University Health Services selects new insurance carrier for fall 2019

Lorenzo dela Cruz/Staff

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University Health Services, or UHS, has selected a new insurance carrier for the Student Health Insurance Plan, or SHIP, the effects of which will be seen starting fall 2019.

UHS will break from Anthem Blue Cross and instead partner with Blue Shield of California, insured by Wellfleet Student, according to a press release from SHIP. The press release added that most students can expect to experience a “modest increase to premiums with some minimal changes to specific copays.”

The price of copay for primary care and counseling office visits will be $15, according to the press release. Under the new insurance carrier, there will be 90 percent coverage for in-network services while the cost of deductibles and out-of-pocket maximums will remain the same. Pharmacy copays at the Tang Center will be lowered slightly and there will be no change to vision and dental plans.

According to the UHS website, benefit changes — including the addition of facial feminization surgery available for transgender individuals — will be in effect starting August 2019. Specialist office visits will now require a copay of $25, an increase from the previous $15 rate, according to the website. Emergency room visits will require a $250 copay compared to the previous copay of $100, though this cost is waived once the individual is admitted.

Orit Weksler, a community mental health provider and a marriage and family therapy practitioner that collaborates with the Tang Center, expressed concern about partnering with Blue Shield.

“Many of us have had bad experiences with Blue Shield, which will be part of the new system,” Weksler said in an email. “We worked as contractors for them and decided not to work with them anymore because they paid us little, were not responsive to questions and problems and refused to provide coverage on too many occasions.”

UHS acknowledged in the press release that certain network disruptions are expected to occur. Some therapists might not be added to the Blue Shield list of available providers, and others will continue care with current students but will not take on more students, Weksler said in an email. She added that students are an at-risk population and therapists who treat this population should be “extra patient, available and alert.”

“Bottom line – the students are shortchanged here: they are getting less services while the level of mental health needs is rising,” said Weksler in an email.

Bahar Navab, associate director of insurance and business development for UHS, said UHS is responding to these disruptions by advocating for contracts consistent with current UC Berkeley SHIP terms.

She added that providers who are currently in the Tang Center’s network will receive the option to sign onto these contracts, though the details are still in the works.

“Blue Shield will invite nonparticipating mental health providers who currently see Berkeley SHIP members, to join a special Berkeley SHIP carve-out network that will offer a contract that is consistent with current Berkeley SHIP terms,” said Navab.

Contact Sasha Langholz at [email protected] and follow her on Twitter at @LangholzSasha‏.