1-100: UHC Plan & Rate Updates Effective January 2017

​​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 h​ere 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 Prod​uct Grid for details.
    
• Virtual Visits:
  
  • ​Virtual office visits are available for new and renewing groups purchasing 2017 plans.
    
  • ​Provider network is Amw​ell and Docto​ron 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 ​Califor​nia 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.

• 1-100 Rate Guide
  

For questions, please contact a member of you b&p Sales Team - 888.722.3373.