Jun 24, 2025
UnitedHealthcare has announced the following rate updates for Q4 2025 in California:
Quarterly Rate Change:
- HMO: 4.3% NorCal, 3.4% SoCal
- PPO: 3.0% NorCal, 3.6% SoCal
- Navigate: Rate Pass
Quoting Availability: July 1, 2025
Plan/Portfolio Changes: There are no changes to the plan portfolio. However, you may now remove the "pending regulatory" disclaimer from HMO SBCs and SOBs.
Network/Zip Code Updates: Zip codes 90140 and 90205 have been added to the Harmony HMO network effective October 1, 2025.
Underwriting Guidelines: Please use the most recent version, which UnitedHealthcare has back-dated to July 1, 2025.
The Choice Simplified Package and Staff Model relaxed participation guidelines are being extended through December 31, 2025. Minimum participation is 25% between participating carriers, with five employees enrolling with UnitedHealthcare (excluding COBRA participants). No minimum CA employee enrollment required. Submit a complete copy of the most recent billing statements from the current carriers reflecting employee census, and applications/waivers from any employees not reflected on the billing statement.
The PEO guideline submission language has also been updated.
Marketing Materials/Forms: A revised Employer Application has been posted and will be added to the Easy Enrollment Kit. The grace period for switching to the new application ends on September 17, 2025.
Contact your Amwins Connect Regional Sales Manager today to learn more about how UnitedHealthcare plans can benefit your clients!
