UC Blue & Gold HMO to replace Western Health Advantage

Doctor playing with pediatric patient

Some important changes are coming to your health benefits during Open Enrollment this fall.

Starting in 2020, UC will no longer offer the Western Health Advantage health plan for employees, retirees, and their dependents. However, for the overwhelming majority of people enrolled with WHA, there should be no changes needed or action that needs to be taken. Current members will be automatically switched to the UC Blue & Gold HMO plan through Health Net—though they can opt for a different plan—and nearly all enrollees will stay with their selected health provider group.

As part of our effort to make health care more affordable for our employees and their families, the monthly employee contribution for UC Blue & Gold for UC Davis employees will now be as low as other HMO health plans offered. Active employees already enrolled in UC Blue & Gold HMO will see their monthly share of premium costs reduced when this takes effect. Employees with other health plans will have the opportunity to switch to UC Blue & Gold HMO at the same reduced monthly premiums.

NOTE: This does not impact coverage residents and medical students are currently receiving through June 2020.

Frequently Asked Questions

  • What is changing?
  • UC Davis is reducing the monthly employee cost for the UC Blue & Gold HMO, so it will be among the lowest cost health plans offered by UC, as part of our effort to make health care more affordable for our employees and their families.

    As part of this change, employees in Western Health Advantage (WHA) will be automatically enrolled in UC Blue & Gold HMO. UC Blue & Gold’s network of providers is almost identical to WHA’s, so WHA members (with possibly a few exceptions — see NorthBay Healthcare and Behavioral Health questions below) will be able to continue with uninterrupted access to their current care team in the year 2020 and beyond.

    To help make the transition easier, employee contributions for all UC Davis enrollees in UC Blue & Gold will be subsidized by UC Davis over the next five years to help grow the UC Blue & Gold insurance pool and reduce the cost of health care for our employees. Unfortunately, it is not possible to subsidize retiree premiums.
  • Why is UC Davis making this change?
  • UC Davis wants employees and their families to have access to the best care, the most innovative technology, and the best expert clinicians through the most affordable, cost-effective health plans.

    By making this change, we can bring down premiums and healthcare costs for our employees, while also ensuring more of our employees have access to the high quality of care provided by UC Davis Health, or other providers in the UC Blue & Gold HMO network.
  • Who will be affected by this transition?
  • All UC Davis employees, retirees, and their eligible dependents currently enrolled in WHA will automatically be enrolled in the UC Blue & Gold HMO unless they enroll in a different plan during open enrollment. Employees who currently have UC Blue & Gold will see their monthly share of premium costs reduced. Employees with other health plans will have the opportunity to reduce their health care costs by selecting UC Blue & Gold HMO. Retirees will pay the full UC Blue & Gold HMO premium.

    Residents and students with Western Health Advantage will continue to be enrolled, and have coverage, through the end of their coverage year in June 2020.

  • When will the change take effect?
  • The change is effective Jan. 1, 2020. Employees and retirees in WHA who do not want to enroll in UC Blue & Gold HMO will have the opportunity to choose another plan in the fall Open Enrollment season (Oct. 31–Nov. 26). Employees currently enrolled in other plans may choose UC Blue & Gold HMO during Open Enrollment and receive the same subsidy as current WHA members. Those who change plans will receive new ID cards.
  • Will I still be able to see my current primary care physician and specialists?
  • WHA and UC Blue & Gold HMO have nearly matching provider networks, so there should be uninterrupted access to your current care team. The exception to this is that NorthBay Healthcare may not be available, and the network through which you access mental health services may be slightly different than the current provider network. The vast majority of WHA enrollees will keep the same doctors they had with WHA. During Open Enrollment, those who use NorthBay and behavioral health providers should verify that their providers will be available through the UC Blue & Gold HMO.
  • I heard that NorthBay Healthcare Group was not part of the UC Blue & Gold HMO network. What if my physician is part of NorthBay?
  • The University of California Office of the President has asked Health Net (which administers UC Blue & Gold HMO) to engage in contract talks with NorthBay Healthcare. We are hopeful they will join the UC Blue & Gold provider network so that our members who use NorthBay Healthcare will see no changes in their providers. Most, if not all, NorthBay providers are network providers under UC’s PPO health insurance plans through Anthem Blue Cross. During Open Enrollment, those who use NorthBay should verify that their providers will be available through the UC Blue & Gold HMO.
  • What medical groups are available under the UC Blue & Gold HMO plan?
  • Locally, the UC Davis Medical Group, Hill Physicians, Mercy Medical Group, Meritage, Woodland Clinic, and St. Joseph Health are offered. Many other groups are available in other parts of urban California.
  • What about behavioral health services?
  • For members moving from WHA to UC Blue & Gold HMO, your behavioral health network will change from Optum Behavioral Health to MHN. UC Blue & Gold went through the same transition in January 2019 with little impact to members, after Health Net contracted with additional providers or made arrangements with others to continue their relationships with members. Overall, members experienced very little disruption through the transition. During Open Enrollment, employees who receive behavioral health services should check to make sure their providers are available since UC Blue & Gold HMO behavioral health services are provided by MHN, not Optum.
  • If I’m in WHA now, will my premiums go up?
  • Historically, employee contributions have risen a little each year and that may still be the case. However, because UC Davis will provide a subsidy to the employee portion of the health care premium, your premium costs will be no higher than other UC HMO premiums.  Retiree premiums cannot be subsidized, which will result in premium increases as they transition to UC Blue & Gold HMO.
  • What do I need to do?
  • If you are in WHA, and if you do not use NorthBay Healthcare or behavioral health providers, you do not need to do anything. You will be automatically switched during the Open Enrollment period, and you should be able to continue to have access to your current doctors. During Open Enrollment, those who use NorthBay or behavioral health providers should take care to determine whether those providers will be available through the UC Blue & Gold HMO. Employees who are not in WHA or UC Blue & Gold HMO currently and want to lower their monthly premium costs, should compare UC Blue & Gold to their current health insurance during Open Enrollment, to see if the costs will be lower.
  • Why should I choose UC Blue & Gold?
  • This plan gives you access to the nationally-recognized experts and specialists here at UC Davis Health. We would like our best doctors taking care of our employees and making sure they stay healthy and have access to the best health care available.
  • Will employees enrolled in other HMOs be affected by this transition?
  • No.