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UnitedHealthcare Enhances Integration of Medical and Specialty Benefits, Helping Improve Health Outcomes and Affordability

UNH | April 28, 2021

Enhancements to UnitedHealthcare’s integrated approach to medical and specialty benefits may help eligible employers save up to 4%* by combining medical benefits with vision, dental and financial protection plans, while supporting a more simplified experience for members

UnitedHealthcare has introduced various enhancements to its integrated approach to medical and specialty benefits, providing members with a more simplified experience and enabling employers to help improve employee health outcomes, increase productivity and lower costs. 1 Through an approach that bundles medical and specialty plans such as vision, dental and disability, employers may save up to 4%* on medical premiums and employees can experience improved health outcomes, due to improved identification and management of chronic conditions, increased engagement in clinical care programs and the use of data to create a simpler member experience. 1

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UnitedHealthcare uses an integrated approach to medical and specialty benefits, which may result in improved health outcomes, increased productivity and lower costs for employers. Source: UnitedHealthcare

Recent enhancements and updates to this integrated approach include:

Potential Premium Savings and Net Cost Guarantee. A study of UnitedHealthcare commercial customers with integrated medical and specialty benefits revealed that they achieved an average reduction of up to 4% in annual medical costs. 1 For employers with self-funded health plans (more than 300 employees) that integrate medical and specialty benefits, UnitedHealthcare offers a Net Cost Guarantee. The savings are the result of improved health outcomes and the operational simplicity from bundling medical and specialty benefits, with employers receiving an administrative fee credit if actual health care costs exceed projections. Separately, a premium savings program known as uBundle® enables certain employers with fully insured plans to save up to 4% per year on medical premiums when combining a UnitedHealthcare medical plan with specialty benefits such as dental, vision, life, disability and supplemental health coverage (accident, critical illness and hospital indemnity plans).*
Launch of UnitedHealthcare Benefit Ally™. Benefit Ally is designed to simplify, automate and expedite payouts for employees whose employers combine three supplemental health plans with medical benefits. Following a qualified accident, critical illness diagnosis or hospital stay, Benefit Ally automatically triggers a payout to the member – all without the plan participant having to submit a claim or additional paperwork. The industry-leading program means members may get benefit payouts faster and easier, while enabling them to focus on getting well. Benefit Ally is available to select employers in 11 states with medical and supplemental health plans, including accident, critical illness and hospital indemnity coverage.** Benefit Ally is expected to be expanded to more employers and states later this year, and builds on the success of a similar capability known as Benefit Assist . Benefit Assist helps make the claims process easier for members, with 77% of supplemental health claims being initiated by Benefit Assistants (rather than the member). 2
Expanded Resources for Employers. Later this year, vision, dental and financial protection aggregate claims information will be added to Health Plan Manager™, an interactive online tool that enables employers to analyze and understand health data, providing an analytics-driven roadmap to help improve health outcomes, mitigate expenses and empower employees to take charge of their health. By adding information related to vision, dental and financial protection plans such as disability, Health Plan Manager helps employers implement more holistic clinical management and employee-engagement programs based on comprehensive analytics applied to various data sources, including aggregate medical and prescription claims, demographics and clinical and well-being information. Employers with integrated medical and specialty plans with UnitedHealthcare already may benefit from a simplified administrative process, including a single invoice for payment and a single website and app login for employees.

“These enhancements build upon UnitedHealthcare’s comprehensive approach to whole-person health, leveraging data and proactive interventions to support a simplified member experience, flag gaps in care and help prevent disease before it starts by encouraging access to preventive care,” said Tom Wiffler, CEO, UnitedHealthcare Specialty Benefits. “With growing evidence of a link between overall health and oral, eye, hearing and financial wellness, combining specialty benefits with medical coverage is encouraging well-being and proving valuable to employers and employees.”

UnitedHealthcare’s integrated approach enables new insights to get a better picture of employees’ health, facilitating clinical interventions, encouraging access to care and supporting them along their journeys toward a healthier lifestyle. For instance, to help support people with diabetes and periodontal disease, the integrated approach cross-checks dental and medical health claim data to determine if members have missed recommended periodontal treatments or cleanings. UnitedHealthcare then follows up with the member with diabetes to help schedule dental treatments or cleanings, which have been shown to reduce inflammation and improve diabetes management. 3

Similar proactive interventions may be possible for employers that combine medical benefits with accident, disability, critical illness, hearing and vision plans. The value of integration extends beyond specialty benefits too, including applications related to prescription medications and behavioral health. In fact, employers may realize an average savings of $16 to $25 per member per month by adopting an integrated approach to medical and pharmacy, while lowering emergency room costs by 11% and inpatient medical costs by 15%. 4

*Potential savings include the impact from an integrated approach and uBundle, which applies only to first-year medical premiums for employers with 51-100 employees; savings through uBundle continue as long as the program is in effect for employers with 101 to 2,999 employees, as long as the qualifying benefits remain in force. uBundle is not available in all states.

**Alabama, Arizona, Georgia, Massachusetts, Minnesota, New Jersey, Pennsylvania, Texas, Utah, Virginia, Wisconsin.

About UnitedHealthcare

UnitedHealthcare is dedicated to helping people live healthier lives and making the health system work better for everyone by simplifying the health care experience, meeting consumer health and wellness needs, and sustaining trusted relationships with care providers. In the United States, UnitedHealthcare offers the full spectrum of health benefit programs for individuals, employers, and Medicare and Medicaid beneficiaries, and contracts directly with more than 1.3 million physicians and care professionals, and 6,500 hospitals and other care facilities nationwide. The company also provides health benefits and delivers care to people through owned and operated health care facilities in South America. UnitedHealthcare is one of the businesses of UnitedHealth Group (NYSE: UNH), a diversified health care company. For more information, visit UnitedHealthcare at www.uhc.com or follow @UHC on Twitter.

UnitedHealthcare Benefit Ally™ offers Accident Protection, Critical Illness and Hospital Indemnity products provided by UnitedHealthcare Insurance Company. Each product provides separate limited benefits. Accident Protection, Critical Illness and Hospital Indemnity coverages are NOT considered “minimum essential coverage” under the Affordable Care Act and therefore none of the products satisfy the mandate to have health insurance coverage. Failure to have other health insurance coverage may be subject to a tax penalty. Please consult a tax adviser. The policies have exclusions, limitations, reductions of benefits, and terms under which the policy may be continued in force or discontinued. For costs and complete details of the coverage, call or write your insurance agent or the company. These products are not available in all states. UnitedHealthcare Insurance Company is located in Hartford, CT.

1 Review of the impact of the UnitedHealthcare integrated approach on Key and National Account customers, 2018
2 UnitedHealthcare book of business, 1/1/2020-11/23/2020.
3 British Dental Journal, 2019, Periodontitis and diabetes | British Dental Journal (nature.com)
4 UnitedHealthcare claims data, 2020