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UnitedHealthcare has announced rate and plan changes for Q4 2018. Rates will be updated for October 1, 2018 and will remain valid through December 2018. All PPO plans have received a rate pass while HMO plans increased 1.5% as a statewide average. The Increase varies by network:

  • Full: 2%
  • Advantage: 2%
  • Alliance: 0%
  • Focus: 1.5%

The eligible ZIP Code list has received one update for Marin County. ZIP Code 94924 has been added to the eligible list for the Signature HMO network and all PPO networks.

Portfolio Updates

Two new HMO plans will be available effective November 1, 2018. These new plans offer a hospital copay benefit instead of the typical coinsurance HMO plans. Both plans will be offered on all four HMO networks.

Plan Name PCP Copay Specialist Copay OP Surgery IP Copay Deductible




Platinum 20-40/500d $20 $40 $250 copay $500/Day $0 $2,250/$4,500
Gold 30-60/1000d $30 $60 $500 copay $1000/Day $0 $5,500/$11,000


With these new HMO plans, UnitedHealthcare will release a new portfolio effective November 1, 2018 called “Choice Simplified III.” The addition of Choice Simplified III means that employers now have four portfolios to choose from. Choice Simplified III will be the only portfolio with access to the two new HMO plans.

Material Updates

With the new plans and portfolio, several materials will be updated for November 2018. Expect the following items to be released by UHC in the next few weeks:

  • Employer Product and Benefit Selection Form
  • Product Grid
  • Product Catalog
  • SOB and SBCs for the new HMO plans

These items will be available on the LISI website as soon as they are released by UnitedHealthcare. Be on the lookout for these updated materials; it will be especially important to make sure to use the correct Product and Benefit Selection Form when enrolling your November and December groups!

Contact your LISI Regional Sales Manager to find out more.