Coverage for Midsize and Large Businesses

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: 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

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.

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! Vitalize^SM: 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.