2021 Individual & Family Product Training - Brian Eck, Associate Vice President, Sales Marti Andro, Manager, Broker Sales
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2021 Individual & Family Product Training Brian Eck, Associate Vice President, Sales Marti Andro, Manager, Broker Sales
We’ll learn
• The UCare difference
• 2021 UCare plans
– What’s new for 2021?
– UCare Individual & Family Plans
– UCare Individual & Family Plans with
M Health Fairview
• Q&A
2
UCare in community
Who is UCare?
Mission How do we live UCare
To improve the this mission? Foundation
health of our Benefits that support Supports preventive
members through health: Dental, unlimited health care, quality for
innovative services online & retail visits, chronic disease
and partnerships Healthy Savings, fitness management, health
across communities programs equity, and reducing
health disparities for
Culturally diverse staff
people with disabilities
serving a culturally
diverse membership
3
Top plan
• Most popular plan on MNsure by enrollment
• Covers the top 99 most commonly prescribed drugs
• Local, friendly customer service
• Both copay and HSA-compatible plan options
• Large provider network
• Savings on prescription drugs
4
UCare Individual & Family plans (IFP)
2021
UCare Individual & Family plans
UCare Individual & UCare Individual &
Family Plans Family Plans with M
Health Fairview
• Core
• Bronze
• Bronze
• Silver
• Silver
• New for 2021 – Gold!
• Gold
New HSA-compatible
New HSA-compatible plans
plans
• Bronze
• Bronze
• Silver
• Silver
6
2021 Highlights
• Expansion to 49 new counties
• New providers including Mayo Clinic Health System,
Sanford Health, Gundersen Medical Center, and more
• Gold level plan from M Health Fairview partner plan
• $25 copay cap on certain diabetes medications
extended through 2021
• Premiums range from increase of 1.6% to decrease of
1.4%
7Service Area Expansion
Expecting competitive position
o Many new providers, including
Sanford, Avera, Gundersen, Mayo
(restrictions apply)
77 total counties (49 new)
o 6 new rating areas
o Excludes 10 counties in SE MN
o UCare IFP only, not M Health FV
o MHF plans will keep the 10-county
greater metro SA
Proprietary & Confidential 8The Mayo Arrangement
Mayo Clinic Health System (MCHS)
o Fully in-network for UCare IFP
o No referrals or PA’s needed
o Includes hospitals in Red Wing, New Prague, and Mankato
Mayo Clinic Rochester
o Limited access for complex specialty care only
o Non-network, unless:
o Member referred by Mayo provider, or
o Member referred by other provider AND has UCare CLS auth
Referral model:
o Mayo scheduling triage
o UCare CLS model
Proprietary & Confidential 9M Health Fairview Gold
Metro area opportunity
Gold plans increasingly popular
M Health Fairview believes there is
significant demand from their patients
Modest first year growth expectations
Same design/benefits as the UCare Gold plan
Same 10-county service area as current MHF Bronze/Silver plans
May be the lowest-cost Gold plan on MNsure
Proprietary & Confidential 10Choose from two networks
• UCare • UCare with M Health
Fairview
‒ M Health Fairview
• M Health Fairview Network
‒ Allina • Independent providers including:
‒ Sanford – U of M Children’s Hospitals
– Southside Community Health
‒ Mayo
Services
‒ Park Nicollet – Southdale Pediatrics
‒ North Memorial Health – Richfield Medical Group
‒ North Clinic – Minnetonka Pediatrics
‒ Essentia Health – South Lake Pediatrics
‒ CentraCare – North Point Health and Wellness
Center
11UCare IFP plans include
• Free preventive care
– Routine screenings, immunizations and checkups
– Pediatric dental checkups and eye exams
– Rewards for completing certain visits
• Free Healthy Savings grocery store discounts
(up to $200/mo)
• Health club membership discounts
• Free, unlimited online care and retail clinic visits
(Except on HSA-compatible plans)
• Community education discounts
• 24/7 Nurse Line
• Tobacco cessation program
12Benefit Change Highlights
No significant changes to Essential Health Benefits (EHB)
o Key set of covered services remains the same
Change* Applies to Why?
Lower deductible Silver HSA • After premium, deductible remains most
important to clients
Higher MOOP All standard • Keep pace with new CMS calculator
plans
Higher coinsurance Bronze, • Keep pace with new CMS calculator
Silver HSA • Coins. is less important to clients
$25 copay cap for All co-pay • Help remove barriers to managing
certain Diabetes Rx plans Diabetes
Higher ER copay Gold • Keep pace with new CMS calculator
.
Proprietary & Confidential 13Benefit Changes (Copay Plans) Bronze Copay 2020 2021 Silver Copay 2020 2021 Deductible $5,900 $5,900 Deductible $2,900 $2,900 MOOP $8,150 $8,550 MOOP $7,700 $7,900 Default coins. 30% after ded. 35% after ded. Default coins. 30% after ded. 30% after ded. Office visits $60 for 3 $60 for 3 Office visits $30 for 3 $30 for 3 ER visit 30% after ded. 35% after ded. ER visit $250 for 1 $250 for 1 Retail/Online $0 $0 Retail/Online $0 $0 Pref. generic Rx $15 $15 Pref. generic Rx $10 $10 Np. generic Rx $25 $25 Np. generic Rx $20 $20 Pref. brand Rx $200 $200 Pref. brand Rx $175 $175 Np. brand & spec. 40% after ded. 40% after ded. Np. brand & spec. 40% after ded. 40% after ded. Proprietary & Confidential 14
Benefit Changes (Copay Plans)
Gold 2020 2021 Core 2020 2021
Deductible $900 $900 Deductible $8,150 $8,550
MOOP $7,200 $7,300 MOOP $8,150 $8,550
Default coins. 20% after ded. 20% after ded. Default coins. 0% after ded. 0% after ded.
$30 for 3 $30 for 3
Office visits $20 $20 Office visits
(PCP only) (PCP only)
ER $150 for 1 $500 for 1 ER 0% after ded. 0% after ded.
Retail/Online $0 $0 Retail/Online $0 $0
Pref. generic Rx $5 $5 Pref. generic Rx 0% after ded. 0% after ded.
Np. generic Rx $15 $15 Np. generic Rx 0% after ded. 0% after ded.
Pref. brand Rx $125 $125 Pref. brand Rx 0% after ded. 0% after ded.
Np. brand & spec. 40% after ded. 40% after ded. Np. brand & spec. 0% after ded. 0% after ded.
Proprietary & Confidential 15Benefit Changes (HSA Plans)
2021 2021
Bronze HSA 2020 Silver HSA 2020
Deductible $6,800 $6,950 Deductible $3,300 $3,000
MOOP $6,800 $6,950 MOOP $6,500 $6,800
Default coins. 0% 0% Default coins. 15% 25%
Office visits 0%. 0% Office visits 15% 25%
ER 0% 0% ER 15%. 25%
Retail/Online 0% 0% Retail/Online 15% 25%
Pref. generic Rx 0% 0% Pref. generic Rx 15% 25%
Np. generic Rx 0% 0% Np. generic Rx 15% 25%
Pref. brand Rx 0% 0% Pref. brand Rx 15% 25%
Np. brand & spec. 0% 0% Np. brand & spec. 15% 25%
Proprietary & Confidential 16Enroll on MNsure
17Working with UCare:
Broker portal
- Manage your list of contacts
- Download UCare materials
- Download template sales materials
- Order materials online
1819
Working with UCare: Order Materials
Working with UCare: Order Materials
Working with UCare: Customize
& Print on Demand Materials
22Working with UCare:
Commission
• Commission structure effective 1/1/2021
– Increased to $18/contract per month
23Contact Us
- Broker customer service: (866) 242-2384
- brokers@ucare.org
- Marti Andro, Broker Sales Manager
- Email: mandro1@ucare.org
- Commission questions BrokerFinancialInquiries@ucare.org
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24Q& A
Let us de-complicate for you!
25Thank you on behalf of the
entire UCare team and those
members we all represent!
26You can also read
