Sonic Health Insurance Plan
Dear Sonic Franchisee:
January 2010
Sonic Health Plan Members:
We are excited to update you on the changes being made to the Sonic Association Benefit Plans. Members will have an expanded choice of benefits and the program operations are being streamlined and improved.
The Association Board decided to change to United Healthcare (UHC) as the carrier for the Association Plan. This change is designed to bring more value to the membership through competitive pricing and expanded benefit offerings. Sonic Industries recently made a decision to move their coverage to United Healthcare as well, and after discussions with them we will be working together to make sure the Sonic brand is well represented.
We have tried to anticipate some of the questions that you may have. The most commonly asked questions and answers are listed below. Please check back to the Sonic Association website for more resources regarding your state and plans.
Sincerely,
Kelley Stuck
Plan Administrator
Sonic Health Plan
4801 Main Street, Suite 350
Kansas City, Missouri 64112
866.456.1421 toll-free ∙ 847.953.4562 efax
Q. Who is eligible for the Plan?
A. Owners and full-time managers.
Q. Will everyone who is currently covered continue to be covered with United Healthcare?
A. Members who currently participate with a group will be eligible for coverage, based on the insurance regulations for each state. Individuals may be moved to an individual policy, depending on the state. In some states this may mean that coverage can be denied. This is why it is important for you to qualify as a member of a group. A husband and wife, each selecting “employee only” coverage, may qualify for group coverage since the minimum group size is two (2) in some states.
Q. When will I know what the coverage will cost?
A. All groups must submit a completed member application for each eligible member, an employer application and a census. Once this is received, you will receive premium rates within two to three weeks.
Q. How soon will the change be made?
A. Groups will be moved to UHC at the first of the month following the time the member applications are received and the group receives rates. Groups that submit information in December will be move to UHC on January 1. All groups must be transitioned to UHC by March 1, 2010 in order to continue coverage.
Q. Will we continue to have a yearly open enrollment at the same time each year?
A. Once the transition is complete (March 1, 2010), all groups will renew on March 1 of each year.
Q. How much will the employer pay of the premium?
A. The employer must pay 50% of the medical premium for owners and full-time managers who participate in the plan.
Q. What other benefits are available in addition to the medical plan?
A. Optional benefits include dental, vision, life/AD&D, short-term disability and long-term disability (disability available for groups with 10+ eligible employees). Services such as Will Planning Services and Emergency Travel Assistance are also included. More information on these benefits will be provided in the open enrollment packet that you receive in early December.
Q. Do all members of a group have to choose the optional benefits?
A. If life coverage is chosen by the group, then the life premium is included with the medical premium. The other benefits listed (dental, vision, short-term disability, long-term disability) are offered on a voluntary basis to the employee. Individuals may choose to participate in the other coverage even if they waive medical coverage. If you choose to offer these additional options to your group, the premium will appear on your monthly billing and you will submit it to UHC with your medical premium.
Q. How do I know if my doctor is in the UHC plan?
A. The UHC Point of Service (POS) medical plan has a national network of providers. You can search for providers on the UHC website www.myuhc.com.
Q. How will the billing be handled?
A. UHC will bill each group directly and you will make payment to UHC. This will eliminate many of the billing issues that have existed with BCBS and ensure a more timely and accurate billing process.
Q. Who do I call when I have a problem or a question?
A. The UHC Customer Service Center is available to answer member question. In addition, the Association will continue to have a dedicated Sonic Association Benefit Plan phone line, using the same toll-free number that you have always used for your benefits. We will be able to answer questions during open enrollment, view billing records, assist with claims issues and continue to be the customer advocate for Franchise members.
Q. Why is this change taking place?
A. It has been difficult to maintain competitive premiums for members. In addition, BCBS is no longer willing to continue the current arrangement.
Q. Will all groups have the same premium rates?
A. To ensure the long-term viability of the plan, we will be following the small group coverage rules of each state. This means benefit designs may vary slightly from state to state and premium amounts will vary between groups. Premiums will be based on location, age, health and group size. Groups of less than 15 eligible members will have age-banded rates. Groups with more than 15 eligible members will have a 4-tier rate structure of employee, employee plus spouse, employee plus children and family.