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2021 Individual & Family Product TrainingBrian Eck,
Associate Vice President, SalesMarti Andro, Manager, Broker
Sales
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We’ll learn
• The UCare difference• 2021 UCare plans
– What’s new for 2021?– UCare Individual & Family Plans–
UCare Individual & Family Plans with
M Health Fairview• Q&A
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UCare in community
Who is UCare?
MissionTo improve the health of our members through innovative
services and partnerships across communities
How do we live this mission?Benefits that support health:
Dental, unlimited online & retail visits, Healthy Savings,
fitness programs
Culturally diverse staff serving a culturally diverse
membership
UCareFoundationSupports preventive health care, quality for
chronic disease management, health equity, and reducing health
disparities for people with disabilities
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Top plan• Most popular plan on MNsure by enrollment
• Covers the top 99 most commonly prescribed drugs
• Local, friendly customer service
• Both copay and HSA-compatible plan options
• Large provider network
• Savings on prescription drugs
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UCare Individual & Family plans (IFP)
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2021UCare Individual & Family plans
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UCare Individual & Family Plans
• Core
• Bronze
• Silver
• Gold
New HSA-compatible plans
• Bronze
• Silver
UCare Individual & Family Plans with M Health Fairview•
Bronze
• Silver
• New for 2021 – Gold!
New HSA-compatible plans• Bronze• Silver
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2021 Highlights
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• Expansion to 49 new counties
• New providers including Mayo Clinic Health System, Sanford
Health, Gundersen Medical Center, and more
• Gold level plan from M Health Fairview partner plan
• $25 copay cap on certain diabetes medications extended through
2021
• Premiums range from increase of 1.6% to decrease of 1.4%
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Service Area Expansion Expecting competitive position
o Many new providers, including Sanford, Avera, Gundersen, Mayo
(restrictions apply)
77 total counties (49 new)o 6 new rating areas o Excludes 10
counties in SE MN
o UCare IFP only, not M Health FVo MHF plans will keep the
10-county
greater metro SA
8Proprietary & Confidential
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The Mayo Arrangement
Mayo Clinic Health System (MCHS)
o Fully in-network for UCare IFP
o No referrals or PA’s needed
o Includes hospitals in Red Wing, New Prague, and Mankato
Mayo Clinic Rochester
o Limited access for complex specialty care only
o Non-network, unless:o Member referred by Mayo provider, or
o Member referred by other provider AND has UCare CLS auth
Referral model:
o Mayo scheduling triage
o UCare CLS model
Proprietary & Confidential 9
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M Health Fairview Gold
Metro area opportunity
Gold plans increasingly popular
M Health Fairview believes there is
significant demand from their patients
Modest first year growth expectations
Same design/benefits as the UCare Gold plan
Same 10-county service area as current MHF Bronze/Silver
plans
May be the lowest-cost Gold plan on MNsure
10Proprietary & Confidential
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Choose from two networks
• UCare
‒ M Health Fairview‒ Allina‒ Sanford‒ Mayo‒ Park Nicollet‒ North
Memorial Health‒ North Clinic‒ Essentia Health‒ CentraCare
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• UCare with M Health Fairview
• M Health Fairview Network• Independent providers
including:
– U of M Children’s Hospitals
– Southside Community Health Services
– Southdale Pediatrics
– Richfield Medical Group
– Minnetonka Pediatrics
– South Lake Pediatrics
– North Point Health and Wellness Center
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UCare IFP plans include • Free preventive care
– Routine screenings, immunizations and checkups– Pediatric
dental checkups and eye exams– Rewards for completing certain
visits
• Free Healthy Savings grocery store discounts (up to
$200/mo)
• Health club membership discounts• Free, unlimited online care
and retail clinic visits
(Except on HSA-compatible plans)• Community education discounts
• 24/7 Nurse Line• Tobacco cessation program
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Benefit Change HighlightsNo significant changes to Essential
Health Benefits (EHB)
o Key set of covered services remains the same
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Change* Applies to Why?Lower deductible Silver HSA • After
premium, deductible remains most
important to clients
Higher MOOP All standard plans
• Keep pace with new CMS calculator
Higher coinsurance Bronze, Silver HSA
• Keep pace with new CMS calculator• Coins. is less important to
clients
$25 copay cap for certain Diabetes Rx
All co-pay plans
• Help remove barriers to managing Diabetes
Higher ER copay Gold • Keep pace with new CMS calculator
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Proprietary & Confidential
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Proprietary & Confidential 14
Benefit Changes (Copay Plans)
Bronze Copay 2020 2021Deductible $5,900 $5,900
MOOP $8,150 $8,550
Default coins. 30% after ded. 35% after ded.
Office visits $60 for 3 $60 for 3
ER visit 30% after ded. 35% after ded.
Retail/Online $0 $0
Pref. generic Rx $15 $15
Np. generic Rx $25 $25
Pref. brand Rx $200 $200
Np. brand & spec. 40% after ded. 40% after ded.
Silver Copay 2020 2021
Deductible $2,900 $2,900MOOP $7,700 $7,900
Default coins. 30% after ded. 30% after ded.
Office visits $30 for 3 $30 for 3
ER visit $250 for 1 $250 for 1
Retail/Online $0 $0
Pref. generic Rx $10 $10
Np. generic Rx $20 $20
Pref. brand Rx $175 $175
Np. brand & spec. 40% after ded. 40% after ded.
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Benefit Changes (Copay Plans)
Proprietary & Confidential 15
Gold 2020 2021 Core 2020 2021 Deductible $900 $900 Deductible
$8,150 $8,550 MOOP $7,200 $7,300 MOOP $8,150 $8,550 Default coins.
20% after ded. 20% after ded. Default coins. 0% after ded. 0% after
ded.
Office visits $20 $20
Office visits $30 for 3
(PCP only) $30 for 3
(PCP only) ER $150 for 1 $500 for 1 ER 0% after ded. 0% after
ded. Retail/Online $0 $0 Retail/Online $0 $0 Pref. generic Rx $5 $5
Pref. generic Rx 0% after ded. 0% after ded. Np. generic Rx $15 $15
Np. generic Rx 0% after ded. 0% after ded. Pref. brand Rx $125 $125
Pref. brand Rx 0% after ded. 0% after ded. Np. brand & spec.
40% after ded. 40% after ded. Np. brand & spec. 0% after ded.
0% after ded.
Gold
2020
2021
Core
2020
2021
Deductible
$900
$900
Deductible
$8,150
$8,550
MOOP
$7,200
$7,300
MOOP
$8,150
$8,550
Default coins.
20% after ded.
20% after ded.
Default coins.
0% after ded.
0% after ded.
Office visits
$20
$20
Office visits
$30 for 3
(PCP only)
$30 for 3
(PCP only)
ER
$150 for 1
$500 for 1
ER
0% after ded.
0% after ded.
Retail/Online
$0
$0
Retail/Online
$0
$0
Pref. generic Rx
$5
$5
Pref. generic Rx
0% after ded.
0% after ded.
Np. generic Rx
$15
$15
Np. generic Rx
0% after ded.
0% after ded.
Pref. brand Rx
$125
$125
Pref. brand Rx
0% after ded.
0% after ded.
Np. brand & spec.
40% after ded.
40% after ded.
Np. brand & spec.
0% after ded.
0% after ded.
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Proprietary & Confidential 16
Benefit Changes (HSA Plans)
Bronze HSA 2020 2021
Deductible $6,800 $6,950MOOP $6,800 $6,950Default coins. 0%
0%
Office visits 0%. 0%
ER 0% 0%
Retail/Online 0% 0%
Pref. generic Rx 0% 0%
Np. generic Rx 0% 0%
Pref. brand Rx 0% 0%
Np. brand & spec. 0% 0%
Silver HSA 2020 2021
Deductible $3,300 $3,000MOOP $6,500 $6,800Default coins. 15%
25%Office visits 15% 25%
ER 15%. 25%Retail/Online 15% 25%Pref. generic Rx 15% 25%Np.
generic Rx 15% 25%Pref. brand Rx 15% 25%Np. brand & spec. 15%
25%
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Enroll on MNsure
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Working with UCare: Broker portal
- Manage your list of contacts
- Download UCare materials
- Download template sales materials
- Order materials online
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Working with UCare: Order Materials
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Working with UCare: Order Materials
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Working with UCare: Customize & Print on Demand
Materials
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Working with UCare: Commission
• Commission structure effective 1/1/2021
– Increased to $18/contract per month
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Stay in the knowLike us on Facebook!
Contact Us
- Broker customer service: (866) 242-2384- [email protected]
Marti Andro, Broker Sales Manager
- Email: [email protected] Commission questions
[email protected]
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mailto:[email protected]:[email protected]
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Q&ALet us de-complicate for you!
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Thank you on behalf of the entire UCare team and those members
we all represent!
2021 Individual & Family Product TrainingWe’ll learnUCarein
communityWho is UCare?MissionHow do we live this
mission?UCareFoundation
Top planUCare Individual & Family plans (IFP)2021UCare
Individual & Family plansUCare Individual & Family PlansNew
HSA-compatibleplansUCare Individual & Family Plans with M
Health FairviewNew HSA-compatible plans
2021 HighlightsService Area ExpansionThe Mayo ArrangementM
Health Fairview GoldChoose from two networksUCare IFP plans
includeBenefit Change HighlightsBenefit Changes (Copay
Plans)Benefit Changes (Copay Plans)Benefit Changes (HSA
Plans)Enroll on MNsureWorking with UCare: Broker portalWorking with
UCare: Order MaterialsWorking with UCare: Order MaterialsWorking
with UCare: Customize & Print on Demand MaterialsWorking with
UCare: CommissionContact UsQ&A
