days regardless of the waiting period they have chosen. This means that employees who select a 7-day waiting period but have 176 or more earned sick hours are paying an increased premium for the lower waiting period but will not be able to start disability benefits until after the use of the required minimum number of sick hours. These participants may wish to consider changing the waiting period to 30 or 90 days. This will decrease their monthly premium.
E5.12(b) Salary Base
This is a system-derived five-digit code that indicates the employee’s full-time (even if the position is part-time) monthly equivalent salary rate (rounded up to the nearest dollar) of covered compensation, which will be used to compute premiums.
NOTE: When calculating the monthly salary base, do NOT include special pay such as overtime and any compensation beyond the maximum of $14,286 per month. However, the highest paid Shift Differential should be included in these calculations.
DO NOT manually adjust the salary base due to increase/decrease in salary. The salary base will be adjusted automatically every January 1.
E5.12(c) Coverage Effective Date
This is a six-digit number that indicates the effective date of Supplemental Disability coverage (i.e., first date of eligibility). For an increase in waiting period, the effective date is the first day of the month following the month in which the increase is processed. For example, a change to increase the waiting period processed online on 03/15/YY will be effective "0401YY".
E5.13 Supplemental Life Insurance Plan
UC automatically provides basic life insurance coverage to all eligible employees. Employees may also purchase additional life insurance (up to four times the employee’s annual salary with a maximum of $1 million) at special group rates.
For Beneficiary forms see Section E2.13.
| For
SUPPLEMENTAL LIFE INSURANCE
eligibility and enrollment criteria,
please refer to
Chart 4.A. For PIE criteria, please refer to Chart 4.B. |
The Supplemental Life Insurance plan code is a one-character field
that indicates the amount of life insurance coverage elected by the employee:
1 one times the annual salary 2 two times the annual salary 3 three times the annual salary 4 four times the annual salary F $20,000 (flat)
E5.13(a) Salary Base
This is a system-derived three-digit code that indicates the employee’s full-time annual salary rate (rounded up to the nearest thousand) as of the most recent January 1 or hire date.
NOTE: DO NOT manually adjust the salary base to reflect an increase/decrease in salary base. Rates and benefit premiums will be automatically adjusted every January along with the annual salary base.
DO NOT key in a salary base for Flat Life Insurance.
E5.13(b) Coverage Effective Date
The "COV EFF DATE" is a six-digit number that indicates the effective date of Supplemental Life insurance coverage.
E5.14 Basic/Expanded Dependent Life Insurance Plan
UC offers two dependent life insurance plans. The basic plan covers the spouse and eligible children for $5,000 each. The expanded plan covers the spouse for an amount equal to 50% of the supplemental life insurance amount (coverage is limited to $200,000) and each eligible child is covered for $10,000.
| For
BASIC/EXPANDED DEPENDENT LIFE INSURANCE
eligibility and enrollment criteria,
please refer to
Chart 4.A. For PIE criteria, please refer to Chart 4.B. |
E5.14(a) Basic/Expanded Dependent Life Plan Code
The Basic/Expanded Dependent Life Plan code is a one-character field that identifies the dependent life insurance plan coverage (if any) elected by the employee.
Y Basic Plan S Expanded dependent life, spouse or same sex domestic partner only B Expanded dependent life, spouse or same sex domestic partner and child(ren) C Expanded dependent life, child(ren)
E5.14(b) Coverage Effective Date
The "COV EFF DATE" is a six-digit number that indicates the effective date of Dependent Life insurance coverage.
UC automatically provides group term life insurance coverage to all eligible employees. The two UC-paid plans are: Basic Life (which provides life insurance equal to the employee’s base salary, up to $50,000) and Core Life (which provides $5,000 of life insurance). Eligibility for either plan is based on the appointment rate and average regular paid time.
| For
BASIC LIFE INSURANCE
eligibility and enrollment criteria,
please refer to
Chart 4.A. For PIE criteria, please refer to Chart 4.B. |
E5.15(a) Basic Life Insurance Salary Base
This is a system-derived code that indicates the employee’s annual salary (rounded UP to the nearest thousand) with a maximum of $50,000 ($45,000 for PERS members).
E5.15(b) Coverage Effective Date
The "COV EFF DATE" is a six-digit number that indicates the effective date of Basic Life insurance coverage.
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