[UCRDBR] UPDATE Health Net - Riverside Medical Clinic Contract Termination 4.1.2023

[Departmental Benefits Representatives]

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February 8, 2023

To:
Department Benefit Representatives
From:
Central HR Benefits Office on behalf of the UC Office of the President
Re:
UPDATE! Health Net - Riverside Medical Clinic Contract Termination 4/1/2023

___________________________________________________________________________


For your reference regarding this update, please see the previous communication below.

The UCR Benefits Office is working with UCOP Health and Welfare Senior Leadership as they continue to negotiate to reach a settlement and avoid the termination of this medical group from the Health Net network.

UCOP has confirmed members may change their medical plan should the Riverside Medical Clinic (RMC) leave the Health Net provider network. However, you may want to delay initiating any change until at least March 15, 2023 in the event UCOP and Health Net reach an agreement and the RMC remains an option.

The medical plan change must be made in the UCPath portal prior to April 1, 2023 using the eForm for Life Event.  E-Forms are found on the member UCPath portal on the left panel under Forms Library, click Access Forms, under the Faculty/Staff Benefits section, click on Benefits eForms: Submit New Form. Members will be required to complete and submit the benefits eForm for a Life Event and note in the Other column the reason for the medical plan change: Involuntary loss of Health Net medical group.

UC Riverside Health (UCR Health) offers physicians within the UC Health Net and Anthem Blue Cross medical plan networks.  Find a new provider or determine the option to continue with your existing Health Net PCP under a different Health Net medical group at this link https://www.ucrhealth.org/find-a-provider/

Continuity of Care<https://www.healthnet.com/portal/member/content/iwc/mysites/uc/transition_of_care.action> is available for assistance with transitioning care for those currently in treatment plans, or with pending surgery or procedures.

Other medical groups available with Health Net in the Riverside area

Regal Medical Group of Riverside County

-        Parkview Community Hospital and Urgent Care

-        Moreno Valley Urgent Care

Optum Care Network Riverside

-        Central Medical Group Express Care

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February 6, 2023

To:
Department Benefit Representatives
From:
Central HR Benefits Office on behalf of the UC Office of the President
Re:
Health Net - Riverside Medical Clinic Contract Termination 4/1/2023
____________________________________________________________________________

We are sharing this information as required due to the impact this may have on Health Net plan members utilizing the Riverside Medical Clinic.  The UCR Benefits Team is working with the UCOP Health and Welfare team to monitor the progress of negotiations between Health Net and the Riverside Medical Clinic. As they continue to negotiate in good faith, Health Net is required to provide advance notice to members of the impending termination should the contract expire before they are able to reach a settlement.

UC Office of the President was recently notified by Health Net that their contract with the Riverside Medical Clinic will terminate April 1, 2023.  Health Net has mailed the attached letters to inform affected members that they will be automatically transferred to Healthcare Partners IPA - North Riverside (Optum) effective April 1, 2023 for care.  It is important for members to carefully review their letters to understand how this may affect their access to services and to contact Health Net promptly if they have any questions.

The contract termination will impact 797 members and of those, only nine members have a Primary Care Physician (PCP) that they can follow to Healthcare Partners IPA - North Riverside (sample RMC TTF letter<https://hr.ucr.edu/sites/default/files/2023-02/riverside_medical_clinic_uc_ttf_letter_draft_hcp.pdf>).  The remaining 788 members' current PCP is not accessible through a Health Net participating medical group (sample REA letter<https://hr.ucr.edu/sites/default/files/2023-02/riverside-medical-clinic-uc-rea-letter-draft_hcp.pdf>).  These members may make a new PCP selection, which includes UC Riverside providers, within 30 days of the date of the letter by contacting the Health Net Customer Contact center at 1-800-539-4072, Monday through Friday, from 8:00 a.m. to 8:00 p.m., Pacific Time, or by visiting www.healthnet.com/uc<http://www.healthnet.com/uc>.  If the member does not make any changes within 30 days, the member will be transferred and assigned to new PCPs.

Unless otherwise notified, Health Net will begin the automatic transfer to Healthcare Partner IPA North Riverside (Optum) at the end of February 2023 and new cards will be sent to members the week of March 6, 2023.  Members may view the changes made by logging in to www.healthnet.com/uc<http://www.healthnet.com/uc>  and viewing "My Account", or by calling the Interactive Voice Response system 24/7 on the back of their current ID card to confirm the changes and verify eligibility.  New ID cards should arrive prior to April 1, 2023, and the old card should be disposed of properly.

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