UC Care has moved Sansum Clinics in Santa Barbara into its Select Tier, UC President Janet Napolitano announced Thursday. UC Care and Sansum reached an understanding that enables Sansum Clinics to be included in the Select Tier (formerly Tier 1).
Sansum Clinics include 48 providers and specialists, five multi-specialty clinic locations and two urgent care centers. In addition, more than 200 physicians are part of the Sansum Santa Barbara Medical Foundation group.
UC Care members pay a copayment rather than coinsurance when they use Select Tier providers for most services.
“We understand the complex provider situation in Santa Barbara and have heard UC Santa Barbara employees’ concerns regarding Sansum and Cottage Hospitals,” said Lori Taylor, executive director of UC Care. “We are happy that we have been able to work out an understanding with Sansum Clinic.”
UC has been unable to reach an agreement with Cottage Hospital.
Employees will be able to find Sansum providers in the Select Tier on the plan’s Find a Provider tool. Cottage Hospitals will remain in the Preferred Tier of UC Care.
Members who see a Sansum provider will pay a copay for most services and have no deductible. If members use Cottage Hospital for inpatient or outpatient services, they must meet the deductible and pay coinsurance. The Select Tier and Preferred Tier co-accumulate with each other to reach the out-of-pocket maximums.
UC Santa Barbara faculty and staff also have access to Sansum Clinics and Cottage Hospitals, with copayments and no deductible, through the Health Net Blue & Gold plan.
In an e-mail to the campus, Chancellor Henry T. Yang said: “I am grateful for President Napolitano’s leadership in helping to ensure that UC Santa Barbara has a local, trusted Tier One provider as a part of the UC Care plan option.”
Because of the extensive changes this year, including the recent developments, the Systemwide Human Resources and Benefits group is offering UC Santa Barbara community members the opportunity to make enrollment changes through February 2014. It is important to note that open enrollment will still close on Nov. 26, so that coverage is not delayed to any employee. Individuals who do not make a selection will be enrolled in a targeted default plan but will have an opportunity to change it before February.
For more information about UC Care, see the plan’s website https://ucnet.universityofcalifornia.edu/compensation-and-benefits/health-plans/medical/uc-care.html.
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