When a UC team scrutinized and then restructured medical plan offerings to employees for 2008, one of Mark Esteban's goals was to give people more resources to improve their health.

With the addition of a University-paid wellness program, new incentives for seeking preventive care, a specialized behavioral health provider and a medical plan that involves a consumer-oriented approach, employees do, indeed, have more choices when it comes to taking control of their health and health care.

Esteban, who has worked at UC for 23 years, the last 5 director of health and welfare policy and program design, believes the project that has consumed him, his staff and numerous others for the past 18 months has resulted in some significant improvements in the quality of employee health benefits. At the same time, UC employees will see decreases in some premiums and only slight increases in other plans - a noteworthy accomplishment in an era of spiraling health care costs.

"The ability of our medical plans to focus on wellness wasn't where we wanted it to be," Esteban says. "UC's new vendor, Staywell, will bring more attention to wellness because it's their specialty. They know how to engage people in understanding their wellness issues. We have great resources at the campuses, too - people and programs who care about the wellness of their employees - and we're trying to have them work together with Staywell," he says. The addition of the Staywell benefits along with waiving copayments for preventive doctor visits and immunizations encourages employees and their family members to pay greater attention to taking care of themselves, which also helps control costs.

"UC is definitely investing in employees with these changes," says Esteban. Another example of that investment is the single provider of behavioral health benefits. Research shows that employees at higher education institutions are more likely to use of behavioral health benefits than other employees. "Our experience confirms this, so it makes sense to improve those benefits," he says. "This change is not about cutting costs. We want people to get the care they need, so we've waived the first three copayments for outpatient mental health visits."

Of course, despite the many enhancements to benefits this year, some people will not be happy because their plan or provider will no longer be available. PacifiCare, an HMO, is out; CIGNA Choice Fund, a Health Reimbursement Account with PPO that involves a more consumer-oriented approach, is in. Though Health Net offers many of the same doctors, specialists and hospitals that PacifiCare offers, there will still be a number of PacifiCare enrollees who may have to find a new doctor.

Esteban says one of the most difficult parts of his job is balancing the diverse needs of the 113,000 employees and 37,000 retirees and their family members enrolled in benefits plans in an affordable way. "There are so many different people with different opinions of what plans and benefits we should offer. We have to manage this project from a global perspective. Not everyone's individual situation is going to be perfect."

Nonetheless, Esteban feels good about the benefits UC is offering this year. "Giving people resources to improve their quality of life is the responsible thing for an employer to do," he says. "Whether they use those resources is the employee's choice, but we want them to have meaningful and high quality choices."