UnitedHealthcare New Alliance HMO Plans, April 2012

UnitedHealthcare is pleased to introduce their new SignatureValue Alliance
HMO plans, a new set of HMO plans with their own tailored network, available as
of April 1, 2012. The medical groups in the Alliance network have been
recognized for offering exceptional care, quality and cost efficiency. Plans will be available to members in parts of Fresno, Kern, Kings, Los Angeles,
Madera, Orange, Riverside, San Bernardino, San Diego, and Ventura counties.

Alliance Plan Highlights

Alliance HMO plans come with built-in health and wellness programs, at no
additional cost, to help your clients’ employees take steps toward an overall
healthier lifestyle. They can get information on their specific health needs and
enroll in online health coaching or other motivational programs for improving
their health. UnitedHealthcare will also send personalized messages and
reminders for preventive care and screenings. Their disease management and case
management programs offer support and guidance to members who are looking for
treatment options for chronic conditions.

Plans also include prescription drug benefits based on clinical quality and
evidence-based medicine, which may lead to potentially better health outcomes
and cost savings. Members can also receive personalized messages to help them
make more informed decisions and save money at the pharmacy.

Alliance Network Overview

Alliance HMO provides coordinated care to members with access to more than
26,000 physicians and specialists and more than 90 hospitals. With
UnitedHealthcare SignatureValue Alliance, members choose a Primary Care
Physician (PCP) from a network of highly acclaimed medical groups in the state,
which consists of:

  • HealthCare Partners Medical Group
  • Heritage Provider Network
  • Monarch HealthCare Medical Group
  • PrimeCare Medical Group
  • Santé Community Physicians
  • Scripps Health

Alliance HMO Plan Line-up

  • SignatureValue Alliance 15-30/300a
  • SignatureValue Alliance 20-40/300d
  • SignatureValue Alliance 30-40/500d
  • SignatureValue Alliance 40-60/800d
  • SignatureValue Alliance 40-60/60%
  • SignatureValue Alliance 20-40/70%/1500ded
  • SignatureValue Alliance 40-60/70%/2000ded
  • SignatureValue Alliance HRA 30-45/90%/1500ded
  • SignatureValue Alliance HRA 35-50/80%/2000ded
  • SignatureValue Alliance HRA 40-55/70%/3000ded
  • SignatureValue Alliance HSA 1500/90%
  • SignatureValue Alliance HSA 2000/80%
  • SignatureValue Alliance HSA 3000/80%

Guidelines

The Alliance plans may be offered standalone or as part of a multi-choice
package, allowing employers to pair the HMO Alliance network alongside specific
PPO plan designs. Premier Source Alliance is also available for employers who
wish to offer HMO Alliance plans alongside another carrier.

UnitedHealthcare (CA small group) Multi-State Guidelines

UnitedHealthCare is modifying the CA Small Business 2-50 underwriting requirements as follows: 

Per AB 1672, groups with 51% of the eligible employees employed in the State of California are considered guaranteed issue groups. 

Groups with more than 49% of the eligible employees employed outside the state of California are considered non-guaranteed issue in California. These groups require health statements and are not eligible for the RAF promotion. 

Underwriting will approve or decline these groups in accordance with the underwriting guidelines.

UHC – California Small Business (2-50) Rate Action – Effective May 1, 2011

 Effective May 1, 2011 the average statewide rates for new business will increase by approximately 3.3% for the PPO product and 0.6% for the HMO product. See following averages by area:  

  • Los Angeles and Ventura Counties: 1.5% decrease for HMO; 3.0% increase for PPO/HSA 
  • Orange County: 1.5% decrease for HMO; 3% increase for PPO/HSA 
  • San Diego County: 3% increase for HMO; 3% increase for PPO/HSA 

For renewing customers, the average statewide annual rate increase is approximately 4% for HMO and 13% for PPO. See the Small Business 2-50 Product Catalog and Rate Guide below for more details. 

Product Catalog 

Rate Guide 

United Healthcare Small Business Rate Action – Effective February 1, 2011

Effective February 1, 2011 the average statewide rates for new business will increase by approximately 2% for PPO. There is no measurable rate change for the HMO product. See following averages by area:  

Los Angeles County: no rate increase for HMO; 1.2% for PPO/HSA

Orange County: no rate increase for HMO; 1% for PPO/HSA

San Diego County: no rate increase for HMO; 3% for PPO/HSA

For renewing customers, the average statewide rate increase is approximately 7% for HMO and 13% for PPO

UHC introduced a new plan, Choice Plus Balanced Value 40/5000/70% (Plan Code J3-U) which comes with per-occurrence deductibles of $500 for outpatient surgery and $1,000 for inpatient hospital services. In addition, UHC are providing Substance Use Disorder supplemental coverage, offered with our HMO plans through an arrangement with U.S. Behavioral Health Plan.

See the Small Business 2-50 Product Catalog and Rate Guide for more details.