RATE CAPS MADE SIMPLE

Selling new and renewing business with UPMC Health Plan
has never been easier!

Here's the deal:

Rate caps for all new business sold with 51 or more enrolled contracts for July 2017 through January 2018 effective dates.
Rate caps for all renewing groups with 51+ enrolled contracts with August 2017 through January 2018 renewal dates.
Move any new or current UPMC Health Plan 51+ group to MyCare Advantage or HealthyU by their third renewal and receive a 50 percent premium credit on the last month (36) of the second renewal year. For groups to qualify for the credit, they must commit to a third renewal year.

Terms and Conditions:

This Rate cap and premium credit program (the “Program”) applies to new and renewing business. For new business, the qualifying period is July 2017 through January 1, 2018 effective dates. For renewing business, the qualifying period is August 2017 through January 1, 2018 renewal dates. Each “Renewal Year” refers to a subsequent, contiguous 12-month contract renewal period following initial purchase or renewal under this offer.
Premium credit is only available to groups who effectuate a third Renewal Year contract with UPMC Health Plan and select and maintain an available HealthyU or MyCare Advantage plan design for such third Renewal Year.
Group’s medical and prescription drug coverage must be purchased exclusively through UPMC Health Plan (full replacement) throughout the initial year and each Renewal Year to qualify for this offer.
This Program applies to Pennsylvania-issued, fully insured large employer group business only.
This Program replaces UPMC Health Plan’s previously offered “Double Play” program as of May 25, 2017.
Rate caps are exclusive of PPACA taxes (Insurer Fee and PCORI) and any new taxes or assessments that may be imposed by an applicable regulatory or taxing authority in the future.
Enrolled employee count is based on number of employees enrolled in employer’s qualifying UPMC Health Plan group product in first month of initial year and each Renewal Year.
This offer and the premium quoted pursuant hereto is contingent upon group maintaining a qualifying plan design, maintaining current plan year/renewal date, and meeting UPMC Health Plan’s otherwise applicable 51+ underwriting guidelines throughout the term of the Program, including but not limited to minimum participation rules. UPMC Health Plan reserves the right to modify premiums under the terms of our applicable 51+ underwriting guidelines.
The $100 per contract producer incentive is for new business only and has a cap of $25,000 per group. The qualifying period is July 2017 through January 2018 effective dates.
Producer Incentive payments will be made within 90 days for eligible effective dates. Determination and payment of earned incentives under this Program are at the sole discretion of UPMC Health Plan. Incentive payments will be made payable to writing producer and paid through general agency, if applicable.
Terms and Conditions are subject to change without prior notice as may be necessary to comply with applicable law, regulation, or other governmental authority. This Program may be subject to the approval of Pennsylvania Insurance Department or other governmental authority.
UPMC Health Plan may, at its sole discretion, cancel, amend, modify, revoke, terminate, or suspend this Program at any time. Participation in this Program and/or election of this offer is not a guarantee of continued plan availability or renewal.

If you have questions, contact your Sales Executive or Account Manager.