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Blue Shield - New Virtual Blue Plans
The Virtual Blue plans give members (small and large groups) the choice of virtual or in-person care. Virtual care includes $0 unlimited visits to primary care, behavioral health and specialty care through a new partnership with AccoladeCare. In-person care is available through the Tandem PPO network in California and via BlueCard when outside of the state.
The two Virtual Blue small group plans available in PRISM are the Virtual Blue Gold Tandem PPO 1500/45 and Virtual Blue Bronze Tandem PPO 7500/75. These can be identified by ‘Virtual Blue’ in the plan name.
When using the PRISM filter options for Narrow or Broad networks, select ‘All’ networks instead of ‘Broad’ only networks to generate plans for Blue Shield’s Virtual Blue, Trio HMO, and Tandem PPO plans.
The recent specialty plans update and reminders are listed below.
Update
5% Dental Rate Cap Extended Through July 2021 Effective Dates
The UnitedHealthcare Dental Rate Cap Program guarantees that groups enrolling in a new plan will receive no more than a 5% increase at their first renewal.
Group size of 2 – 100 eligible employees.
Applies to both employer sponsored and voluntary coverage.
Available to both new business and new coverage existing accounts (NCEA).
Reminders
Enhanced Dental Plan Options
FlexAppeal Enhanced (X series)
Dental plan codes with the letter ‘X’ include coverage for white composites, implants, and up to four cleanings per year with a supportive diagnosis.
Preventive MaxMultiplier (H series)
Dental plan codes with the letter ‘H’ do not apply preventive and diagnostic services towards the annual maximum (the same concept as Delta Dental’s ‘DPM Waiver’ and Principal’s ‘Preventive Passport’ feature).
Off-Cycle Specialty Adds UnitedHealthcare allows certain specialty products to be added off-cycle without any approvals. The rate guarantee period will be adjusted so the off-cycle products renew at the policy anniversary.
Products that DO NOT require approval to be added off-cycle:
Contributory and voluntary dental.
Contributory and voluntary vision.
Non-contributory and contributory basic life.
Non-contributory and contributory long-term disability.
Non-contributory and contributory short-term disability (employees working in CA, HI, RI, NY, NJ, and Puerto Rico are not eligible).
Products that DO require approval to be added off-cycle:
Supplemental (Voluntary Life).
Voluntary short-term and voluntary long-term disability.
Your success is important to us, and we’re actively working on new solutions to support you throughout the year. To get the latest news via text messaging in the future, simply provide your cell phone number here.
Your success is important to us, and we’re actively working on new solutions to support you throughout the year. To get the latest news via text messaging in the future, simply provide your cell phone number here.
Your success is important to us, and we’re actively working on new solutions to support you throughout the year. To get the latest news via text messaging in the future, simply provide your cell phone number here.
Prepare for Q2-2021 with these rates actions, broker bonus programs, updates, and reminders from UnitedHealthcare.
Q2-2021 Small Group Rate Actions
Northern California Quarterly Change: PPO +2.7% and HMO +2.3% Annual Renewal: PPO +3.9% and HMO +3.0%
Southern California Quarterly Change: PPO +2.1% and HMO +2.3%
Annual Renewal: PPO +0.3% and HMO +1.8%
Broker Bonus Programs*
‘New’ Sales Bonus
Eligible California agents will receive a $100 bonus for each member enrolled in medical coverage sold during the bonus period.
Eligible groups are fully insured medical groups with up to 100 eligible employees in California that have an effective date from January 1, 2021 – December 31, 2021, and have at least 10 employees enrolled in UnitedHealthcare medical coverage.
Groups must be a California situs to be eligible for the bonus.
Renewal Bonus
Eligible agents can earn an additional $100 bonus for each enrolled employee for groups that receive the ‘New’ Sales Bonus for 2021, and renew coverage in 2022.
Another $100 bonus will be paid for each enrolled employee if the group renews coverage again in 2023.
Bonus example:
When an agent sells an eligible medical group with 60 enrolled employees, with an original effective date in 2021, the agent is eligible for a new sales bonus of $100 per enrolled employee, or $6,000 ($100 x 60 employees).
When this group renews fully insured medical coverage in 2022 with 65 enrolled employees and is active on December 31, 2022, the agent will receive a 2022 renewal bonus of $6,500 ($100 x 65 employees).
When the same group renews fully insured medical coverage in 2023 with 70 enrolled employees and is active on December 31, 2023, the agent will receive a 2023 renewal bonus of $7,000 ($100 x 70 employees).
Current Small Business Broker Bonus
The current bonus program is in place and will be in addition to the bonus programs mentioned above for new groups written in 2021.
Effective dates: March 1, 2020 through February 28, 2021.
Eligible groups are fully insured medical groups, located in California, that have at least 10 enrolled eligible employees.
The maximum bonus for eligible groups or a collection of affiliated groups is $50,000.
Example of the payout amounts by group size and medical coverage:
Staff Model Guidelines Only 5 California employees enrolled in UnitedHealthcare to offer alongside up to 2 Staff Model carriers, 60% overall participation required.
Out-of-State Guidelines Does not require 51% to reside in a state.
Participation Certificate Groups with 10+ employees can submit a participation certificate in lieu of a DE9C.
Start-Up Groups
6 weeks in business and 2 weeks payroll prior to the effective date.
Packaged Savings Discounts for bundling specialty coverage (dental, vision, life and/or short-term disability) with medical coverage.
Monthly credit per enrolled medical employee per month.
Dollar amount to be credited does vary by line of coverage.
Dental
UnitedHealthcare is extending the 5% dental rate cap until July 2021 effective dates.
Enhanced dental plans available:
– X Series: Implants, white composites, and up to 4 cleanings per year (no missing tooth clause).
– H Series: Preventative and diagnostic services do not count toward the annual maximum.
Implants and ortho included in the CA DHMO plans.
Vision
Retail network includes Lens Crafters, 1-800 Contacts, Warby Parker. and Glasses USA.
Additional exam and materials benefits are available for diabetic, pregnant/nursing women and children under the age of 13.
Wellness Reminders
Motion HSA Prepaid Debit Card
HSA members (employee or spouse) can choose to receive incentives via an HSA deposit or via a prepaid debit card during Motion registration. The debit card may be used for non-health care-related expenses.
Prepaid card option is effective January 1, 2021.
Employee and spouse can have their own HSA account or prepaid debit card.
Existing members will receive a notification.
Members can change their options throughout the plan year.
Motion and Apple Fitness+
Motion members with an Apple Watch® can now receive 5 months access to Apple Fitness+ at no additional cost from January 1, 2021 through June 30, 2021.
Important Dates
April 1, 2021 rate guides have been posted to the UnitedHealthcare portal.
New business submission deadlines are the 10th of every month.
April 1, 2021 renewals are available.
COVID-19 Public Health Emergency has been extended to April 20, 2021.
UnitedHealthcare will cover medically appropriate COVID-19 testing during the national public health emergency period.
Your success is important to us, and we’re actively working on new solutions to support you throughout the year. To get the latest news via text messaging in the future, simply provide your cell phone number here.
Effective January 1, 2021, 1-800 Contacts has become UnitedHealthcare’s newest online provider. Eligible members can apply their contact lens allowance by logging in at 1800contacts.com and selecting the insurance link.
LensCrafters, a recent UnitedHealthcare partner, offers consumers a large selection of designer frames, convenient hours and locations.
Your success is important to us, and we’re actively working on new solutions to support you throughout the year. To get the latest news via text messaging in the future, simply provide your cell phone number here.
Starting in 2021, UnitedHealthcare Motion® members with an Apple Watch® will be eligible to sign up for Apple Fitness+ and get a five consecutive month subscription at no additional cost.
Members will have access to Apple Fitness+ digital studio-style workouts with real-time metrics from Apple Watch synced to their iPhone, iPad or Apple TV, so they can follow their workout progress on screen. And they can choose from 10 workout types, with new workouts added every week that can be completed anytime, anywhere. Members can handpick music from their favorite artists to stay motivated. What’s more, Motion members may earn financial rewards for participating in Apple Fitness+ workouts.
Eligibility
The Apple Fitness+ promotion is available to any Motion-eligible member who activates the offer between January 1 – June 30, 2021, and has registered for UnitedHealthcare Motion and paired an Apple Watch on the UHCMotion mobile app. Once members pair an Apple Watch, they’ll receive a notification on how to redeem the Fitness+ promotion code.
Your success is important to us, and we’re actively working on new solutions to support you throughout the year. To get the latest news via text messaging in the future, simply provide your cell phone number here.
Includes 66 retail chains that offer convenient evening and weekend hours (good to know for groups with out-of-state locations). Many of the retail stores offer consumer discounts, on-going promotions, and a large inventory, unlike many private practice providers that are unable to due to space limitations.
Download the vision provider network flyer to learn more.
Enhanced Maternity and Pediatric Vision Benefits
Additional maternity and pediatric vision benefits are included at no extra cost to members:
Two eye exams are covered each plan year for mothers-to-be and children up to the age of 13.
Coverage for one new pair of glasses (frames and lenses) at no additional premium cost if the vision prescription changes .5 diopter or greater in a plan year.
Please note: these details are not included in UnitedHealthcare’s vision benefit summaries – only in this flyer.
Online Vision Providers: Warby Parker and GlassesUSA.com
Your success is important to us, and we’re actively working on new solutions to support you throughout the year. To get the latest news via text messaging in the future, simply provide your cell phone number here.
Specialty Benefits Quick Quote Tool for Small Business
UnitedHealthcare’s newly launched Specialty Benefits Quick Quote Tool is a web-based self-service quoting tool that allows brokers to quickly and easily provide dental, vision, and basic life quotes for groups with 2-100 eligible employees. Easily access it through United eServices using your UeS login information
New Features Include:
Summary census only for dental and vision quoting 2-50. No need to enter a full census!
Comprehensive product portfolio.
Advanced search options to filter portfolios based on needs.
Side-by-side plan comparisons of benefits and rates.
Plan Administrator Guide for Life and Disability Products
Get helpful action items and definitions to review as you administer your UnitedHealthcare life and disability coverage. Download the Plan Administrator Guide.
Your success is important to us, and we’re actively working on new solutions to support you throughout the year. To get the latest news via text messaging in the future, simply provide your cell phone number here.
Your success is important to us, and we’re actively working on new solutions to support you throughout the year. To get the latest news via text messaging in the future, simply provide your cell phone number here.
UnitedHealthcare has announced the following updates to their specialty plans:
Specialty rate pass.
In-force dental and vision renewing through April 2021 will receive a rate pass or better.
In-force basic life, supplemental life, STD and LTD renewing through January 2021 will receive a rate pass or better.
Applicable for groups of 2-100 eligible lives.
Includes UnitedHealthcare and All Savers business.
Dental rate cap extension through March 2021 effective dates.
New and existing groups enrolling in dental plans will receive no more than a 5% increase at their first year renewal. For example, if a new dental plan is sold for a December 1, 2020 effective date, the group will not have an increase greater than 5% on their December 1, 2021 renewal.
Admin Credit: Voluntary or Employer-Sponsored Specialty Bundling Program
Adding three or more specialty lines, including voluntary coverages, can help groups get a substantial one-time administrative credit.
Requirements:
– Effective dates of July 2020 through January 2021.
– 1 to 100 groups.
– Minimum of three lines of coverage sold together.
– Eligible lines of coverage: dental, vision, basic life, supplemental life, STD and LTD.
– Must meet the minimum annual premium threshold.
Your success is important to us, and we’re actively working on new solutions to support you throughout the year. To get the latest news via text messaging in the future, simply provide your cell phone number here.
