Resources

Enrollment Guides and Certificates of Insurance

See the following documents for detailed plan information, including exclusions and limitations.

Making Changes to Your Coverage

Once you enroll, coverage changes are allowed only during the annual Open Enrollment period or when you have a qualified life event (e.g., you get married or divorced, start or end a domestic partnership, add a new child to your family). For these events, you have 31 days from the date of the event to make changes to your existing coverage.

If you are a new hire, you have 31 days from your date of hire to enroll.

You can cancel coverage at any time. If you cancel coverage, your coverage will end on the last day of the month that you disenroll.

To make changes to or cancel your coverage, call the UC Plus Customer Service Team toll-free at (888) 212-7201.

Frequently Asked Questions

This is a brief overview only. Please refer to the Supplemental Health Plans guide, or the plan Certificates of Insurance for complete details on benefits, limitations and exclusions.

General Questions Applicable to All 3 Plans

1. What are supplemental health plans?
The UC supplemental health plans pay cash benefits directly to you when you or an enrolled dependent experiences a qualifying injury, critical illness, or hospital stay. These plans provide an extra layer of protection that complements your UC medical and disability insurance.

2. How are these plans different from medical and disability plans?
These plans are designed to supplement other health insurance plans; they are not a replacement for them.

Medical plans are designed to pay doctors and hospitals for specific medical services after you pay your deductible or copayment/coinsurance. The supplemental health plans don’t pay doctors or hospitals—they pay you. Supplemental health plans are not a replacement for medical coverage and do not meet the minimum essential coverage requirements of the Affordable Care Act.

Disability plans provide regularly scheduled monthly income replacement payments for non-occupational injuries/illnesses. The supplemental health plans do not provide monthly income. They pay one-time lump-sum cash benefits to you. Once you’ve spent the money, you don’t get more.

3. Am I eligible to participate?
UC faculty and staff employees eligible for full-time, part-time or core benefits are eligible to participate. Retirees, postdoctoral scholars/fellows, and medical residents are not eligible.

4. Can my dependents participate?
You can enroll your eligible spouse/domestic partner and children in the same plans you enroll yourself in.

5. Who do I call with questions about benefits or how to enroll?
Call the UC Plus Customer Service Center at (888) 212-7201, Monday through Friday 6:00 a.m. to 5:00 p.m. Pacific, to speak with a UC dedicated representative. These specially trained representatives are available to answer questions about the plans and provide assistance with enrollment.

6. What is UC Plus?
UC has partnered with Aflac to offer group coverage with preferred pricing designed especially for UC employees. This group of plans is commonly referred to as UC Plus, or UC Plus Supplemental Health Plans.

7. Can I receive benefits from more than one plan?
Yes—in certain limited situations where you are enrolled in multiple plans and have a medical situation that qualifies for benefits under each of those plans. For example, if you were to be diagnosed with a qualifying critical illness and subsequently hospitalized, you could be eligible for benefits from both the Critical Illness and Hospital Indemnity plans.
If you have additional questions about qualifying for or claiming benefits from more than one plan, contact the UC Plus Customer Service Center at (888) 212-7201, Monday through Friday 6:00 a.m. to 5:00 p.m. Pacific.

8. Can I enroll if I already have a supplemental health insurance policy with Aflac?
Yes. You may have coverage in another Aflac insurance policy and enroll for coverage in the UC plans. If you decide to keep coverage in multiple plans, please carefully consider the benefits and cost of each, and make sure your coverage is appropriate for your needs. If you have additional questions, contact the UC Plus Customer Service Center at (888) 212-7201, Monday through Friday 6:00 a.m. to 5:00 p.m. Pacific.

9. How do I enroll?
Call the UC Plus Customer Service Team at (888) 212-7201.

10. How do I pay for these benefits?
You pay the full cost of coverage through convenient payroll deductions. Your premiums are paid with after-tax dollars, which means you don’t pay taxes on benefit payments received from the plans.

11. How do I file a claim for benefits?
After January 1, 2020, you can file claims for benefits online, by fax or by postal mail. From this website, click on Resources in the upper right-hand corner, then select File a Claim. There you’ll find claim forms, instructions, and a link to submit claims online. You can elect to have benefits paid via direct deposit by completing the Electronic Funds Transaction Authorization section of the claim form. All claims for benefits should be submitted within 20 days of the covered event or as soon as reasonably possible. If you have questions or need assistance, call the UC Plus Customer Service Center at (888) 212-7201, Monday through Friday 6:00 a.m. to 5:00 p.m. Pacific.

12. How do I check the status of a claim?
The standard processing time for a claim submitted with all required supporting documentation is 3–5 business days. If it has been more than 5 days, you can call the UC Plus Customer Service Team at (888) 212-7201 to request a status update.

13. How do I appeal a claim decision?
If your claim for benefits is denied, you have the right to file an appeal with Aflac. Appeals must be submitted in writing (free-form letter) to: Aflac Appeals Group, PO Box 427, Columbia, SC 29202, within 60 days of the notice of denial. Include additional medical documentation and other pertinent information you would like considered.

14. When can I cancel my coverage?
Coverage will end on the last day of the month in which the cancellation is requested. You may cancel your coverage anytime by calling the UC Plus Customer Service Center at (888) 212-7201, Monday through Friday 6:00 a.m. to 5:00 p.m. Pacific.

15. How do I update my personal information with Aflac?
Update your address, phone number, email, and information for your participating dependents by logging in to your Aflac account or by calling the UC Plus Customer Service Team at (888) 212-7201.

16. How do I make midyear changes to my coverage if I have a qualified life event?
You can make midyear changes only when you have a qualifying life event (e.g., you get married or divorced, start or end a domestic partnership, add a new child to your family). Report your life event and process changes by calling the UC Plus Customer Service Team at ( 888) 212-7201.

17. What happens to my coverage if my employment ends?
If you retire or terminate employment, you have the option to port (buy and pay for) the coverage for yourself and your participating dependents. Portability allows you to continue coverage with the same benefits, plan provisions, and premium rates as the UC plan(s). Your payment for ported coverage is made directly to Aflac.

18. Can my family continue coverage if I die?
Yes. If your surviving spouse is enrolled for coverage at the time of your death, your spouse may elect to continue coverage for him or herself and any participating dependent children. Coverage will continue with the same benefits, plan provisions and premium rates as the UC plan(s). Payment for survivor coverage is made directly to Aflac.

Accident Plan

1. Are work-related injuries covered?
Yes. The UC plan provides 24-hour coverage for qualifying injuries occurring both on and off the job.

2. How is this plan different from worker’s compensation?
Workers’ compensation provides regularly scheduled monthly income replacement payments for occupational injuries/illnesses. This plan does not provide monthly income. It pays one-time lump-sum cash benefits to you. Once you’ve spent the money, you don’t get more.

3. How is this plan different from UC’s AD&D plan?
The accidental death and dismemberment (AD&D) plan pays a death benefit if you die in an accident. This plan does not provide a death benefit.

Critical Illness Plan

1. Can I enroll if I have a pre-existing condition?
There are no pre-existing condition exclusions that prevent you from enrolling in this plan. Coverage is guaranteed issue, meaning that eligible employees can enroll regardless of health status. However, only qualifying illnesses diagnosed while you are participating in the plan are eligible for benefits.

2. How are benefits paid for a cancer recurrence?
The plan has limitations on how benefits for a recurrence or new diagnosis of cancer are paid. Benefits are payable for a recurrence or new diagnosis of cancer only if a participant is (1) treatment-free from cancer for at least 12 months before the diagnosis date, and (2) in complete remission prior to the diagnosis date. See the Critical Illness plan Certificate of Insurance for complete information, or contact the UC Plus Customer Service Center at (888) 212-7201, Monday through Friday, 6:00 a.m. to 5:00 p.m. Pacific, if you have additional questions about the cancer limitation provision.

3. Are benefits available for a recurrence of the same critical illness?
The plan will pay benefits a second time for the same critical illness if (1) the second date of diagnosis is at least 6 consecutive months (must be 12 months treatment-free and in remission for cancer) after the first date of diagnosis, and (2) the second date of diagnosis occurs while the participant is covered in the plan.

4. How are benefits paid if I am diagnosed with a second unrelated critical illness?
The plan will pay benefits for a diagnosis of a second (different and unrelated) critical illness only if the two dates of diagnosis are separated by at least one month. Cancer diagnoses are subject to the cancer diagnosis limitation. See the Critical Illness plan Certificate of Insurance for complete information.

5. Why isn’t my illness covered?
The plan provides coverage for a limited number of critical illnesses. Those selected for inclusion are representative of illnesses most commonly included in group critical illness supplemental health plans. UC reviews benefit plan design annually, and plans are subject to change at time of renewal. See the Critical Illness plan Certificate of Insurance for a complete list of qualifying illnesses.

6. Does a wellness exam with my physician qualify for the health screening benefit?
Routine wellness exams on their own do not qualify. This benefit is payable only for health screening tests or diagnostic procedures that are performed in connection with a routine examination. Qualifying health screening tests include, but are not limited to, Pap tests, fasting blood glucose tests, serum cholesterol tests, chest X-rays, and stress tests. See the Critical Illness plan Certificate of Insurance for a complete list of qualifying tests and procedures.

7. Why is the cost for my coverage different from my spouse’s cost?
Monthly premiums for the plan are age banded. Generally, the older you are, the higher the premium. Costs for you and your spouse may differ based on your ages.

Hospital Indemnity Plan

1. How do hospital confinement benefits work?
The plan pays a standard benefit of $200 per day for each day you are confined in a hospital as an in-patient (up to 31 days). In addition to the standard $200 daily benefit, the plan pays an extra benefit of $200 for each day you are confined in an Intensive Care Unit (up to 10 days), and an extra benefit of $100 for each day you are confined in an Intermediate Intensive Care Step-Down Unit (put to 10 days).

2. Are visits to an Emergency Room or Urgent Care Center covered?
No. The plan does not provide coverage for treatment in an emergency room or urgent care center, or for outpatient treatment or confinement to an observation unit.

3. I am pregnant now. Is this considered a pre-existing condition?
No. There are no pre-existing condition exclusions in the plan. Qualifying hospital admissions/confinements occurring after your enrollment date are eligible for coverage.

4. If I have my baby in a hospital, will we both receive benefits?
You will be eligible for admission and confinement benefits. Healthy newborns are not generally admitted into the hospital following birth. However, the plan will pay benefits for each day the newborn is confined to the hospital. If a newborn is ill and admitted to the hospital, the plan will pay applicable admission and confinement benefits.

Have Questions or Need Help?

Call the UC Plus Customer Service Team toll-free at (888) 212-7201, Monday through Friday, 6:00 a.m. to 5:00 p.m. Pacific, excluding holidays.