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united heatlhcare

Small Group Dental Plans
(2-50 employees)

--Search Dentists Here--

UHC Dental Plans

AM Best Rating:  A
NCQA: Excellent

UnitedHealthcare provides a full spectrum of small employer dental plans. UnitedHealthcare is one of the businesses of UnitedHealth Group (NYSE: UNH), a diversified Fortune 50 health and well-being company.

health plans onlineIn Network Only Plans

UnitedHealthcare's hottest plans. Using a large PPO network of dentists, employees can be offered unheard of annual maximums up to $3,500. Rates are awesome and employees can use any PPO provider, but have no access to dentists outside the large PPO network. Search PPO Dentists by clicking here.

health plans onlinePPO Plans

Traditional plans allowing the use of PPO dentists or a dentist out of network. With some plans "out of network dentists" can be paid at the 85th or 90th percentile of Usual & Customary (UCR) charges. Other plan designs use a "maximum allowable charge" for paying out of network providers. Search PPO Dentists by clicking here.

health plans onlineDHMO Plans

The lowest cost plans available because they use a smaller list of dentists than the PPO list discussed above. These plans offer copays similar to HMO health plans. Employees must choose a specific dentist during enrollment to direct their dental care. Search DHMO Dentists by clicking here.

In Network Only Plans

  IN NETWORK Only Plans
Plan Prev. & Diag Minor Rest. Endo/
Perio
Crown & Brd Ortho Deduct Ortho Elig Ann. Max Life Ortho Voluntary?
PIN52 100% 50% 50% 50% 0% 50/150 N/A  $ 1,500   No
PIN53 100% 50% 50% 50% 0% 50/150 N/A  $ 1,500   Yes
PIN55 100% 80% 50% 50% 50% 25/75 Child & Adult  $ 3,500  $1,500 Yes
PIN56 100% 80% 50% 50% 0% 25/75 N/A  $ 3,500  $     -   Yes
PIN57 100% 80% 50% 50% 50% 25/75 Child & Adult  $ 3,500  $1,500 No
PIN58 100% 80% 50% 50% 0% 25/75 N/A  $ 3,500  $     -   No

PPO Plans

In Network Benefits (Outside network see bottom chart)

Plan Type Waiting Period Prev. & Diag Minor Rest.   Endo Perio Crown & Brd Ortho Deduct Ortho Elig Ann. Max Life Ortho CMM? Vol?
P0018 Passive 12 Months 100% 80%   80% 80% 50% 50% 50/150 Child Only $1,500 $1,500 No No
P3306 Incentive 12 Months 100% 80%   50% 50% 50% 0% 50/150 N/A $1,000   Yes Yes
P3337 Passive 12 Months 100% 80%   50% 50% 50% 0% 50/150 N/A $1,000   Yes Yes
P3350 Incentive None 100% 80%   50% 50% 50% 0% 50/150 N/A $1,500   Yes Yes
P3354 Incentive 12 Months 100% 90%   60% 60% 60% 0% 50/150 N/A $1,500   Yes Yes
P3378 Passive None 100% 80%   80% 80% 50% 0% 50/150 N/A $1,000   Yes Yes
P3362 Incentive None 100% 90%   60% 60% 60% 0% 50/150 N/A $2,000   Yes Yes
P3388 Passive None 100% 80%   80% 80% 50% 50% 50/150 Child Only $1,500 $1,500 Yes Yes
P3434 Incentive None 100% 80%   80% 80% 50% 0% 50/150 N/A $1,000   Yes No
P3439 Incentive None 100% 80%   80% 80% 50% 0% 50/150 N/A $1,500   Yes No
P3486 Incentive None 100% 80%   80% 80% 50% 0% 50/150 N/A $1,000   Yes No
P3389 Passive None 100% 80%   80% 80% 50% 0% 50/150 N/A $1,500   Yes Yes
P4210 Incentive None 100% 90%   90% 90% 60% 0% 50/150 N/A $1,000   Yes No
P4212 Incentive None 100% 90%   90% 90% 60% 50% 50/150 Child Only $1,000 $1,000 Yes No
P4213 Incentive None 100% 90%   90% 90% 60% 0% 50/150 N/A $1,500   Yes No
P4214 Incentive None 100% 90%   90% 90% 60% 50% 50/150 Child & Adult $1,500 $1,500 Yes No
P4216 Incentive None 100% 90%   90% 90% 60% 0% 50/150 N/A $2,000   Yes No
P4878 Passive None 100% 80%   50% 50% 50% 50% 50/150 Child Only $1,000 $1,000 Yes No
P4879 Passive None 100% 80%   80% 80% 50% 0% 50/150 N/A $1,000   Yes No
P4881 Passive None 100% 80%   50% 50% 50% 0% 50/150 N/A $1,500   Yes No
P4883 Passive None 100% 80%   80% 80% 50% 0% 50/150 N/A $1,500   Yes No
P4980 Passive None 100% 80%   80% 80% 50% 50% 50/150 Child & Adult $2,000 $2,000 Yes No
P4983 Incentive None 100% 90%   90% 90% 60% 50% 50/150 Child Only $2,000 $1,000 Yes No
P5329 Incentive None 100% 80%   80% 80% 50% 0% 50/150 N/A $1,000    Yes   No 
P5330 Incentive None 100% 80%   80% 80% 50% 0% 50/150 N/A $1,500    Yes   No 
P5331 Incentive None 100% 90%   90% 90% 60% 50% 50/150 Child Only $1,500 $1,000  Yes   No 
P5300 Passive None 100% 80%   80% 80% 50% 50% 50/150 Child Only $2,500 $1,000 Yes No

Out of Network Benefits

Plan Prev. & Diag Minor Rest. Endo Perio Crown & Brd Ortho Deduct Ortho Elig Ann. Max Life Ortho UCR
P0018 100% 80% 80% 80% 50% 50% 50/150 Child Only $1,500 $1,500 85%
P3306 80% 50% 50% 50% 50% 0% 50/150 N/A $1,000   MAC
P3337 100% 80% 50% 50% 50% 0% 50/150 N/A $1,000   85%
P3350 80% 60% 50% 50% 50% 0% 50/150 N/A $1,500   85%
P3354 100% 80% 50% 50% 50% 0% 50/150 N/A $1,500   85%
P3378 100% 80% 80% 80% 50% 0% 50/150 N/A $1,000   85%
P3362 100% 80% 50% 50% 50% 0% 50/150 N/A $2,000   85%
P3388 100% 80% 80% 80% 50% 50% 50/150 Child Only $1,500 $1,500 85%
P3434 80% 60% 60% 60% 50% 0% 50/150 N/A $1,000   85%
P3439 80% 60% 60% 60% 50% 0% 50/150 N/A $1,000   85%
P3486 80% 50% 50% 50% 50% 0% 50/150 N/A $1,000   85%
P3389 100% 80% 80% 80% 50% 0% 50/150 N/A $1,500   85%
P4210 100% 80% 80% 80% 50% 0% 50/150 N/A $1,000   85%
P4212 100% 80% 80% 80% 50% 50% 50/150 Child Only $1,000 $1,000 85%
P4213 100% 80% 80% 80% 50% 0% 50/150 N/A $1,500   85%
P4214 100% 80% 80% 80% 50% 50% 50/150 Child & Adult $1,500 $1,500 85%
P4216 100% 80% 80% 80% 50% 0% 50/150 N/A $2,000   85%
P4878 100% 80% 50% 50% 50% 50% 50/150 Child Only $1,000 $1,000 90%
P4879 100% 80% 80% 80% 50% 0% 50/150 N/A $1,000   90%
P4881 100% 80% 50% 50% 50% 0% 50/150 N/A $1,500   90%
P4883 100% 80% 80% 80% 50% 0% 50/150 N/A $1,500   90%
P4980 100% 80% 80% 80% 50% 50% 50/150 Child & Adult $2,000 $2,000 90%
P4983 100% 80% 80% 80% 50% 50% 50/150 Child Only $2,000 $1,000 90%
P5329 70% 50% 50% 50% 50% 0% 50/150 N/A $750   MAC
P5330 70% 50% 50% 50% 50% 0% 50/150 N/A $1,000   MAC
P5331 70% 50% 50% 50% 50% 50% 50/150 Child Only $1,000 $1,000 MAC
P5300 100% 80% 80% 80% 50% 50% 50/150 Child Only $2,500 $1,000 90%

DHMO Plans

Dental Rates & Benefits

 

 

 

Rates

Bakersfield INO PPO
Fresno INO PPO
Inland Empire INO PPO
Los Angeles INO PPO
Marysville INO  
Oakland INO PPO
Orange INO PPO
Sacramento INO PPO
San Diego INO PPO
San Francisco INO PPO
San Jose INO PPO
Santa Barbara INO PPO
Santa Rosa INO PPO
Stockton INO PPO
Ventura INO PPO

Underwriting

Dental Dual Option Guidelines

HMO/PPO

  • Minimum of 5 eligible employees, 3 enrolling.
  • Normal participation guidelines apply based on whether the group is voluntary or contributory, while meeting the minimum of 3 enrolled.
  • A minimum of 10 eligible employees and 8 enrolled is required between the two options when a PPO plan is offered that includes orthodontic services.

PPO/PPO

  • Minimum of 10 eligible employees, 10 enrolling.
  • Normal participation guidelines apply based on whether the group is voluntary or contributory, while meeting the minimum of 10 enrolled.
  • A minimum of 8 enrolled is required on any option that includes orthodontic coverage when a plan with orthodontic and a plan without is sold.
  • Combination of plans must be logical, e.g. high and low options. 
  • Plans must differ by more than just orthodontia on one plan.

HMO/HMO

  • Minimum of 5 eligible employees, 3 enrolling.
  • Normal participation guidelines apply based on whether the group is voluntary or contributory, while meeting the minimum of 3 enrolled.
  • Combination of plans must be logical, e.g. high and low options.  Target differential 30%

Enrollment Guidelines

What paperwork should we submit for a stand alone dental, vision, life or disability plan?

  • Signed group application
  • Signed member enrollment form for all eligible employees (including those waiving coverage; waiver forms are not required for voluntary plans)

OR

  • Enrollment spreadsheet (waivers are not required)
  • Plus one of the following:
    • Prior carrier bill (showing the client has had recent medical or ancillary coverage with any carrier) OR
    • Current Payroll OR
    • Quarterly Wage and Tax Statement 

AND

  • A binder check equal to the first month’s premium made payable to UnitedHealthcare (A binder check is not required for voluntary case submissions.)
  • A copy of the proposal or rate sheet
  • Dental cases:  If the group requests to waive the dental waiting period for initial enrollees on a 12 month wait plan, the group submission should also include:

    • A Certificate of Coverage (COC) or Summary Plan Description (SPD)

Supplemental Life & Disability cases: A supplemental employer and employee form is required.
Life cases: An Evidence of Insurability (EOI) Form is required if the life benefit is above the Guarantee Issue (GI) amount:

Eligible Employees

Guarantee Issue Amount

2 to 5 eligible employees

$25,000

6 to 19 eligible employees

$50,000

20 to 50 eligible employees

$100,000

51 to 99 eligible employees

$175,000

Send to our office:

Health Plans Online, Inc.
31194 La Baya Dr. Ste. 201
Westlake Village, CA 91362

Submission Timeline:

It is ideal to submit all completed forms two weeks before the requested effective date to provide ample time for the carrier to underwrite and provide a group number.