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<div class="WordSection1">
<p class="MsoNormal"><a name="_Hlk150845535"><img width="159" height="60" id="_x0000_i1025" src="cid:image001.jpg@01DA16DA.C5FA5590"><o:p></o:p></a></p>
<p class="MsoNormal"><span style="mso-bookmark:_Hlk150845535"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="mso-bookmark:_Hlk150845535"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></span></p>
<p class="MsoNormal"><span style="mso-bookmark:_Hlk150845535"><span style="font-family:"Arial",sans-serif">November 14, 2023<o:p></o:p></span></span></p>
<p class="MsoNormal"><span style="mso-bookmark:_Hlk150845535"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></span></p>
<table class="MsoNormalTable" border="0" cellspacing="0" cellpadding="0" width="723" style="width:542.5pt;border-collapse:collapse">
<tbody>
<tr style="height:19.4pt">
<td width="103" valign="top" style="width:76.95pt;padding:0in 5.4pt 0in 5.4pt;height:19.4pt">
<p class="MsoNormal" style="mso-margin-top-alt:3.0pt;margin-right:0in;margin-bottom:3.0pt;margin-left:0in">
<span style="mso-bookmark:_Hlk150845535"><span style="font-family:"Arial",sans-serif">To:<o:p></o:p></span></span></p>
</td>
<span style="mso-bookmark:_Hlk150845535"></span>
<td width="621" valign="top" style="width:465.55pt;padding:0in 0in 0in 0in;height:19.4pt">
<p class="MsoNormal" style="mso-margin-top-alt:3.0pt;margin-right:0in;margin-bottom:3.0pt;margin-left:0in">
<span style="mso-bookmark:_Hlk150845535"><span style="font-family:"Arial",sans-serif">Department Benefits Representatives (DBRs)<o:p></o:p></span></span></p>
</td>
<span style="mso-bookmark:_Hlk150845535"></span>
</tr>
<tr style="height:19.95pt">
<td width="103" valign="top" style="width:76.95pt;padding:0in 5.4pt 0in 5.4pt;height:19.95pt">
<p class="MsoNormal" style="mso-margin-top-alt:3.0pt;margin-right:0in;margin-bottom:3.0pt;margin-left:0in">
<span style="mso-bookmark:_Hlk150845535"><span style="font-family:"Arial",sans-serif">From:<o:p></o:p></span></span></p>
</td>
<span style="mso-bookmark:_Hlk150845535"></span>
<td width="621" valign="top" style="width:465.55pt;padding:0in 0in 0in 0in;height:19.95pt">
<p class="MsoNormal" style="mso-margin-top-alt:3.0pt;margin-right:0in;margin-bottom:3.0pt;margin-left:0in">
<span style="mso-bookmark:_Hlk150845535"><span style="font-family:"Arial",sans-serif">Central HR Benefits Office on behalf of UC Office of the President<o:p></o:p></span></span></p>
</td>
<span style="mso-bookmark:_Hlk150845535"></span>
</tr>
<tr style="height:22.55pt">
<td width="103" valign="top" style="width:76.95pt;border:none;border-bottom:solid windowtext 1.0pt;padding:0in 5.4pt 0in 5.4pt;height:22.55pt">
<p class="MsoNormal" style="mso-margin-top-alt:3.0pt;margin-right:0in;margin-bottom:3.0pt;margin-left:0in">
<span style="mso-bookmark:_Hlk150845535"><span style="font-family:"Arial",sans-serif">Re:<o:p></o:p></span></span></p>
</td>
<span style="mso-bookmark:_Hlk150845535"></span>
<td width="621" valign="top" style="width:465.55pt;border:none;border-bottom:solid windowtext 1.0pt;padding:0in 0in 0in 0in;height:22.55pt">
<p class="xmsonormal" style="mso-margin-top-alt:3.0pt;margin-right:0in;margin-bottom:3.0pt;margin-left:0in">
<span style="mso-bookmark:_Hlk150845535"><b><span style="font-family:"Arial",sans-serif">Open Enrollment Exception Handling Process<o:p></o:p></span></b></span></p>
</td>
<span style="mso-bookmark:_Hlk150845535"></span>
</tr>
</tbody>
</table>
<p class="MsoNormal"><span style="mso-bookmark:_Hlk150845535"><b><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></b></span></p>
<p class="MsoNormal"><span style="mso-bookmark:_Hlk150845535"><b><span style="font-family:"Arial",sans-serif">DBRs, please share this important information with your department via your internal listserv.<o:p></o:p></span></b></span></p>
<span style="mso-bookmark:_Hlk150845535"></span>
<p class="MsoNormal"><span style="font-size:14.0pt;font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif">Following are instructions for handling employee requests for exceptions to the Open Enrollment deadline.
<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif">The Open Enrollment portals in UCPath
<b>will close at 5 pm on Friday, November 17, 2023.</b> Requests for exceptions to the deadline should be sent to the UCPath Center, as described below.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif">Employees should submit an
<b><i>Open Enrollment Benefits eForm </i></b>to request late enrollment after the end of the Open Enrollment period. Please note that submission of an Open Enrollment deadline exception request does not constitute automatic approval. All forms received after
November 17, 2023, at 5 p.m. will be reviewed for extenuating circumstances prior to approval or denial.
<o:p></o:p></span></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif">Employees should follow the steps outlined below:<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<ol style="margin-top:0in" start="1" type="1">
<li class="MsoNormal" style="line-height:105%;mso-list:l1 level1 lfo1"><span style="font-family:"Arial",sans-serif">Log into UCPath at
<a href="http://ucpath.universityofcalifornia.edu/"><span style="color:windowtext">http://ucpath.universityofcalifornia.edu/</span></a> and enter your Single Sign-On credentials<o:p></o:p></span></li><li class="MsoNormal" style="line-height:105%;mso-list:l1 level1 lfo1"><span style="font-family:"Arial",sans-serif">On the UCPath Dashboard, select the Open Enrollment option under Forms Library<o:p></o:p></span></li><li class="MsoNormal" style="line-height:105%;mso-list:l1 level1 lfo1"><span style="font-family:"Arial",sans-serif">Choose the Benefits eForm: Open Enrollment option<o:p></o:p></span></li><li class="MsoNormal" style="line-height:105%;mso-list:l1 level1 lfo1"><span style="font-family:"Arial",sans-serif">A new eForm will populate with your personal information. Based upon your benefits primary position, please select the corresponding benefit
program. The options provided are:<o:p></o:p></span></li><ol style="margin-top:0in" start="1" type="a">
<li class="MsoNormal" style="line-height:105%;mso-list:l1 level2 lfo1"><span style="font-family:"Arial",sans-serif">Faculty/Staff Benefits<o:p></o:p></span></li><li class="MsoNormal" style="line-height:105%;mso-list:l1 level2 lfo1"><span style="font-family:"Arial",sans-serif">Graduate Student Benefits<o:p></o:p></span></li><li class="MsoNormal" style="line-height:105%;mso-list:l1 level2 lfo1"><span style="font-family:"Arial",sans-serif">Medical Resident Benefits<o:p></o:p></span></li><li class="MsoNormal" style="line-height:105%;mso-list:l1 level2 lfo1"><span style="font-family:"Arial",sans-serif">Postdoctoral Scholar Benefits<o:p></o:p></span></li></ol>
</ol>
<p class="MsoListParagraph" style="text-indent:-.25in;line-height:105%;mso-list:l1 level1 lfo1">
<![if !supportLists]><span style="font-family:"Arial",sans-serif"><span style="mso-list:Ignore">5.<span style="font:7.0pt "Times New Roman"">
</span></span></span><![endif]><span style="font-family:"Arial",sans-serif">Under the Reason for Request drop-down menu, select “<b>2024 Open Enrollment</b>”<o:p></o:p></span></p>
<ol style="margin-top:0in" start="6" type="1">
<li class="MsoNormal" style="line-height:105%;mso-list:l1 level1 lfo1"><span style="font-family:"Arial",sans-serif">The Late Enrollment section will populate. You must provide details in the
<b>Reason For Late Enrollment Request</b> comment section. Please provide a detailed explanation as to why you are requesting late enrollment for the Open Enrollment period as the reason provided will be considered in the decision to approve or deny your enrollment
request. <o:p></o:p></span></li><li class="MsoNormal" style="line-height:105%;mso-list:l1 level1 lfo1"><span style="font-family:"Arial",sans-serif">Make your benefit elections and submit the eForm.
<o:p></o:p></span></li></ol>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif">Once the Open Enrollment eForm has been reviewed by UCPath, a follow-up email will be sent indicating whether the enrollment request has been approved or denied.
<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif">Employees who do not have computer access may fill out paper forms to request an Open Enrollment deadline exception. Employees must fill out the applicable Health Benefits Open Enrollment Form
(for Residents, Postdocs, or all other employees), and ensure the Late Enrollment section is completed.
<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif">All of the applicable forms are in the UCPath Forms Library, but can also be accessed through the following links:<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<ul style="margin-top:0in" type="disc">
<li class="MsoNormal" style="mso-list:l2 level1 lfo2"><b><span style="font-family:"Arial",sans-serif">Health Benefits Open Enrollment</span></b><span style="font-family:"Arial",sans-serif"> <o:p></o:p></span></li></ul>
<p class="MsoNormal" style="margin-left:.5in"><span style="font-family:"Arial",sans-serif"><a href="https://www.ucop.edu/ucpath-center/_files/mypath/oe/oe-form.pdf"><span style="color:windowtext">https://www.ucop.edu/ucpath-center/_files/mypath/oe/oe-form.pdf</span></a><o:p></o:p></span></p>
<ul style="margin-top:0in" type="disc">
<li class="MsoNormal" style="mso-list:l2 level1 lfo2"><b><span style="font-family:"Arial",sans-serif">Postdoctoral Scholar Health Benefits Open Enrollment Form
<o:p></o:p></span></b></li></ul>
<p class="MsoNormal" style="margin-left:.5in"><span style="font-family:"Arial",sans-serif"><a href="https://www.ucop.edu/ucpath-center/_files/mypath/oe/oe-form-postdoc.pdf"><span style="color:windowtext">https://www.ucop.edu/ucpath-center/_files/mypath/oe/oe-form-postdoc.pdf</span></a><o:p></o:p></span></p>
<ul style="margin-top:0in" type="disc">
<li class="MsoNormal" style="mso-list:l2 level1 lfo2"><b><span style="font-family:"Arial",sans-serif">Unpaid Leave of Absence Open Enrollment Form
<o:p></o:p></span></b></li></ul>
<p class="MsoNormal" style="margin-left:.5in"><span style="font-family:"Arial",sans-serif"><a href="https://www.ucop.edu/ucpath-center/_files/mypath/oe/oe-lwop-form.pdf"><span style="color:windowtext">https://www.ucop.edu/ucpath-center/_files/mypath/oe/oe-lwop-form.pdf</span></a></span><span class="MsoHyperlink"><span style="color:windowtext;text-decoration:none"><o:p></o:p></span></span></p>
<ul style="margin-top:0in" type="disc">
<li class="MsoNormal" style="mso-list:l2 level1 lfo2"><b><span style="font-family:"Arial",sans-serif">Postdoctoral Scholar Unpaid Leave of Absence Open Enrollment Form
</span></b><b><o:p></o:p></b></li></ul>
<p class="MsoNormal" style="margin-left:.5in"><span style="font-family:"Arial",sans-serif"><a href="https://www.ucop.edu/ucpath-center/_files/mypath/oe/oe-postdoc-lwop-form.pdf"><span style="color:windowtext">https://www.ucop.edu/ucpath-center/_files/mypath/oe/oe-postdoc-lwop-form.pdf</span></a><o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif">Paper forms may be submitted in a variety of ways:<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal" style="margin-left:.5in"><b><span style="font-family:"Arial",sans-serif">Create an Inquiry in UCPath<o:p></o:p></span></b></p>
<p class="MsoListParagraphCxSpFirst" style="margin-left:1.0in;mso-add-space:auto;text-indent:-.25in;mso-list:l3 level1 lfo3">
<![if !supportLists]><span style="font-family:Symbol"><span style="mso-list:Ignore">·<span style="font:7.0pt "Times New Roman"">
</span></span></span><![endif]><span style="font-family:"Arial",sans-serif">UCPath:
<a href="http://ucpath.universityofcalifornia.edu"><span style="color:windowtext">http://ucpath.universityofcalifornia.edu</span></a><o:p></o:p></span></p>
<p class="MsoListParagraphCxSpMiddle" style="margin-left:1.0in;mso-add-space:auto;text-indent:-.25in;mso-list:l3 level1 lfo3">
<![if !supportLists]><span style="font-family:Symbol"><span style="mso-list:Ignore">·<span style="font:7.0pt "Times New Roman"">
</span></span></span><![endif]><span style="font-family:"Arial",sans-serif">Log in using Single Sign On (SSO)<o:p></o:p></span></p>
<p class="MsoListParagraphCxSpMiddle" style="margin-left:1.0in;mso-add-space:auto;text-indent:-.25in;mso-list:l3 level1 lfo3">
<![if !supportLists]><span style="font-family:Symbol"><span style="mso-list:Ignore">·<span style="font:7.0pt "Times New Roman"">
</span></span></span><![endif]><span style="font-family:"Arial",sans-serif">Click Ask UCPath<o:p></o:p></span></p>
<p class="MsoListParagraphCxSpLast" style="margin-left:1.0in;mso-add-space:auto;text-indent:-.25in;mso-list:l3 level1 lfo3">
<![if !supportLists]><span style="font-family:Symbol"><span style="mso-list:Ignore">·<span style="font:7.0pt "Times New Roman"">
</span></span></span><![endif]><span style="font-family:"Arial",sans-serif">Select Submit An Inquiry
<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left:.5in;text-indent:.5in"><span style="font-family:"Arial",sans-serif">Use the following drop-down selections:<o:p></o:p></span></p>
<p class="MsoListParagraphCxSpFirst" style="margin-left:1.5in;mso-add-space:auto;text-indent:-.25in;mso-list:l0 level1 lfo4">
<![if !supportLists]><span style="font-family:"Courier New""><span style="mso-list:Ignore">o<span style="font:7.0pt "Times New Roman"">
</span></span></span><![endif]><span style="font-family:"Arial",sans-serif">Topic:
<b>Open Enrollment</b><o:p></o:p></span></p>
<p class="MsoListParagraphCxSpMiddle" style="margin-left:1.5in;mso-add-space:auto;text-indent:-.25in;mso-list:l0 level1 lfo4">
<![if !supportLists]><span style="font-family:"Courier New""><span style="mso-list:Ignore">o<span style="font:7.0pt "Times New Roman"">
</span></span></span><![endif]><span style="font-family:"Arial",sans-serif">Category:
<b>Late Enrollment Request </b><u><o:p></o:p></u></span></p>
<p class="MsoListParagraphCxSpLast" style="margin-left:1.5in;mso-add-space:auto;text-indent:-.25in;mso-list:l0 level1 lfo4">
<![if !supportLists]><span style="font-family:"Courier New""><span style="mso-list:Ignore">o<span style="font:7.0pt "Times New Roman"">
</span></span></span><![endif]><span style="font-family:"Arial",sans-serif">Subject:
<b>OE Late Enrollment Request</b><o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left:.5in"><b><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></b></p>
<p class="MsoNormal" style="margin-left:.5in"><b><span style="font-family:"Arial",sans-serif">Email<o:p></o:p></span></b></p>
<p class="MsoNormal" style="margin-left:.5in"><span style="font-family:"Arial",sans-serif">Email address:
<a href="mailto:ucpath@universityofcalifornia.edu"><span style="color:windowtext">ucpath@universityofcalifornia.edu</span></a><o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left:.5in"><span style="font-family:"Arial",sans-serif">Email Subject:
<b>OE Late Enrollment Request</b><o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left:.5in"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal" style="margin-left:.5in"><b><span style="font-family:"Arial",sans-serif">Postal Mail<o:p></o:p></span></b></p>
<p class="MsoNormal" style="margin-left:.5in"><span style="font-family:"Arial",sans-serif">14350-1 Meridian Pkwy<br>
Riverside, CA 92518<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left:.5in"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif">Due to the significant changes in medical plan premiums for 2024, we expect a higher volume of exception requests pertaining to those plans. UCPath is dedicating experienced team members to review
these cases, in collaboration with the UCOP Health & Welfare Team.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif">Please note that in the event an OE deadline exception for a medical plan change is approved after January 1, 2024, for a reason other than UC administrative error, the employee’s medical plan
premiums must be paid on a post-tax (i.e., “no TIP”) basis for the entire 2024 year, in accordance with IRS regulations. In addition, it will be the employee’s responsibility to re-enroll in TIP for 2025. Employees will be notified of this by UCPath if their
request is approved after the plan year begins.<o:p></o:p></span></p>
<p class="xmsonormal" style="background:white"><b><span style="font-size:11.0pt;font-family:"Arial",sans-serif"><o:p> </o:p></span></b></p>
<p class="MsoNormal"><b><u><span style="font-family:"Arial",sans-serif">Appeals<o:p></o:p></span></u></b></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif">Employees whose requests are denied by UCPath may submit an appeal using the
<a href="https://ucnet.universityofcalifornia.edu/tools-and-services/administrators/group-insurance-appeals-process.html">
<span style="color:windowtext">procedures outlined on UCnet</span></a>.<o:p></o:p></span></p>
<p class="MsoNormal"><o:p> </o:p></p>
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