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Covered California for Small Business – New Blue Shield Plans
New Cigna + Oscar (C+O) small group sales and renewals will not be offered in 2025. At C+O’s request, all plans and rates have been removed from the quote engine. However, you can still quote or renew your C+O groups through December 15, 2024 by contacting us at quotes@claremontcompanies.com or 800.696.4543. Please note: the last day of coverage will be December 14, 2025.
UnitedHealthcare Small Group Rate Actions and Bonus Programs
Jan 18, 2021, 4 Minute Read
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.
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