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UnitedHealthcare Q3-2016 Small Group Rate Pass and Updates

UnitedHealthcare Q3-2016 Small Group Rate Pass and Updates

UnitedHealthcare Q3-2016 Small Group Rate Pass and Updates, UnitedHealthcare,

UnitedHealthcare’s Q3 rates for small groups (1-100), some of the lowest in the market, will remain unchanged through September 30, 2016. Benefit changes and underwriting updates are listed below. What’s more, several of the underwriting changes allow more groups to qualify for coverage.

Don’t miss out on the broker bonus program for new groups!


Underwriting Changes Effective April 1, 2016

  • Small Group participation requirement has been lowered to 60%.
  • Owner-Only Groups are now permitted if they are a C or S corporation AND the owners are not spouses. Owner-only groups where the owners are spouses are not eligible.
  • Employer contribution is changing to:
    • At least 50% of the employee premium, OR
    • A minimum of $100 of the employee premium.
  • The revised Underwriting Guidelines will be available soon on the UnitedHealthcare Broker Portal.

Retroactive Benefit Changes Effective January 1, 2016

  • Rx code HQ has changed to 394 – Family Rx Deductible has been revised from $750 to $500 due to CDI objection on the maximum Rx Deductible on Bronze plans; this Rx plan is paired with the PPO Medical Bronze 40/6600/0% (AE-JC AE-JH). The new summary will be available soon on the  UnitedHealthcare Broker Portal.
  • Rx code 353 – both the retail and mail order copays have a copay maximum of $500 for each Tier. This change mirrors the state exchange plan designs. Download the revised Rx Benefit Summary.
  • Applicable marketing materials (i.e. Product Grid) will be updated to reflect the changes.

Q3 Sales Bonus Effective July 1, 2016 through September 30, 2016

  • California agents who sell new medical groups with up to 100 eligible employees, effective July, August and September, can earn a bonus of up to $100 for each enrolled employee. Learn more.

Contact the small group experts at 800.696.4543 or


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