Medium & Large Business Health Plans

2026 product updates and reminders

Wellbeing and incentive programs

Univera Healthcare gives you access to a wide variety of reward and incentive programs, including perks that help members save on healthy products and services like fitness club memberships, acupuncture, massage, and more.

Vitalize^℠
Vitalize is a digital homebase dedicated to engaging teams in their health. Supported by Personify Health^TM, it gives employees the tools to make small everyday changes, build healthy habits, have fun with friends, and experience the lifelong rewards of better overall wellbeing. Vitalize is embedded in all Fully Insured plans and available as a buy-up for Self-Funded and Minimum Premium plans. We have five different reward options available based on the experience and incentives that groups are looking to offer.

New for 2026

NEW! Rewards 5
We have expanded our suite of reward programs to include a new claims verified and action-based incentive program. The subscriber and their spouse or domestic partner can now earn rewards by tracking healthy habits and completing preventive screenings and health checks. The more they do, the more they’ll earn—for up to $600 in Rewards Cash. Available as a buy-up.
NEW! Teledermatology
Teledermatology is now available through MDLIVE and will be included with 2026 renewal for groups that currently have MDLIVE. Get a diagnosis, treatment, and prescription (as needed) from a board-certified dermatologist for more than 3,000 skin, hair, and nail conditions in an average turnaround time of 24 hours.

Condition management

You also have access to comprehensive care and disease programs for conditions such as diabetes, chronic kidney disease, cancer, and behavioral health, cardiac and musculoskeletal disorders.

Vori Health
Back pain can be disruptive – and 18% of those who seek help only complete one PT visit.¹ To support faster, more effective recovery, we offer digital musculoskeletal (MSK) care for back, neck and joint issues through our partner, Vori Health, a nationwide virtual-first specialty medical practice.
Enhanced Diabetes Management
Our Enhanced Diabetes Education Program offers structured, personalized support for members struggling with diabetes. Guided by the American Association of Diabetes Educators curriculum, certified diabetes care and education specialists help members build essential self-management skills across seven core areas. Engaged participants experience improved quality of life, a 70% reduction in ED visits and readmissions, and a 51% increase in primary care visits.²

Pharmacy programs

We offer a full range of programs that are proven to help make medications more affordable, promote proper utilization and ideally improve members’ overall health, all while driving to the lowest net cost.

Core pharmacy suite
Our core pharmacy suite of back-end solutions serves as the foundation of our programs, offering clinical strategies that integrate right into your services. Through an approach that includes formulary management, cost and waste reduction, GLP-1 trend management, cancer care and specialty drug optimization, we’re delivering an average savings of $27.77 per member per month.³
For Self-Funded Large Groups
- Save more on specialty drugs with HelpScript
  To help manage rising specialty medication costs, members have access to HelpScript, an independent company offering a financial assistance program that lowers out-of-pocket drug costs on the medical benefit. By optimizing copays, HelpScript reduces costs for both employees and the employer. Lower costs mean better access to treatment, improved adherence and stronger health outcomes.
- SafeGuardRx: Cost management program targeting high-cost therapies
  This program delivers savings from drug manufacturers through early discontinuation credits and other cost management strategies – specifically focused on some of the most expensive therapy classes, including inflammatory conditions, MS, and oncology.

¹ 2021-2022 Health plan data
² Outcomes data is based on full year 2022 claims experience for members engaged in both the Enhanced Diabetes Education Program and the standard CM/DM for members with a primary diagnosis of Diabetes using a Pre/Post methodology.
³ Based on 2023-2024 Health Plan Data Claims. An opt-in may be associated with programs for self-funded, minimum premium and article 47 groups.

Personify Health is an independent company and offers a digital wellbeing service on behalf of Univera Healthcare.
MDLIVE is an independent company, offering telehealth services in the Univera Healthcare service area.
Vori Health is an independent company that offers virtual musculoskeletal (back, neck, and joint) health care and physical therapy services to Univera Healthcare members.
Univera Healthcare has contracted with Expion Health Company, an independent company, to provide HelpScript program benefits to our members.
Univera Healthcare has contracted with Express Scripts, an independent company, to provide their program, SafeGuardRX, to Univera Healthcare members.

Medical plans

With multiple plan types and options, we have coverage that’s right for every group and every member. Our network gives you access to more of the best doctors, specialists, and hospitals in your neighborhood and around the globe than any other. We’ve also negotiated great rates with these providers, which means everyone pays less for a higher quality of care.

Local 39-county network: 100% of hospitals and 99% of doctors in our area accept our plans
National network: In-network benefits with more than 1.4 million practitioners and 5,600 hospitals throughout the United States through the PHCS/Multiplan system

Also, we know that going to the doctor’s office isn’t always an option, so our plans allow employees to access care and support right from home through MDLIVE^® telemedicine, Vori Health, and the Wellframe^® app. Learn more about these convenient tools in the tools & resources tab.

Medicare solutions

We can also help you with Medicare Advantage, Part D, and Supplement plans for retirees and employees working past age 65. View group Medicare options.

MDLIVE is an independent company, offering telehealth services in the Univera Healthcare service area.
Vori Health is an independent company that offers virtual musculoskeletal (back, neck and joint) health care and physical therapy services to Univera Healthcare members.
Wellframe is an independent company that provides a health and wellness support mobile app to Univera Healthcare members.

Member health management

When your team is healthier, your business runs more smoothly. That’s why our comprehensive approach to Member Health Management is essential. With our system of clinical programs, reminders, and education, we surround your employees with the help they need to stay on track with their health goals, live better, and work harder.

Whether someone on your team is dealing with a chronic or complex condition, or just needs a reminder to go to the doctor once in a while, you can feel confident knowing someone is looking out for them—at no additional cost.*

Some highlights of our comprehensive roster of member health management services include:

Utilization management
Care management
Disease management
Behavioral health management
Wellbeing and incentive programs

^*Included for Fully Insured. Buy-up for Self-Funded.

Tools & resources

We’re dedicated to making health care more convenient for greater employee engagement. That’s why we offer self-service support tools and resources.

Vitalize^℠: Available through a partnership with Personify Health, Vitalize is a digital homebase for health and wellbeing. Members can access tools to build healthy habits, track fitness, make everyday changes, and get a clear view of their overall health.
Headspace: Integrated with Personify Health, Headspace is our preferred mindfulness partner for managing stress, anxiety, focus, and sleep.¹
Member portal: Members can log in to their member portal to learn more about benefits and their plan’s coverage. Available are self-services tools and helpful resources, including find a doctor, estimate out-of-pocket medical costs, and order member card(s).
Vori Health: Virtual physical therapy for musculoskeletal (MSK) conditions.
MDLIVE^® telemedicine: 24/7 access to both physical and behavioral health care.
Wellframe^®: Guidance and support from licensed health care professionals to help manage issues like anxiety, maternal health, asthma, and more.
Pharmacy Home Delivery: Members can save time and money by having prescriptions delivered to their home.
Welvie My Surgery^℠: Resources for navigating the entire surgery decision-making process.¹
24/7 Nurse Call Line: Members can contact a nurse by phone anytime—24 hours a day, seven days a week—with general health questions. If ongoing support is needed, members may be referred to a member care manager, so they’ll have the support that best fits their needs.

¹ Included for Fully Insured/Buy-up for Self-Funded and Minimum Premium

Voluntary benefits services

When you integrate services like dental, administrative services and stop loss with medical benefits, Univera Healthcare can support employees with a more complete view of their health. Leading to more proactive support to help keep employees healthy and costs of care down.

Dental

Large group dental packages (more than 50 eligible employees)

With Univera Dental Select, groups get comprehensive dental coverage with the flexibility of choosing from a variety of coinsurance, deductible, and annual maximum options. With an emphasis on preventive care, Univera Dental Select helps employees maintain their complete oral health, reducing the need for more costly dental care in the future.

With Univera Healthcare, members get:

One-stop shop for comprehensive medical and dental coverage
Flexible benefit options at competitive rates
Easy access to a broad network of providers
Large network of dental providers with plans including DenteMax
100% employee-paid options available

Dental annual maximum rollover: Regular dental visits can greatly reduce the occurrence of major oral health issues, saving money for both employers and employees. The dental annual maximum rollover incentivizes preventive care by rewarding employees with funds they can roll over to use as needed in the future.

Groups new to enrolling in our dental plan will be able to keep any accrued rollover account funds from another plan when they enroll in a dental plan that includes the annual maximum rollover benefit. We will match the funding members have with a competitor up to the rollover account maximum.

Dental preferred packaging: To help make selecting the right plan easier, we’ve created four preferred package options. They are a great place to start for groups that are new to dental or need help navigating through some of our popular levels of coverage. The new packages vary, with coverage options that range from a focus on preventive care to more comprehensive coverage featuring orthodontia, and generous annual maximums.

Vision plans

When you help employees take care of their eye health, they can enjoy a better quality of life, lower costs, and peace of mind in knowing they’re taking care of their whole health. That’s why group vision plans with low out-of-pocket costs are now available from Univera Healthcare.

All vision plans include:

Low-cost eye exams
Fully covered and low-cost on-trend frame options through the Exclusive Collection
Competitively priced plan options and multiple contribution options
Access to great discounts on lens add-ons, additional pairs of eyeglasses, LASIK services and other great extras*

Through our partner, Davis Vision, employees have access to a large network that includes 1,558 provider locations in the 8-county Western New York region and 196,000+ points of access nationwide, including independent eye care professionals, 4 of the top 5 eyewear retailers and online retailers.

*Not all providers participate in Davis Vision discounts, including the fixed lens option pricing. Members should contact their provider prior to scheduling an appointment to confirm if discount and fixed lens options are offered.

Davis Vision is an independent company providing vision benefit management services and access to their network.

Pharmacy management

We oversee every aspect of pharmacy care on a member-by-member basis to keep costs low and keep businesses and their employees safe. Plus, we regularly connect with local physicians to stay current on new medications that can lower costs even further.

With integrated benefits from Univera Healthcare, you get the complete package:

One member card
Zero claims integration fees, hidden costs for utilization management, or reporting fees
Local, dedicated pharmacy, sales, and customer service team for more responsive service
Real-time formulary management to identify the most effective drugs at the lowest cost —based on real member data (not national statistics)

Stop loss insurance

We’re in the business of protecting local businesses from catastrophic claims, We treat stop loss as an important part of our business, not a commodity. So you get the timely support and payments you need, when you need them most.

An integrated approach to care: By rolling stop loss in with medical and pharmacy coverage, we can use real-time member data to help prevent catastrophic events. The result: pricing consistently below the industry’s average stop loss trend.
Reimbursements when they matter most: With wire transfer availability, we can make deposits directly into health plan accounts — with funds immediately available. We can also provide credit to claim billing for extraordinary, large reimbursements.
Administration without the frustration: One point of contact for billing and customer service. Direct access to underwriters. And one consolidated bill for ASO administrative fees and stop loss payments when you also have medical through us — with no need to verify enrollment between carriers.

Administrative services

Health insurance administration is complicated. We can help connect you with workplace management solutions to help ensure regulatory compliance while improving efficiencies and bottom lines. Meaning your business can save more by focusing on other business priorities.

You can get administrative support for things like:

Fully integrated reimbursement accounts
Compliance services
Full COBRA administration
Nondiscrimination testing

Talk to a Univera Healthcare sales representative to learn more.

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Coverage for Midsize and Large Businesses