[UCRDBR] California Senate Bill 368 Medical Plans Compliance

[Departmental Benefits Representatives]

[cid:image001.jpg at 01DA6406.65925080]


February 20, 2024

To:
Department Benefits Representatives (DBRs)
From:
Central HR Benefits Office on behalf of UC Office of the President
Re:
Medical Plans - Compliance with California Senate Bill 368Medical Plans - Compliance with California Senate Bill 368

DBRs, please share this very important information via your internal listserv.

As mandated by California Senate Bill 368 passed in 2021 (CA SB368 - not to be confused with the 2023 bill of the same number), health plans must provide Explanation of Benefits (EOBs) to include deductible and out-of-pocket maximum information to members every month when services are accessed.  Following are how our medical plans are complying with this law:


*         UC PPO plans by Anthem will continue to provide EOBs when services are accessed.  However, these plans are not regulated by State laws.



*         Health Net provided a sample EOB<https://hr.ucr.edu/sites/default/files/2024-02/oopm-and-deductible-letter-abs-2023-v1-mf-11.21.2022.pdf>.  Members should receive the EOBs around the 3rd Wednesday of any month when services are accessed.


*         Kaiser Permanente began this process in July 2022.  Visit kp.org/resourceguide<https://o365ucr.sharepoint.com/sites/HumanResources/Shared%20Documents/Benefits%20Unit/Communications/DBR%20Listserv/2024/kp.org/resourceguide> to access the Member Resource Guide (page 21) for more information.


*         Optum issued a notification<https://hr.ucr.edu/sites/default/files/2024-02/i-9-notice-to-enrollees.pdf> on the bill's requirements to subscribers the week of February 12, 2024. Members should begin to receive EOBs when services are accessed.

-------------- next part --------------
An HTML attachment was scrubbed...
URL: <https://lists.ucr.edu/pipermail/ucrdbr/attachments/20240220/7d045470/attachment.html>
-------------- next part --------------
A non-text attachment was scrubbed...
Name: image001.jpg
Type: image/jpeg
Size: 3750 bytes
Desc: image001.jpg
URL: <https://lists.ucr.edu/pipermail/ucrdbr/attachments/20240220/7d045470/attachment.jpg>