1-100: What You Need to Know About UHC

​Rates & Commissions

Medical

• 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:

2016

• 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

2015

• 4Q: PPO Rate Pass
• 3Q: HMO and PPO Rate Pass

Commission

• 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

• Platinum Select Plus PPO 15/15%
• Gold Select Plus PPO 20/250/20%
• Gold Select Plus PPO 20/750/20%
• Silver Select Plus PPO 40/1800/30%
• Bronze Select Plus HSA 4500/40%
• UHC's ACEC Engineering Trust

Two Portfolios

• 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

Medical Networks

• 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.

Medical Underwriting

• ​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).
  

b&p Resources

• 4Q UHC Rate Update
  
• 4Q Medical Book Rates
  
• Year Over Year Rate Increase
  
• Competitive Plans by County
  
• 25+ Q4 New Sales Bonus
  
• 2-99 Specialty Bonus
  
• Medical Group Comparison
  
• Medical Underwriting
  
• 51-100 Transition Presentation
  
• 2016 Special Open Enrollment
  

More Information

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.