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UHC Specialty Newsletter: Fundamentals of Dental, Vision, Life & Disability

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Get Back to the Fundamentals of UHC's Specialty Products

From plan maximums to guaranteed issue amounts, UHC is breaking down the basics to help you make informed decisions for small business employer groups.

 

Dental

  • Employer Contribution
    • Contributory: 50%-100% employer contribution
    • Voluntary: 0%-49% employer contribution, 0% towards dependents
  • Employee Participation
    • Contributory: 75% participation of eligible employees less valid waivers, not to fall below 50% of total eligible employees
    • Voluntary: 2 eligible employees, 2 enrolling
  • Ortho/Implant Participation: 5 eligible employees, 3 enrolling
  • Standalone: Yes, sell dental without other UHC products down to 2 eligible employees
  • Dual Option
    • DHMO/DPPO requires 5 eligible employees, 3 enrolling
    • DPPO/DPPO requires 10 enrolling employees
    • 20% relativity spread between the two plans
    • 2 key differences between the two plan offerings
  • Under 5 eligible
    • Annual maximum up to $1,500
    • Consumer MaxMultiplier
  • Over 5 Eligible
    • Annual maximum options also include $2,000, $2,500, $3,000, $5,000, and unlimited
    • Child Only Ortho or Child and Adult Ortho
    • Consumer MaxMultiplier
    • FlexAppeal Preventive MaxMultiplier (“H” plans)
    • FlexAppeal Enhanced (“X” plans)

 

Things to consider when quoting and selling UHC Dental:

  • Voluntary or Contributory
  • Incentive or Passive
  • Waiting Period or No Waiting Period
  • Endo/Perio in Major Services or Endo/Perio in Basic Services
  • MAC or UCR (70%-95%)

 

Vision

  • Employer Contribution
    • Employer Paid: 50%-100% employer contribution
    • Voluntary: 0%-49% employer contribution
  • Employee Participation
    • Employer Paid: 75% participation of eligible employees less valid waivers, not to fall below 50% of total eligible employees
    • Voluntary: 2 eligible employees, 1 enrolling
  • Standalone: Available
  • Dual Option: Not available
  • 2-99 Eligible
    • Frequency: 12/12/12, 12/12/24, 12/24/24, 24/24/24
    • Exam Copay: $0, $10, $15, $20, $25
    • Material Copay: $0, $10, $15, $20, $25, $30
    • Frame Allowance: $100, $130, $150, $175, $200
    • Contact Allowance: $105, $125, $150, $175, $200
    • Progressives covered at a copay by tier (I, II, III, IV)

 

Basic Life

  • Employer Contribution
    • Non-Contributory: 100% employer contribution
    • Contributory: 25%-99% employer contribution
    • Voluntary: not available on Basic Life, would require supplemental life
  • Employee Participation
    • Non-Contributory: 100% participation of eligible employees, waivers do not apply to life products
    • Contributory: 75% participation of eligible employees
    • Voluntary: not available on Basic Life, would require supplemental life
  • Standalone
    • 2-5 eligible employees: requires 2 additional specialty lines
    • 6+ eligible employees: available

 

Guarantee Issue and Plan Maximum for Basic Life

Group Size Guarantee Issue Plan Max
2-5 Eligible Employees $25k $50k
6-19 Eligible Employees $50k $175k
20-50 Eligible Employees $100k $250k
51-99 Eligible Employees Lesser of $175k or Plan Max $350k

Supplemental Life

  • Employer Contribution: Voluntary: 100% employee paid
  • Employee Participation:
    • 2-9 eligible employees: not available
    • 10+ eligible employees: 25% participation eligible employees
  • Standalone: No, requires Basic Life

 

Guarantee Issue and Plan Maximum for Supplemental Life

Group Size Guarantee Issue Plan Max
10-19 Eligible Employees $30k $100k
20-50 Eligible Employees $30k $100k or $200k
51-99 Eligible Employees $50k or $80k $100k or $200k or $300k

Disability

  • Employer Contribution
    • Non-Contributory: 100% employer contribution
    • Contributory: 25%-99% employer contribution
    • Voluntary: 0%-24% employer contribution
  • Participation
    • Non-Contributory: 100% participation, 2+ eligible
    • Contributory: 50% participation, 10+ eligible
    • Voluntary: 25% participation, 10+ eligible
  • The STD benefit duration and LTD elimination period must align to avoid a gap in coverage
    • 13 weeks = 90 days
    • 26 weeks = 180 days
  • Standalone: Available with 6+ eligible

 

Long Term Disability

  • Benefit: 50%, 60%, 66.67%
  • Duration: 2-year, 5-year, ADEA I with NRA (retirement)
  • Elimination Period: 90 days, 180 days

 

Short Term Disability

  • Benefit: Flat amount, 50%, 60%, 66.67%
  • Duration: 13 weeks, 26 weeks
  • Elimination Period: 0/7, 7/7, 0/14, 7/14, 14/14 days

 

For questions or help with a UHC quote, please contact a member of your B&P Sales Team – 888.722.3373.