UnitedHealthcare

For ACA Medical, UHC requires a minimum of 10 enrolled employees to offer composite rates in the following states: AL, AZ, FL, GA, IA, IL, IN, KY, LA, MS, NC, OH, and SD.

LF: Each Agency must obtain UHC market leader approval 

• No quoting past effective dates

• Only quote effective dates 1st of the month

• No “life partners”

Direct API quoting with UnitiedHealthcare for Dental, Vision, and Basic Life & AD&D plans

Preferred plans* available in all 50 states

*UHC determines which plans are preferred to present for quoting. In order to provide simplicity of use, and to assist with plan selection, the API quoting services quote a subset of the available plans for each state.

UHC's API only allows quoting for effective dates less than 90 days in the future.

Dental:
2-50 size employer groups (up to 100 in ACR- Adjusted Community Rating groups only, currently NY & CA)
Dental Plans with Orthodontia: 5 eligible, 3 or more employees enrolled.
SIC Code - SIC codes are required for dental. No “dummy” codes (e.g. 9999). SIC codes 8020 and 8021 are ineligible for quoting.

Employer Participation:

• Voluntary dental plans:
  • Employer may contribute 0 to 49% of the total premium.
  • 0% participation of eligible employee.

• Contributory/Employer-Paid dental plans:
  • Employer contribution- 50% or more of the employee rate. At least 75% participation of eligible employees who do not waive coverage, not to fall below 50% of total eligible employees.

Re-Rating for Dental, Vision and Basic Life will occur if there is a census change by +/-10% and for Basic Life total monthly benefit change by more than 10%.

Vision:

2-100 size employer groups 

SIC Code - SIC codes are required for dental. No “dummy” codes (e.g. 9999).  SIC Code 8042 is ineligible for quoting.

Employee Participation and Contribution Information:

• Voluntary plans: minimum 1 or more enrollees required; no participation percentage required.
• Minimum group size eligible for New Business Quoting: 2
• Minimum enrolled employees for Sold Case Installation: 1
• Employer sponsored plans at least 75% participation of eligible employees less valid waivers, not to fall below 50% of total eligible employees.
• For employee core/voluntary dependent Vision plans: 75-100% employer contribution for employees; no employer contribution requirements for dependents; at least 75% participation of eligible employees less valid waivers, not to fall below 50% of total eligible employees.

Re-Rating for Dental, Vision and Basic Life will occur if there is a census change by +/-10% and for Basic Life total monthly benefit change by more than 10%.

Basic Life:

2-50 size employer groups 

Groups with 2-5 eligible may be sold without medical but must have 2 additional ancillary products

Certain SIC code restrictions do apply- see below
Conversion is available to individual whole life when losing life coverage under certain circumstances outlined by the contract. Portability- not available

Rates are guaranteed for 24 months

Plan Types:

• Flat Volume: Increments of $5,000 benefit increments, with minimums and maximums listed below.
• Times Salary: Benefit tied in increments of the employee’s salary.
• Occupational: Life benefit based on employee occupational categories.

Plan Benefits:

• Employee Benefit Amount - $15,000 volume to plan maximum in $5,000 increments
• Plan Maximums:  2-5 - $50,000,
                              6-19 - $175,000,
                              20-50 - $250,000
• Guarantee Issue:  2-5 - $25,000,
                              6-19 - $50,000, 
                              20-50 - $100,000

Employee Participation:

• Non-Contributory-100% or Contributory- 75%
• Minimum group size eligible for New Business Quoting: 2
• Minimum enrolled employees for Sold Case Installation: 2

SIC Code restrictions:
1222, 1230, 1231, 1240, 1241, 1411, 1420, 1422, 1423, 1429, 1440, 1442, 1446, 1450, 1452, 1453, 1454, 1455, 1459, 1470, 1472, 1473, 1474, 1475, 1476, 1477, 1479, 1480, 1481, 1490, 1492, 1496, 1499, 4111, 4119, 4120, 4121, 4130, 4131, 4140, 4141, 4142, 4150, 4151, 4170, 4171, 4172, 4173, 4311, 4412, 4420, 4421, 4422, 4423, 4424, 4430, 4432, 4440, 4441, 4449, 4450, 4452, 4453, 4454, 4459, 4460, 4463, 4464, 4469, 4480, 4481, 4482, 4489, 4490, 4491, 4492, 4493, 4499, 4512, 4513, 4520, 4521, 4522, 4580, 4581, 7361, 7363, 8631, 8699, 8811