Health Net is changing in San Francisco for 2013 – If you are currently enrolled in Health Net Blue & Gold, these changes may impact you

What is happening?

A new accountable care arrangement (ACA) will be available to all University of California employees and non-Medicare retirees, and their families in San Francisco, beginning 1/1/13. Health Net has created this ACA in collaboration with Hill Physicians Medical Group, UCSF Medical Center, St. Mary’s Medical Center and Saint Francis Memorial Hospital.

Effective January 1, 2013, Brown & Toland in San Francisco WILL NOT be part of the Blue & Gold network. California Pacific Medical Center in San Francisco (four campuses including St. Luke’s in San Francisco) also WILL NOT be part of Health Net Blue & Gold

Why are Brown & Toland and CPMC not included in the Blue & Gold network in San Francisco?

Hill Physicians Medical Group, UCSF Medical Center, St. Mary’s Medical Center and Saint Francis Memorial Hospital together with Health Net – and in collaboration with the University of California – have formed an Accountable Care Arrangement. The idea behind the new arrangement is to have a select group of high quality providers provide and coordinate health care to University of California employees, non-Medicare retirees and their families in San Francisco County who enroll with Health Net.

Other changes in the Blue & Gold network are being implemented throughout California to assist the University of California in keeping health care costs down - both for the UC system and employees.

Who is affected?

Employees enrolled in Health Net Blue & Gold AND you/your family members are currently assigned to Brown & Toland medical group providers.
All impacted employees will receive a custom letter from Health Net outlining their options. Copies of the letters can be found on the Health Net website.

Not Affected…

Employees enrolled in Health Net Blue & Gold AND you/your family members all are currently assigned to Hill Physicians medical group providers

What do I need to do - Employee Actions

If you want to change medical groups/PCP for your and/or your family members you will need to call Health Net at 1-800-539-4072 by 12/1/12 for a January 1, 2013 effective date
If you want to change medical plans to keep your Brown & Toland providers, you must select a new medical plan during Open Enrollment
If you take NO action and you are currently enrolled in Health Net Blue & Gold with a Brown & Toland primary care provider, you will automatically be assigned to a provider/medical group participating in Health Net Blue & Gold. In most cases, you will be assigned to a San Francisco Hill Physicians provider.
If you take NO action and you are currently enrolled in Health Net Blue & Gold with a Brown & Toland primary care provider who also is affiliated with Hill Physicians, you will be transferred to Hill Physicians medical group so you can continue with your primary care provider. However, please note that the referral specialists, labs, and hospitals available in a new medical group might be different than those offered by your current medical group even if you primary care doctor is available through both.

Employee Action Guide - For more detailed information on options and what actions you need to take

How do I select a new primary care physician in San Francisco

UCSF Primary Care

All physicians at UCSF are included in the Health Net Blue & Gold Network and are part of Hill Physicians Medical Group.
Representatives from primary care at UCSF will be available at the Open Enrollment Help Desks to answer questions and can assist you in selecting a new primary care provider.
Frequently_Asked_Questions_about_Access_and_Privacy_at_UCSF_Medical_Center_(2).pdf

San Francisco Community Primary Care Providers (Dignity Health)

Hill Physicians Medical Group at 1-800-321-MORE (6673) between 8:00 a.m. and 5 p.m., M-F

Health Net at 1-800-539-4072 between 8:00 a.m. and 6 p.m., M-F

You can view a complete Blue & Gold HMO network list for 2013 on the Health Net website or you can request a copy of the directory by calling Health Net.

If the primary care physician I want to select is new and not showing on the Health Net website, what should I do?

If you want to sign up with a Hill Physicians doctor that has not yet been added to the website, please sign up with an alternative physician that is in the same practice and call Health Net to request a physician change after the provider has been added.

How do I change my provider and/or medical group?

You must call Health Net if you want to change your medical group/provider to a Health Net Blue & Gold participating provider. You cannot make this change online on At Your Service or on the UC Open Enrollment website.

What happens if I’m currently in treatment and my doctor is no longer available as part of the Blue & Gold HMO network?

Depending on your situation, your options may include establishing care with a new provider or requesting a transition of care exception. More detailed information on Transition of Care can be found here.

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