What’s New for 2024
VitalizeSM: Vitalize is a digital home base dedicated to engaging teams in health and wellbeing. Our partnership with Virgin Pulse* will give employees the tools to make small, everyday changes to their wellbeing that are focused on the areas they want to improve the most. They’ll build healthy habits, have fun with friends, and experience the lifelong rewards of better health and wellbeing. Vitalize will be embedded for Fully Insured and available as a buy-up for Self-Funded. Based on the experience and incentives you’re looking to offer, we have several different reward options available as a buy-up.
Headspace for Meditation, Sleep, and Stress Relief: Headspace, powered by Virgin Pulse, is a leading digital mindfulness-based mental health app that helps members take care of their minds. The Headspace app includes hundreds of exercises and meditations for stress relief, focus, productivity, and sleep. It is designed to bring wellbeing resources together into a seamless, personalized, and easy-to-use experience. The Headspace app provides an experience comparable to Calm® and will be replacing Calm beginning January 2024.
Virtual Physical Therapy for Musculoskeletal (MSK) Management**: Members receive virtual access to a holistic team of specialty medical doctors, physical therapists, health coaches, and nutritionists. Virtual physical therapy visits will be covered in full (subject to deductible, where applicable), and included as a telemedicine service.
REACH Kidney Care: Our Care Management Team is partnering with REACH Kidney Care, a kidney health management program designed to benefit members along the continuum of kidney disease, specifically targeting members with Stage 4 and 5 chronic kidney disease (CKD). At no cost to members, REACH will provide one-on-one, individualized care management, both in person and virtually, to help them navigate their health in a way that best fits their life.
Wellness Your Way: Beginning in 2024, there will be an additional rewardable payout option of $200 per family contract, or $100 per subscriber, and $100 per spouse or domestic partner, to be used on programs and services to help keep members and their families healthy.
Dental Preferred Packaging: To help make selecting the right plan easier, we’ve created four preferred package options. They are great places to start if you’re brand 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.
* Virgin Pulse is a separate company and offers a digital wellbeing service on behalf of Univera Healthcare.
** Pending final contract between the parties.
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: More than 98% provider participation within these counties, including all major hospitals and strategic physician groups
- National Network: In-network benefits with more than 1,200,000 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 telehealth, telemedicine, and the Wellframe® app. Learn more about these convenient tools in Tools & Resources.
Univera Clear Options
The clarity and predictability of a copay plan—without the higher premiums.
For groups looking for a fresh new way to keep expenses in check while still providing a simple plan employees love, there’s Univera Clear Options. It works just like a traditional copay plan, only with additional copay levels. The result? An easy-to-understand and predictable copay plan with lower premiums than you might normally expect.
The many benefits of Univera Clear Options include:
- Six copay levels so costs are always transparent and predictable
- No deductible or coinsurance to figure out
- Copays go toward the out-of-pocket max
- Preventive care is covered in full from day one
- All plans are FSA and HRA compatible
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.
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 free self-service support tools that make it easier than ever to get care.
NEW! VitalizeSM: A digital home base for health and wellbeing. By partnering with Virgin Pulse, we help members make small everyday changes to their wellbeing that are focused on the areas they want to improve the most. Members will build healthy habits, have fun with friends, and experience the lifelong rewards of better health and wellbeing.
Online Member Accounts: From viewing their member card and benefits to viewing claims, tracking their deductible and out-of-pocket spending, and more, members have more visibility into their plan than ever before.
Telemedicine: For non-emergency conditions and emotional wellbeing needs, telemedicine gives members convenient access to medical and behavioral health care 24/7/365 from the comfort of their home. In-network telemedicine services provided by a member’s physician or our partner, MDLIVE®, are covered in full (subject to deductible where applicable).
Wellframe® App: Wellframe is a convenient way for members to receive confidential, text-based, one-on-one outreach from our care managers using a smartphone or tablet. Members can receive guidance, support, and tips to help achieve their health care goals and reduce costs.
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.
Find a Doctor & Estimate Medical Costs Tool: Members are more in control of their care with the ability to quickly and easily find their most affordable local and national care options with our online tools.
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.
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
- Rewarded for regular dental care through Dental Rewards, a program offering monetary incentives for getting dental exams and cleanings
- 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.
NEW! 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.
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 350 provider locations in the 8-county Western New York region and 130,000+ 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.
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)
- Access to 48 on-staff pharmacists and 17 medical directors
- 4-6% reduction in overall medical costs*
*Health Plan Data
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.
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.
Talk to a Univera Healthcare rep today.
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