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1-100: UHC Plan & Rate Updates Effective January 2017
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Oct 28, 2016
United Healthcare announced rate adjustments
for January 1, 2017 effective dates with underwriting and benefit changes.
Rates are available for quoting!
RATES
Medical:
- HMO: -3% average DECREASE from January 2016
- PPO: 0.9% average INCREASE from October 2016
PLANS & BENEFITS
- Portfolios: There will be two (2) portfolio options in
2017: Choice Simplified and Multi-Choice State. Click here for details.
- New
Plans:
- Navigate PPO plans will be available as in-network plans only.
- PCP selection and electronic referrals are required.
- Existing
Plans:
- Most UHC Small Group plans will receive
benefit changes.
- View the Product Grid for
details.
- Virtual
Visits:
- Virtual office visits are available for new
and renewing groups purchasing 2017 plans.
- Provider network is Amwell and Doctoron Demand.
Rx CHANGES
- The mandatory mail
order Rx program that went into effect July 2016 will be eliminated for both
new and renewing groups (upon renewal) and for both HMO and PPO products.
- PPO & EPO plans
will use the California Custom PDL.
- HMO plans will use the
HMO Four-Tier PDL.
NETWORKS
- Navigate PPO will be
effective January 1, 2017.
- 72,000+ providers and 285 hospitals.
- Navigate plans are in-network only.
- Member must select a PCP; referrals not
required for specific services.
- Alliance network
service area is expanding in Madera, Riverside, San Bernardino, San Diego, and
San Luis Obispo counties.
COMMISSIONS
- Small Group Medical commission for California will change to a 5% flat commission for groups with a
January 1, 2017 or later effective date.
- All existing business
is vested.
UNDERWRITING
- Effective January 1,
2017, UHC will consider start-up groups that have been in business at least 6
weeks, instead of 50% of the previous calendar quarter, with payroll. All other Small Group requirements must be met.
- PLEASE NOTE: The Participation Certification
Form cannot be used for start-ups.
JANUARY BOOK RATES
Book rates for January 2017 effective dates
are provided below and on the b&p website.
For questions, please contact a member of you
b&p Sales Team - 888.722.3373.