University of California Health and Insurance Coverage for Residents and Fellows

Medical Plan Options

What to Know

Exelixis offers three medical plan options to all U.S. employees working at least 30 hours a week. California employees have a fourth option, the Kaiser HMO plan.

Blue Shield PPO HDHP with HSA
Blue Shield PPO Plan
Blue Shield EPO Plan
Kaiser HMO Plan
Additional Resources

Blue Shield PPO HDHP with HSA

This plan is available to all U.S. employees.

It is the only Exelixis plan paired with a tax-advantaged Health Savings Account (HSA) to help you save on health care expenses. During each calendar year that you’re enrolled, the company contributes $1,000 to your HSA for employee-only coverage and $2,000 for employee + dependents coverage.

This plan offers the lowest paycheck contributions of all the medical plans. Plus, you get contributions from Exelixis to your HSA every calendar year of $1,000 or $2,000, depending on your coverage tier, and you do not need to contribute to the HSA to get the employer contributions.

Don’t be deterred by the higher deductible. There’s no cost for eligible in-network medical services once you meet the deductible (and prescriptions go to a copay), and preventive care is covered 100% at no cost to you, even before you meet the deductible. Between the Exelixis contribution to your HSA and the low per-paycheck deductions, this plan is the most cost-effective option for many employees.

Deductible
Out-of-pocket maximum
Office visit
ER visit
Lab tests, X-rays
Hospital admission
Prescription drug – Retail
Prescription drug – Mail order
In-Network
$1,600 individual / $3,200 family
$2,500 individual / $4,500 family
$0 after deductible
$0 after deductible
$0 after deductible
$0 after deductible
$10 / $25 / $40 after deductible (up to 30-day supply); specialty: 30% up to $200
$20 / $50 / $80 after deductible (up to 90-day supply); specialty: 30% up to $400
Out-of-Network
$1,600 individual / $3,200 family
$2,500 individual / $4,500 family
20% after deductible
$0 after deductible
20% after deductible
20% after deductible (plan pays max of $600 per day)
25% after deductible + $10 / $25 / $40; specialty: 30% up to $200 per prescription + 25% of purchase price
Not covered

Your Contribution Costs

Employee: $24.92
Employee + Spouse: $50.77
Employee + Child(ren): $48.92
Employee + Family: $78.00

How You Can Save With the HDHP with HSA

  • Lowest paycheck contributions of all the Exelixis medical plans
  • The only medical plan that comes with a Health Savings Account (HSA), which you can use to pay for eligible health care expenses and which offers triple tax advantages:
    • No federal taxes and no state taxes (in most states)
    • No taxes on the interest you earn
    • No taxes when you use your funds for eligible expenses
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Blue Shield PPO Plan

This plan is available only to U.S. employees who were enrolled in it as of December 31, 2023.

The Blue Shield PPO plan has the highest per-paycheck contributions of any plan. It also has a higher out-of-pocket maximum than other plans. However, this plan gives you the flexibility to use out-of-network providers. You pay less when you stick with in-network providers versus out-of-network providers.

After you meet your deductible, the plan starts to share the cost of your care. For routine, in-network office visits, you pay a $20 copay, and the plan covers the rest. And for in-network diagnostic tests, you pay 10% of the total cost. Preventive care is 100% covered at no cost to you—even before you meet your deductible.

Deductible
Out-of-pocket maximum
Office visit
ER visit
Lab tests, X-rays
Hospital admission
Prescription drug – Retail
Prescription drug – Mail order
In-Network
$750 individual / $1,500 family
$4,000 individual / $8,000 family
$20 copay
$100 copay, plus 10% after deductible
10% after deductible
$400 copay, plus 10% after deductible
$15 / $30 / $50 (up to 30-day supply); specialty: 30% up to $200 per prescription
$30 / $60 / $100 (up to 90-day supply); specialty: 30% up to $400
Out-of-Network
$1,000 individual / $2,000 family
$5,000 individual / $10,000 family
30% after deductible
$100 copay, plus 10% after deductible
30% after deductible
30% after deductible (plan pays max of $600 per day)
25% + $15 / $30 / $50; specialty: 30% up to $200 per prescription + 25% of purchase price
Not covered

Your Contribution Costs

Employee: $120.00
Employee + Spouse: $244.62
Employee + Child(ren): $234.92
Employee + Family: $376.62

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Blue Shield EPO Plan

This plan is available to all U.S. employees.

The Blue Shield EPO offers a large network and great coverage. Your per-paycheck contributions under the EPO plan are substantially lower than the Blue Shield PPO, but slightly higher than the Blue Shield PPO HDHP with a Health Savings Account.

Under this plan, you don’t have a deductible, and you have a lower out-of-pocket maximum. However, you’re only covered for services you receive from network providers, except in emergencies. If you decide to enroll in this plan and you want to keep visiting the doctors you have now, make sure those doctors are in the new EPO network. Your cost share for most routine tests is a $20 copay, and preventive care is fully covered at no cost to you.

No referrals to specialists are required.

Deductible
Out-of-pocket maximum
Office visit
ER visit
Lab tests, X-rays
Hospital admission
Prescription drug – Retail
Prescription drug – Mail order
In-Network
$0
$1,500 single / $3,000 family
$20 copay
$100 copay
$20 copay
$250 copay
$10 / $25 / $40 (up to 30-day supply); specialty: 30% up to $200 per prescription
$20 / $50 / $80 (up to 90-day supply); specialty: 30% up to $400 per prescription
Out-of-Network
Not covered
Not covered
Not covered
Not covered
Not covered
Not covered
Not covered
Not covered

Your Contribution Costs

Employee: $60.00
Employee + Spouse: $122.31
Employee + Child(ren): $117.69
Employee + Family: $188.31

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Kaiser HMO Plan

This plan is only available to California employees.

The Kaiser HMO plan is a health maintenance organization (HMO) plan. Kaiser offers an all-under-one-roof plan with referrals to other Kaiser providers. If you want a managed approach to your care, this might be the plan for you. Under the Kaiser HMO, you don’t have a deductible, and there’s a lower out-of-pocket maximum. Your cost share for routine office visits is a $20 copay, there’s no charge for diagnostic tests, and preventive care is fully covered at no cost to you.

You can only use in-network providers—except in emergencies—and you must receive a referral to specialists from your primary care provider.

Deductible
Out-of-pocket maximum
Office visit
ER visit
Lab tests, X-rays
Hospital admission
Prescription drug – Retail
Prescription drug – Mail order
In-Network
$0
$1,500 single / $3,000 family
$20 copay
$100 copay
$0
$250 copay
$10 generic / $25 brand / $25 specialty (up to 30-day supply)
$20 generic / $50 brand (up to 100-day supply)
Out-of-Network
Not covered
Not covered
Not covered
Not covered
Not covered
Not covered
Not covered
Not covered

Your Contribution Costs

Employee: $35.72
Employee + Spouse: $74.75
Employee + Child(ren): $71.18
Employee + Family: $113.53

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Additional Resources

Blue Shield

Benefit Summaries and Coverage Descriptions

PPO HDHP with HSA
2025

Blue Shield HDHP Benefit Summary (2025)
Blue Shield HDHP SBC (2025)

2024

Blue Shield ASO Custom Full PPO (HDHP HSA) Summary of Benefits (2024)
Blue Shield ASO Custom Full PPO (HDHP HSA) Summary of Benefits and Coverage (2024)
Blue Shield HDHP Evidence of Coverage

PPO
2025

Blue Shield PPO Benefit Summary (2025)
Blue Shield PPO RX Summary (2025)
Blue Shield PPO SBC (2025)

2024

Blue Shield ASO Custom PPO Enhanced Outpatient Prescription Drug Benefit (2024)
Blue Shield ASO Custom Full PPO Split Deductible (PPO) Summary of Benefits and Coverage (2024)
Blue Shield ASO Custom Full PPO Split Deductible (PPO) Summary of Benefits (2024)
Blue Shield PPO Evidence of Coverage

EPO
2025

Blue Shield EPO Benefit Summary (2025)
Blue Shield EPO RX Summary (2025)
Blue Shield EPO SBC (2025)

2024

Blue Shield ASO Custom EPO Enhanced Outpatient Prescription Drug Benefit (2024)
Blue Shield ASO Custom Full EPO Summary of Benefits (2024)
Blue Shield ASO Custom Full EPO Summary of Benefits and Coverage (2024)
Blue Shield EPO Evidence of Coverage

Prescription Drugs

Blue Shield Preferred Pricing and Discounts
Blue Shield Prime Drug Formulary
Blue Shield Prime Drug Formulary Search Tool

Emotional and Physical Well-Being

LifeReferrals 24/7
Headspace for Blue Shield Members
Wellvolution for Blue Shield Members
Blue Shield: Fitness Your Way
Blue Shield: NurseHelp 24/7
Blue Shield Total Health and Wellness

Helpful Tools

Blue Shield Enrollment Kit
Blue Shield Find a Provider Tool
Blue Shield: How to Find a PPO Provider
Blue Shield Member ID Card Instructions
Blue Shield Mobile App Instructions
Blue Shield Treatment Cost Estimator

Kaiser

Benefit Summaries and Coverage Descriptions

2025

Kaiser HMO Northern CA Summary of Benefits and Coverage (2025)
Kaiser HMO Southern CA Summary of Benefits and Coverage (2025)

2024

Kaiser HMO Evidence of Coverage (2024)
Kaiser Benefit Summary (2024)
Kaiser Chiropractic Benefits (2024)
Kaiser Summary of Benefits and Coverage (2024)
Kaiser Chiropractic Evidence of Coverage

Emotional and Physical Well-Being

Kaiser Health and Wellness Resources
Kaiser Mental Health
Kaiser: Power of Self-Care
Kaiser Weight Management
Kaiser Wellness Coaching

Helpful Tools

Kaiser Away from Home Care Options
Kaiser Cost Estimator
Kaiser Find a Doctor Tool
Kaiser Mobile App

Medicare

Medicare Resources
What Employees Need to Know When Turning Age 65

Medical FAQ

How do I elect my benefits?

Log into Workday thru Single Sign On (SSO) to elect your benefits.

I am a new hire. When will my health insurance start? Will I need to re-enroll for the next year?

As a new hire, you will have 30 days starting on your date of hire to make your benefits elections. Your insurance benefits will be effective on the day of your start date, even if you complete your elections a week later. Once the 30 day enrollment period has ended, your choices will be final until the next enrollment period or until you have a qualifying life event.

When will the carriers receive my information?

Our files feeds over to our carriers every Tuesday and Friday morning.

When can I expect to receive my medical card?

Medical cards usually take 72 hours to process. Once fully processed it can take  5-10 business days to be mailed out. You will be able to download an electronic version of your card by registering online at www.blueshieldca.com. Please note that your information can take up 48 hours to be sent to the online portal to access the virtual card.

What happens if I’ve misplaced/lost my medical insurance card?

Please reach out to your insurance provider to replace your card.

I have a dependent enrolled in my benefits who is turning 26.  Will his/her coverage extend through the end of the month and does not expire explicitly on his/her birthday? Is there an option for COBRA continuation of coverage for him/her?

Yes, the benefits will go through the end of the month in which he/she turns 26. Yes, there is the option for COBRA continuation. Our COBRA administrator will send you the paperwork if you choose to elect it.

My dependent turns 26 this month, how do I remove him/her from my plan?

Your dependent’s coverage will be effective until the end of the month and will automatically be removed the following month. Our COBRA administrator will send information regarding continuation should you choose to elect it.

Can the out-of-pocket amount paid into my spouse’s high-deductible plan be transferred to the Exelixis high-deductible plan?

Unfortunately, OOP expenses/deductibles cannot be transferred from a spouse’s plan to Exelixis’ plan.

One of my dependents has moved to a different state, are they still eligible to be covered under my insurance plan?

Blue Shield HDHP plan is available nationwide. The dependent will need to create an account online by registering at engagementpoint.com. Through the member portal s/he will be able to access all the resources and schedule care in his/her location. Please confirm the dependent’s new address to benefits@exelixis.com so we can have Blue Shield update it on their end.

When can I add my spouse or child? Do we need to be on the same plan?

The times that you can enroll your dependents are when you are a New Hire, during Open Enrollment (in November for a January 1 effective date) or if you experience a qualifying life event (QLE). Loss of employment for your spouse is a QLE as long as it is done within 30 days of your spouse losing coverage.

You, your spouse and all dependents need to be on the same plan type.

You would need to log into Workday and add your spouse’s information then elect a mid-year enrollment to add your spouse to your plans. You will not be able to change your plans, you can only add your spouse or child onto the plan you are currently enrolled in.

Am I able to enroll in Medicare but continue to stay on the Exelixis health plans?

Employees that are actively working and enrolled in a healthcare plan through their employer can delay Medicare enrollment until retirement and can continue to remain on the HDHP plan and contribute to HSA.

If you delay enrollment in Part A and B there will not be a late enrollment penalty as you still have coverage from our plan.

If you were to enroll in Medicare it would be your secondary coverage as you would still be covered under our plan.

Is there a number I can call if I have additional questions for Blue Shield?

Yes, you can call Member Services at 855-829-3566.

Is there a number I can call if I have additional questions/grievance for Kaiser?

Yes, you can call Member Services at 800-464-4000.

The government recently released new guidance under the Families First Coronavirus Response Act (FFCRA) that addresses the expansion of the COVID testing mandate to include over the counter (OTC) testing beginning January 15, 2022. Where can I find more information?

Kaiser Members: kp.org/covid
Blue Shield Members: Coverage for COVID-19 Testing

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Medical

Blue Shield

Group #: W0065462
855-599-2657
blueshieldca.com

Member Services
7 a.m.– 7 p.m. PT, Monday–Friday

Teladoc: 800-835-2362
NurseHelp 24/7: 877-304-0504
Access to care outside of CA:
855-599-2657
Access to care outside of U.S.:
855-599-2657

CVS Caremark (pharmacy)

866-346-7200

Pharmacy information (all plans)
PCN: 77993333
BIN: 004336

Medical

Kaiser Permanente

Group #: 037087
Member Services: 800-464-4000 (24/7, except holidays)
Advice Line: 866-454-8855 (24/7)
kp.org