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UHC CAA Gag Clause Confirmation of Compliance now available

October 4th, 2023 in Broker Broadcast

The CAA provision requires an annual “gag clause prohibition compliance attestation” (GCPCA). UnitedHealthcare completed the review of agreements and ensured compliance with the prohibition on gag clauses on price or quality information as required under the CAA Gag Clause.

  • UnitedHealthcare will make the attestation for fully insured customers as required.
  • For ASO and Level Funded customers, UnitedHealthcare is providing a Confirmation of Compliance (pdf) to support the customers doing their own attestation.
  • For customers with both fully insured and self-funded business, UnitedHealthcare will attest for fully insured plans and customers must attest for the self-funded plans.

UMR and Surest will follow the same process. Brokers may share the following UMR or Surest branded documents with customers, as appropriate:

Click here to read the full article from UnitedHealthcare

October Updates

October 4th, 2023 in Broker Broadcast

2024 Product Portfolio Updates

  • CVS is back in the Broad Pharmacy Network, effective 1/1/2024. Existing groups will need to make a plan change at renewal to a 2024 plan design to take advantage of the broad network addition.
  • $0 Virtual Visit Copay on HSA Plans
  • NEXUS plan design

Q4 Reminders

Digital ID card and paperless preference options to launch this month. Beginning in October, UnitedHealthcare will introduce digital medical ID cards to plan subscribers who have elected “paperless” in their account preference settings. Subscribers who have elected to go paperless for “required communications” will receive an email between Oct. 4 and Oct. 31 containing information about their new digital medical ID card, how to access and change their medical ID card paperless preference and how to add their medical ID card to their Apple or Google wallet.

  • When a subscriber selects paperless on myuhc.com they will not receive a physical ID card.
    • Subscribers that selected paperless will receive an email starting 10/4/2023 with notification that future ID cards will be digital.
    • ID card preference will launch 11/7/2023.
  • When will a physical medical ID card be mailed?​
    • New UHC sponsored plan subscribers will receive a physical ID card. ​
    • If a subscriber moves to a new employer and then comes back to the same employer, they will receive a physical medical ID card again, as a first issue.​
    • If a subscriber moves to a non-UHC plan and then moves back in a subsequent year, they will not receive a physical medical ID card.

BCBS Claims Data – Request HB2015 for all of your BCBS TX groups with 10+ enrolled employees

  • Ordering these reports allows us to provide UHC Level Funded underwritten rates for your group without the need for employee applications. UHC Level Funded rates can save your client up to 20%
  • January groups – request HB2015 beginning 9/15

UHC Broker Bonus extended to include effective dates through Jan. 31, 2024

1/1/24 Plan Grids

Warner Pacific Parent Company Completes Acquisition of Foster Benefit Resources

August 4th, 2023 in Agent Broker Broadcast Employer

Acquisition enables NR West to strengthen its presence in North Texas,
bringing best-in-class services to the brokers across the region

NR West, the parent company of The Insurance Exchange, a premier Dallas-based General Agency, today announced that it has completed its acquisition of Foster Benefit Resources, a full-service General Agency specializing in fully insured and self-funded employee benefits in the North Texas area.

Foster Benefits has a history of providing superior service to its clients through its dedicated team, a majority of whom have a tenure of 10+ years. Moving forward, brokers can continue to expect the same industry-leading service and expertise, along with expanded resources and employer-benefit solutions.

“Foster Benefits has established itself as a staple General Agency in the North Texas market and is well-known for being deeply ingrained in large regional associations and the community at-large,” said John Walker, President at The Insurance Exchange. “Our partnership is a testament to Foster Benefits’ reputation, and we look forward to utilizing their 30+ years of experience and long-standing industry relationships to further strengthen our offerings in the region.”

Through this acquisition, The Insurance Exchange will leverage Foster Benefits’ strong presence in the North Texas area to deliver new tools and technologies to the broker and agency market while continuing to provide best-in-class services to their existing clientele.

“We are thrilled to welcome Foster Benefits, a firm with a long-standing commitment to delivering exceptional results, to the NR West family,” said John Nelson, Co-CEO of Warner Pacific. “Partnering with Foster Benefits enables us to pursue strategic opportunities aimed at providing our customers with an expanded range of high-quality services as we continue to innovate new products and scale our offerings.”

Kim Foster, who will be retiring as President of Foster Benefits, added: “As we enter the next phase in Foster Benefits’ evolution, we look forward to working with The Insurance Exchange to create new opportunities for the business and our representatives as we position ourselves as the provider of choice in the North Texas employee benefits industry.”

About Warner Pacific

With over $4 billion of in-force premiums, servicing more than 70,000 employers, Warner Pacific is a top-producing General Agency for many of the nation’s largest insurance carriers. Warner Pacific provides insurance brokers and agents in California, Colorado, Florida, Texas and Oklahoma with sales assistance, innovative technology and back-office service. To learn more about Warner Pacific, visit https://www.warnerpacific.com/.

About Foster Benefit Resources

Founded in 1990 by Stan Foster, and then most recently led by its President, Kim Foster, Foster Benefit Resources is a full-service General Agency marketing fully insured and level-funded employee benefits. Through an experienced team that is focused on guiding clients through a complicated industry and their relationships with carrier partners, Foster Benefits offers organizations the ability to free up resources to continue growing their business.

To learn more about Foster Benefit Resources, visit https://www.fosterbenefits.com/.

Media Contact

Julia Kaufman
jkaufman@prosek.com
(646) 916-1156

UHC JULY UPDATES

July 21st, 2023 in Broker Broadcast

As part of our effort to keep you informed, we’ve included the updates and reminders that UnitedHealthcare has released for the month of July.

HB2015 reports – make sure to order HB2015 reports for your fully insured renewals after the 15th of the month, to get the prior month’s data

  • For groups 10+, this allows you to receive underwritten group rates for UHC level-funded

UHC Broker Rollout Meetings are next week!  If you cannot attend, please reach out to your Insurance Exchange Sales rep for updates or watch your inbox for a Broker Broadcast.

15-month rate guarantees are back:

  • Offered for effective dates from 8/1/2023 to 4/1/2024
  • This means level-funded group installs from 8/1/2023 to 4/1/2024 will need either the 12 OR 15-month rate guarantee form included

Current UHC groups are eligible to move from FI to LF – renewal teams are hosting Conversion Training Calls. Links to register are below. Reach out to your TIE renewal rep for more information on this:

UHC Broker Bonus:

  • For any new business case sold or existing case transitioned from UHC fully insured to level-funded with an effective date between 4/1/2023 and 9/1/2023, you will receive an additional one-time bonus of $60 per enrolling employee.
  • As a quick example, selling 50 new members during the bonus period would result in an additional $3000 in compensation.
  • Broker bonus details are attached here – 2023 UHC Broker Bonus Details

Level-funded training courses:

CourseSegmentRegistrationDates and Times
SAMx Level Funded
Quote and Enroll
Small BusinessRegisterJuly 24, 2023
1–2 PM
Uhceservices for
Brokers
All SegmentsRegisterJuly 25, 2023
2–3 PM
SAMx Level Funded
Renewal Training
Small BusinessRegisterAugust 8, 2023
12 – 12:30 PM
Uhceservices for
Brokers
All SegmentsRegisterAugust 8, 2023
2– 3 PM
SAMx Level Funded
Quote and Enroll
Small BusinessRegisterAugust 29, 2023
11 AM – 12 PM
Uhceservices for
Brokers
All SegmentsRegisterSeptember 12, 2023
2– 3 PM
SAMx Level Funded
Renewal Training
Small BusinessRegisterSeptember 13, 2023
1:30 – 2 PM
SAMx Level Funded
Quote and Enroll
Small BusinessRegisterSeptember 27, 2023
2 – 3 PM
All Savers to Level
Funded Transition
All SegmentsRegisterOctober 4, 2023
11 AM – 12 PM

For questions or additional details, please contact your TIE Sales Representative at 972.991.6500.

UnitedHealthcare Level Funded and Fully Insured Updates

June 28th, 2023 in Agent Broker Broadcast

  • Level Funded – UHC is no longer accepting old versions of the level-funded application – the latest 5 health question app must be used. 
  • Level Funded – All Texas Enrollment Packages have been updated.
    • New Billing & Collection Agreement
    • 15 month rate guarantee option now available August through April
    • Contact me for other states enrollment package and underwriting checklist
  • Level Funded – TX Updated Underwriting Checklist – New Guidelines! Updated language for participation requirements and ineligible groups
  • PCORI – The amounts are now sent directly to the group
    • Reports were mailed to the groups June 15th
    • Not posted on uhceservices.com for the employer or broker
    • Your assigned Customer Service Account Manager is able to access it upon request 
  • Small Group Fully Insured – All groups with only 1 enrolled subscriber are now required to submit not only the latest wage & tax report, but also the previous calendar year’s 4 quarterly wage & tax reports.
  • Charter Torch – Improving network strength in rural areas
    • Baylor – Bosque – Coryell – Eastland – Titus
    • Wichita – Wilbarger -Young
  • New Vision Benefit Summaries
    • Benefit lens options now in body of summary

If you have any questions, please do not hesitate to reach out to us.  We’re here to help!

Joe Sherman
972.404.2621 Office
jsherman@insxch.com

Jay Cooke
972.404.2605 Office
jcooke@insxch.com

Gina Escobar
972.983.9784 Cell
gescobar@insxch.com

UHC COVID-19 At-Home Test Benefit

January 19th, 2022 in Broker Broadcast

Beginning January 15, 2022, UnitedHealthcare Fully Insured and Level Funded individual and group health plan members can get up to eight FDA-authorized or approved OTC COVID-19 at home tests at no cost to them, after reimbursement, and without a doctor’s prescription.

There are two ways that eligible members can receive reimbursement for these COVID-19 at home test kits:

  • Preferred Retailers – The list of Preferred Retailers and their websites may be found in the Preferred Retailer list on uhc.com.
  • Other retailers or online – For purchases of FDA-authorized or approved OTC COVID-19 at home tests at any in-store or online retailer other than at the in-store pharmacy counter, members must submit a receipt for reimbursement via the UnitedHealthcare member portal for a maximum reimbursement of $12 per test. Many COVID-19 tests are sold as a two-pack so that means the test pack would be reimbursed at $24 ($12 for each test).

For more information/details, please see these UHC resources:

New Forms Required

September 3rd, 2021 in Broker Broadcast

UnitedHealthcare has created new enrollment forms for UnitedHealthcare Level Funded plans.  The new enrollment forms will be required for all submitted business beginning with 11/1 effective dates

As a courtesy, we have compiled the forms and created separate enrollment packages for Small and Large group.

AllSavers Name Change

September 3rd, 2021 in Broker Broadcast

UnitedHealthcare AllSavers product name is officially changing to UnitedHealthcare Level Funded.

This name change will take effect beginning with 11/1 effective dates.

All Savers Portfolio Update

June 24th, 2021 in Broker Broadcast

The All Savers portfolio update, effective 9/1/21 is now live. The following are the big talking points:

Prescription Drug Lists

  • Advantage & Essential Prescription Drug List on Standard Select Network
  • Specialty Medication Cost Share (SMCS)

Plan Designs

  • Personal Protect Plan Category 
    • Networks: Choice+/Choice
    • 100% Coinsurance
    • Deductible Levels: $3000, $4000, $5000, $6000, $7000 and $8500
    • Prescription Benefit Option applies: Advantage or Essential
    • 1 – 3% higher premium compared to Traditional PPO/EPO 100% plans
    • No Emergency Room Copay
  • HSA plan with Core Plus Preventive Prescription Drug List

Please see below for the new plan grid as well as the popular “Why All Savers” brochure.  Please remember we can enroll All Savers groups with a minimum of 5 EEs enrolling.

2021 All Savers Plan Grid

Why All Savers” Brochure

2021 Texas Producer Performance Guide

April 28th, 2021 in Agent Broker Broadcast

UnitedHealthcare has released the Texas Producer Performance Guide for 2021.  Inside the guide, you will find updated medical base commissions for fully insured groups with up to 50 eligible employees will be effective 7/1/21.  Click the icon below and see page 7 for additional details regarding the change in commissions.

  2021 Texas Producer Performance Guide

For questions or additional details, please reach out to your TIE Sales Representative at 972.991.6500.

COBRA and American Rescue Plan Act and Premium Tax Credits

April 14th, 2021 in Agent Broker Broadcast

American Rescue Plan Act of 2021 (ARPA) includes provision for a COBRA continuation coverage premium subsidy for individuals and families who experienced a loss in coverage due to select circumstances, like involuntary job loss or reduction of hours. 

UnitedHealthcare has released an overview of changes for brokers, the resource can be viewed here.

Please contact Stacey Priddy, TIE Director of Account Management, at 972.404.2611 with any questions.

UnitedHealthcare 1 – 50 Fully Insured Portfolio Updates

March 8th, 2021 in Agent Broker Broadcast

2021 Adjusted Community Rated Plans

  • 4 New Product Grids Across Texas – Simple to Multi-Choice
    • Charter Package (Dallas-Fort Worth, Houston, El Paso, Lubbock)
    • Core/Core Essential Package (TX Panhandle – Amarillo)
    • Nexus Package (CTX – Austin & San Antonio)
    • Core Package (available in remaining areas across TX)
  • Essential Prescription Drug List (PDL) is across all plans and packages

Plan Overview

  • Performance Plans – Top Selling Plans that provide up to 15% savings!
  • New Assured Plans – Premium Designation used in a new way to lower costs PPO/EPO network
  • Primary Advantage Plans – New $70 Specialist copay
  • High Deductible Health Plans (HSA) – All include motion!
  • Pair up our multiple network options (ChoicePlus, Choice, Navigate, Charter, Core, and Core Essential)

Grids

To eliminate delay in processing, please make sure to send all RFP requests directly to our rating department at rfp@insxch.com

UHC 2-50 Fully Insured Portfolio for January 1, 2021 – Available Now!

October 6th, 2020 in Agent Broker Broadcast

UnitedHealthcare’s 2-50 Fully Insured Portfolio for January 1, 2021 is now available to quote.

4 Packages Available Across Texas

Most Popular Plans & Networks Still Offered

  • PROFormance Plans – $10 or $15 PCP copays
  • Primary Advantage – $0 PCP copay for kids & adults (unlimited)
  • Assured Plans – Lower cost option utilizing Premium Designation program for tiered benefits
  • Charter/Navigate – HMO network options that have become a popular base plan option

Included benefits for Fully Insured plans at no additional COST:

  • Unlimited Virtual Visits at $0 for copay plans (Teladoc, AmWell, Doc on Demand)
  • $0 Kids PCP copay (available on all copay plans except Assured)
  • 3 Face to Face EAP Visits
  • Motion included on all High Deductible Health Plans (HSA) – Employees and Spouses can earn up to $1095 annually
  • Real Appeal – 52-week weight loss program with personalized 1‑on‑1 coaching & a Success Kit
  • Quit for Life – Tobacco Cessation program with digital and telephonic tools & resources

2021 PDL – Essential 4-Tier

CARES Act Resources

April 3rd, 2020 in Agent Broker Broadcast

In an effort to help small businesses understand the intricacies of the CARES Act and benefits available to them, the U.S Senate Committee on Small Business & Entrepreneurship has created the following guide.

For more information, we encourage you to visit the U.S. Small Business Administration’s dedicated page for Coronavirus (COVID-19): Small Business Guidance & Loan Resources.

In addition to the above resource, we highly recommend visiting the U.S Treasury’s page on the CARES Act where you can find an overview of the Small Business Paycheck Protection Program and more.

As always, The Insurance Exchange is here for you and your clients. We are closely monitoring the constant changes and guidance provided by the U.S. government and our local carrier partners. Please do not hesitate to reach out to us with any questions or concerns you may have.

UHC COVID-19 Update

March 25th, 2020 in Agent Broker Broadcast

The Insurance Exchange is committed to providing you with the most up to date information from UHC on COVID-19 as it becomes available.

UHC COVID-19 Special Enrollment Period Updated information:

The Special Enrollment period UHC is offering its clients has been extended from March 23rd to April 6, 2020, for a April 1, 2020 effective date.

All Savers is also offering this special enrollment period.

There are specific guidelines that will apply to the Special COVID-19 Enrollment Opportunity. Please refer to the link:  https://www.uhc.com/content/dam/uhcdotcom/en/B2B-Newsletters/b2b-pdf/covid-19/faqs-special_enrollment.pdf

UHC has provided the following broker resources to help keep up to date with information as it becomes available:

Please direct members to the following link as the above resources are not designed to be shared with members: (https://www.uhc.com/health-and-wellness/health-topics/covid-19)

HealthiestYou: Coronavirus (COVID-19)

March 13th, 2020 in Broker Broadcast

If you think you might be infected with coronavirus (COVID-19), HealthiestYou doctors will answer your questions about the disease, ask a series of questions to evaluate your risk, and advise you on next steps. Their team is trained on the latest protocols for local and national notification, testing, and management of people under investigation for the virus.

Current members can request a phone or video visit with a HealthiestYou doctor by clicking here.

Not currently a member? You can signup instantly by clicking here!

Coronavirus (COVID-19): Help Your Clients Prepare

March 10th, 2020 in Agent Broker Broadcast

With the spread of Coronavirus (COVID-19), many employers are desperately searching for guidance.  We have complied the information below in an effort to keep you informed.  The attached articles include recommended strategies from the CDC for employers

Interim Guidance for Businesses to Plan and Respond to COVID-19
This guide provides information from the Centers for Disease Control and Prevention about how businesses and employers can plan for and respond to coronavirus disease 2019 (COVID-19). Click Here

Coronavirus Disease 2019 (COVID-19) Fact Sheet
This one-page fact sheet from the Centers for Disease Control and Prevention provides an overview of COVID-19 and coronaviruses in general. Click Here

UHC 1095-B and 1095-C forms

January 29th, 2020 in Broker Broadcast

Based on recent guidance for the Affordable Care Act, most printed 1095-B forms will have been suppressed and not mailed in January. These were previously sent to fully insured group subscribers. However, since the forms are no longer required for federal tax purposes, they are not required to be mailed in January like they have in the past. [Read more..]

2019 Broker Survival Guide

August 9th, 2019 in Agent Broker Broadcast

The 2019 4th Quarter Survival Guide for UnitedHealthcare and All Savers is here!  Product portfolios, value added benefit information, and much more are included in the pdf attached below.  If you have any questions, please contact your TIE Sales rep at 972.991.6500.

2019 Broker Survival Guide

All Savers 15-Month Rate Guarantee

July 15th, 2019 in Agent AllSavers Broker Broadcast

  • Available for 10/1, 11/1, 12/1, 1/1, 2/1, 3/1 and 4/1 effective dates!!
  • Same rates for either 12 months or 15 months
  • 15 Month rate guarantee is a 3 month contract followed by a 12 month contract
    • Example:  12/1s become 3/1’s
  • 15 Month Rate Guarantee Confirmation Form to be signed by the Broker and Employer

*Note:  Group forfeits surplus for the first 3 months

Reconciliation for the 15 months will follow the normal process from 2nd 12-month policy. Reconciliation rules still follow; the group has to be effective 3 months beyond the renewal date in order to be eligible for a potential surplus.  *See Chart above

Questions?  Please Contact:
Joe Sherman – 972.404.2621
Kevin Balkin – 972.404.2620
Amanda Wooldridge – 972.404.2619
Paula Johnson – 972.404.2623
Stacey Priddy – 972.404.2611

All Savers Portfolio Update 8/19

July 15th, 2019 in Agent Broker Broadcast

This All Savers portfolio update is effective 8/1/19:

  • PROFORMANCE Plans being added to All Savers
  • Most plans – $0 copay on kids 19 and under (similar to the UHC fully insured plans)
  • 15 month rate guarantee is available for groups with effective dates of 10/1/19 through 4/1/20 (no rate increase for choosing the 15 month option) **click here for details**
  • Navigate & Charter plans are now part of the All Savers portfolio (prior to this there were only PPO / EPO options) – make sure to ask your sales rep for specific details

You also have the option of having the Lab & X-rays being covered under the OV – Plans ending in e

OR

Lab & X-rays being subject to the deductible and coinsurance – Plans ending in LX (roughly a 5 – 7% savings)

We have attached the new plan grid as well as the popular “Why All Savers” brochure below .  Please remember we can enroll All Savers groups with a minimum of 5 EEs enrolling.