Skip to content Skip to navigation

Changes to your medical plan options for 2020

A new plan, Trio by Blue Shield, is available to those who live in the plan’s service area. Also, Stanford is discontinuing the EPO plan amid concerns about the plan's affordability moving forward.

When Open Enrollment begins on Oct. 21, 2019, Stanford employees and retirees under age 65 will see a few changes to medical plan options for 2020. Affordability, flexibility and choice have all played a big role in planning for next year, says Neal Evans, director of health and life benefits in University Human Resources.

Participants in the Aetna Exclusive Provider Organization (EPO) plan have been notified that Stanford will no longer offer the plan, effective Jan. 1, 2020. As mentioned during Open Enrollment last year, there have been concerns about the plan continuing to be an affordable option for participants, and for the university, moving forward.

Trio, a Blue Shield plan, will be available in 2020 to all benefits-eligible employees and retirees under age 65 who live in the plan's service area, which includes several Bay Area counties.

  • Trio plan premiums are priced between the Kaiser HMO and Stanford Health Care Alliance (SHCA) plans.
  • Trio uses a select Blue Shield of California network of doctors and hospitals (the Trio ACO HMO provider network).
  • Similar to the Kaiser HMO and SHCA plans, Trio participants have a primary care doctor (PCP) to coordinate their care, and they pay a copayment at the point of service rather than meeting a deductible. If participants choose to see a doctor or use a hospital outside the network, they pay the full cost of care.
  • Trio provides some benefits for long-term travelers and students or family members living apart through the Away From Home care program; availability varies by county.

Balancing choice and cost

In the past few Open Enrollment surveys, employees have said that access to their favorite doctors is as important as cost in choosing a health plan, Neal says. "Not everyone in our plans has the same needs, so we try to provide plan choices that cover most situations," he adds. "Not everyone has a daughter away at college in a different state, but if you do, you need a plan that will cover her. Not everyone has a doctor they love and see often, but if you do, you need a plan where your doctor is in-network."

And yet, cost is something we have to watch closely, he adds, because the health care market in the Bay Area is one of the nation’s most expensive, and because some of the providers our employees prefer are among the most expensive in the country.

One thing that is not changing is that Stanford remains one of the few employers in the Bay Area to offer free employee-only coverage in a medical plan; in 2020, Kaiser remains the lowest-cost plan and employee-only coverage continues to be free for full-time employees.

Reviewing plan options

There are many factors that influence a family’s decision in electing a plan. Here are a few plan features employees have told us make the difference for them, along with which plans provide those benefits.

  Healthcare + Savings Kaiser HMO Stanford Health Care Alliance Trio (new) ACA Basic High Deductible
Nationwide network      
Requires Primary Care Physician for referrals    
Includes Stanford Health Care providers*    
Accepts Palo Alto Medical Foundation providers*      
Has a copay, no deductible    
Covers non-network mental health/substance abuse care      
Eligible for a flexible spending account (FSA)    
Eligible for a health savings account (HSA)      
Out-of-pocket maximum

* Note: Stanford cannot guarantee that any doctor, medical group or hospital will continue to participate in any plan’s network. This information is current as of Sept. 25, 2019.

More resources

Medical Plan Comparison Tool

Trio plan profile

Open Enrollment microsite

Benefits & Rewards, Health