2017 Vendor Changes for Blue Shield Medical Plans

In an effort to improve customer service for plan members and assist in controlling costs, the University of California (UC) has selected Anthem to replace Blue Shield as the claims administrator and network provider for UC Care, Health Savings Plan (HSP), Core and Blue Shield Medicare plans. Anthem is well-positioned to support UC as a long-term partner through a constantly changing health care landscape. The changes will be effective January 1, 2017.

Anthem will also administer behavioral health benefits for these plans, replacing Optum. Prescription drug benefits for PPO plans will be administered through Optum Rx, which is a pharmacy expert specializing in the delivery, clinical management and affordability of prescription medications.

What this means for current UC Care, HSP and Core members

Employees who are currently enrolled in UC Care, HSP, Core or Blue Shield Medicare plans will not see any changes in their coverage or provider network this year.

In 2017, these plans will continue to offer many of the same features, including the option to see a specialist without a referral and to see non-network providers. However, a few changes may affect you:

  • Provider network: Anthem’s medical provider network is very similar to Blue Shield’s, so most members will be able to continue seeing their current medical providers. There is considerable, but currently not complete, overlap between Anthem’s behavioral health provider network and Optum’s network. Throughout 2016, Anthem will be working actively to expand its behavioral health provider network to minimize any provider disruptions for UC employees.
  • Pharmacy benefits: Medications covered under your current plan will continue to be covered by Optum Rx. Some prescription co-pays may increase or decrease depending on the medication. Members will be able to confirm their prescription co-pays during Open Enrollment.

More information about these 2017 changes will be available during Open Enrollment this fall. Updates about 2017 provider networks and prescription costs will be provided as new details become available. In the meantime, please refer to the Frequently Asked Questions for general information about the transition.

RElated Information