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΢Ƶ is assuring its own employees who are members of Western Health Advantage: You will not lose access to ΢Ƶ Health.

Effective Jan. 1, ΢Ƶ Health will no longer offer primary care services in Western Health Advantage. But ΢Ƶ is assuring its own employees who are members of the WHA health maintenance organization: You will not lose your access to ΢Ƶ Health care.

  • First, the UC Office of the President negotiates every summer with various health plans to determine which of them will be offered the next year. WHA is part of the talks, and this could result in a WHA plan just for UC employees — a plan that would give them access to ΢Ƶ Health.
  • In the alternative, ΢Ƶ Health will be an option in other plans that are already available to UC employees, and those plans are expected to continue in 2018. Open enrollment is scheduled from Oct. 26 to Nov. 21.

΢Ƶ Health announced last month that it was modifying its 20-year relationship with WHA, to withdraw as a primary care provider in WHA’s commercial network.  All WHA enrollees still have access to primary care through ΢Ƶ Health until the end of this year, and the health system expects to continue providing specialty and hospital care to WHA commercial plan enrollees after Dec. 31.

“There is no expectation that there will be any impact to UC employees, retirees and their eligible dependents that receive their health insurance through WHA and have a ΢Ƶ Health PCP,” ΢Ƶ Health officials said in a statement.

UCOP’s negotiations with WHA and other plans should conclude in late summer. “At that time, we will know whether WHA will be available to UC employees and retirees for 2018,” according to the statement from ΢Ƶ Health. “Regardless, UC employees, retirees and their eligible dependents will continue to have access to ΢Ƶ Health primary care and specialty services through other health plans.”

΢Ƶ officials said they did not take lightly their decision to close ΢Ƶ’ primary care provider group to WHA members.

“After months of analysis, ΢Ƶ Health concluded that due to the uncertainty in today’s health care environment, continuing the WHA relationship as it has existed was not fiscally prudent,” according to the statement. “Unfortunately, WHA leadership and ΢Ƶ Health were unable to come to agreement on a strategy to address these concerns in a way that would allow us to continue to provide primary care services to other employer groups.”

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