[Ucrea] Navitus - Benefit Correction Notice sent 09-01-2023

[Demetrius A Patrick]

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September 5,  2023

To:       UC Riverside Emeriti and Retirees
From:  Central HR Benefits Office on behalf of UC Office of the President
Re:       Navitus - Benefit Correction Notice sent 09-01-2023
___________________________________________________________________________

The Benefit Correction Notice<https://hr.ucr.edu/sites/default/files/2023-09/Navitus-Benefit-Correction-Notice-sent-09-01-2023.pdf> was mailed by the University of California and Navitus on September 1, 2023.  Navitus found that during the years 2022 and 2023, Coverage Gap Discounts were applying to the High Option $1,000 member Maximum Out-of-Pocket (MOOP).  This mistake caused members to meet their MOOP early and to receive $0 copays prematurely. Claims may have processed in the Coverage Gap phase when they should have processed in the Catastrophic phase.

Navitus has taken the following corrective steps:

  *   A system enhancement has been completed to prevent a reoccurrence of this error.
  *   A Navitus claims audit found:
     *   1115 members had this occur within their year 2022 claims
     *   390 members within their year 2023 claims
  *   Members will not be asked for recoupment of underpaid copays (although they may notice changes to their MOOP and may also have future copays until their MOOP is truly met)
  *   The Benefit Correction Notice<https://hr.ucr.edu/sites/default/files/2023-09/Navitus-Benefit-Correction-Notice-sent-09-01-2023.pdf> was mailed on September 1, 2023

Questions can be directed to Navitus at 1-833-837-4309, 24/7/365.


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