Rate Cap and Producer Incentive extended in Western PA

August 2019 – December 2019 Effective Dates

Receive Up To $200 Per Contract For New Groups!

Here's the deal:

Rate caps for all new business sold with 51 or more enrolled contracts for August 2019 through December 2019 effective dates.
On the first renewal year the renewal rate is capped at *6%. The second renewal year is capped at *8%.
Move a new group that qualified during this incentive program period to a MyCare Advantage or UPMC HealthyU product by their third renewal and receive 50% monthly premium credit. The premium credit will be applied 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.
For August 2019 through December 2019 effective dates, a producer incentive of $100 per contract will be paid for all groups with 51 or more enrolled contracts. Would you like to increase your incentive to $200 per contract? If the sold group receives an initial renewal increase of 5% or less from the current carrier, we will double your incentive to $200 per contract.

Terms and Conditions:

This Rate cap and premium credit program (the “Program”) applies to new business only. The qualifying period is August 2019 through December 2019 effective 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.
*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 or $200 per contract producer incentive is for new business only and has a cap of $25,000 per group. The qualifying period is August 2019 through December 2019 effective dates.
Producer incentive payments will be made within 60 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.
Proof of the initial renewal increase must be submitted to Producer Relations (producerrelations@upmc.edu) within 15 days of the effective date.
Producer incentive is subject to the terms and conditions set forth in the Producer Agreement between the contracted producer or General Agency and UPMC Health Plan.

If you have questions, contact your Sales Executive