UC Self-Funded Health Plans

UC Health oversees management of UC's self-funded and flex-funded health plans for faculty, staff and retirees.

The University of California is one of the largest employers in the state. It employs more than 141,000 benefit eligible employees at its undergraduate, graduate, research, laboratory, medical center, agricultural and administrative locations. Employees may choose from six health insurance coverage options that include High Deductible, PPO and HMO plan types. Employee contributions vary depending on four tiers of salary groupings and the number of eligible family members enrolled (Self, Self + Adult, Self + Child, and Self + Family).

As both a major employer and a provider of health services, UC recognized the opportunity to become more effective in health plan management, financing, benefit design and employee contribution pricing.

Department goals include member education about plan design and features, improving member satisfaction, partnering with UC providers and the plan administrators to establish innovative models to improve quality of care and outcomes, engaging in responsible cost containment efforts, and development of a flex-funded HMO product for UC employees (Blue & Gold) with an ACO relationship with UC providers.

The rationale to move to self-funded and flex-funded arrangements include:
  1. Providing affordable, predictable year-over-year premium increases (limited to 5%)
  2. Facilitating the ability to include UC Health Programs of excellence in benefit design
  3. Keeping UC dollars within UC system, where feasible
  4. Providing an opportunity for UC providers to take on financial risk
The self-funded health plan team seeks to make UC-branded health plans the clear choice for employees and their families and retirees by offering innovative, differentiated, compelling, affordable and comprehensive health plans with outstanding member experience.

Governance includes an Executive Steering Committee (ESC), which has fiduciary responsibilities for UC health benefits programs, and a Joint Operating Committee (JOC), which has operational oversight of UC health benefits programs. The governance structure enables objective and unbiased issues review, discussion, and decision-making and ensures checks-and-balances on plan strategy and operations.