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1-100: What You Need to Know About UHC
Sep 28, 2016
Rates & Commissions
- 4Q 2016 HMO: Rate Pass
- 4Q 2016 PPO: 10% statewide average DECREASE
- 1Q 2017 HMO: 3% statewide ANNUAL average DECREASE
- 1Q 2017 PPO: 3.7% statewide ANNUAL average DECREASE
UHC has issued Medical rate passes every quarter since 3Q 2015! Here is the history and take a look at the year over year comparison:
- 4Q: HMO Rate Pass and PPO DECREASE
- 3Q: HMO and PPO Rate Pass
- 2Q: HMO and PPO Rate Pass
- 1Q: HMO and PPO Rate Pass
- 4Q: PPO Rate Pass
- 3Q: HMO and PPO Rate Pass
- 1-50: 6.5% year 1; 6% year 2+
- 51-100: 5% year 1; 4% year 2+
Medical Plans & Benefits
Competitive Medical Plans for 4th Quarter
- Choice Simplified: All plans except the richest Platinum Select Plus, Core, Signature and Focus plan
- Choice Simplified (II): All plans except Advantage and Alliance HMO plans
ACEC - UHC's Engineering Trust
- Composite rates and Large Group (101+) PPO plan designs
- Group must be a member of, or join the ACEC Trust
- Contact your b&p Group Sales Rep to learn more - 888.722.3373
- Select Plus PPO: 100,000 docs / 303 hospitals
- Core PPO: 75,000 docs / 295 hospitals
- Signature HMO: 48,000 docs / 210 hospitals
- Advantage HMO: 28,000 docs / 153 hospitals
- Alliance HMO: 23,000 docs / 127 hospitals
- Refer to b&p's Bay Area Medical Group Comparison for details.
- New business implementation has been reduced to 2-3 business days; member IDs are now issued following the group approval.
- DE-9C will not be required for 10+ eligibles that complete the Participation Certification form.
- Full-time 1099 employees are eligible with at least one (1) eligible owner.
- Alongside Kaiser participation is 60% combined across both UHC and Kaiser with a minimum of five (5) enrolled.
- Individual coverage, on and off the Exchange, is considered a valid waiver.
- Flexible when 51% of employees are located out-of-state; broker must be licensed in the writing state.
- Owner only C-Corps, S-Corps, and LLCs are permitted IF they are not husband and wife.
Ancillary Plans & Benefits
- Niche Dental Options
- DHMO Direct Compensation plans
- FlexAppeal Enhanced Rider includes: implants; four (4) cleanings per year; and white fillings for molars
- Preventive Max Multiplier Rider pays preventive claims without reducing the Calendar Year Maximum (CYM)
- Dual Option (DHMO and PPO) down to five (5) eligible with three (3) enrolled.
- 10+ eligibles required for PPO Ortho with minimum eight (8) enrolled.
- Voluntary Dental (2+ enrolled) and Voluntary Vision (1+ enrolled)
- Costco is considered an in-network Vision provider.
Discounts & More
- Packaged Savings is an opportunity to receive up to $7 per-employee-per-month savings when ancillary products are bundled with UHC Medical.
- Dental: $3 pepm
- Vision: $2 pepm
- Life: $1 pepm
- STD: $1 pepm
- Fitness reimbursement available up to $240 per employee and spouse/domestic partner.
- No-fee services available such as COBRA, FSA, and Premium Only Plans (POP).
Please contact any member of your b&p Sales Team for assistance with UnitedHealthcare quote requests and questions regarding the details above - 888.722.3373.