Jan 08, 2025
UPDATES: UnitedHealthcare has announced the following updates, retroactive to 01/01/2025:
- Core Bronze 60/5400/40% (DZ-GX) is now Core Bronze 60/5800/40% (DZ-GX). Specialist copay is limited to the first three visits; additional specialist visits are subject to deductible & coinsurance.
- Navigate Bronze 60/5400/40% (DZ-G6) is now Navigate Bronze 60/5800/40% (DZ-G6). Specialist copay is limited to the first three visits; additional specialist visits are subject to deductible & coinsurance.
- A typo in the the skilled nursing facility care benefit will be updated for the Select Plus and Core HDHP plans on the plan grid (the per-occurrence deductible will be removed).
- The Underwriting Guidelines with effective date of September 1, 2024, are the most current.
The revised SBCs, SOBs, Product Grids and Plan/Benefit Selection Form will be posted as soon as they are available.
[09/10/2024] UnitedHealthcare has announced their small group updates for Q1 2025 in California.
Quarterly Rate Change:
- PPO: 0.4% statewide average (SoCal 0.5%; NorCal 0.3%)
- Navigate: 7.0% statewide average (these rates are updated annually)
- HMO: -2.4% statewide average (represents a decrease)
Annual Rate Change
- PPO: 5.3% statewide average (SoCal 4.6%; NorCal 5.9%)
- Navigate: 7.0% statewide average
- HMO: 0.0% statewide average (rate pass)
Note: rates are pending completion of regulatory review.
Quoting Availability: on or before 10/1/2024
Plan/Portfolio Updates:
- 57 plans in Choice Simplified and 12 plans in MultiChoice State Package; the Silver PPO Non-Diff will remain available in both packages for non-ID employees only (same as 2024)
- Care Cash has been removed from two Silver and two Bronze plans
- Virtual visits for all plans at $0 member cost share, except for HDHP plans (new for 2025)
- PCP selection will no longer be required on Select Plus PPO plans.
- Infertility optional benefit will continue as shown in the rate tables: HMO 3.4% and PPO 4.9%
- Plans DZ-GZ and DZ-G2 are not creditable to Medicare Part D. All other plans are creditable.
- Broad Rx Network across all plans
- Plan grids, plan mapping, SBCs and SOBs will be made available in Forms & Benefits as they are disseminated.
Network Updates:
- 90134 added to zip availability across all networks
- 91759 turned off for SignatureValue and SignatureValue Alliance
- SignatureValue Harmony no longer available in Northern California rating areas (Area 2 and Areas 4-9). All Northern California Harmony Members will be mapped to the SignatureValue HMO upon the group's 2025 renewal date.
Underwriting Guidelines: no changes; continue to use the July 2022 version
Contact your Amwins Connect Regional Sales Manager for more information.
