Quarterly Rate Change:
HMO: 1.8% Statewide
PPO: 3.5% Statewide
Navigate: Rate Pass
Annual Rate Change:
HMO: 0.8% Statewide
PPO: 8.0% Northern California
PPO: 8.2% Southern California
PPO: 8.1% Statewide
Plan/Portfolio Changes: There are no changes to the plan portfolio; however, the optional infertility benefit will continue at the same premium percentage loads without change (HMO plans at 3.4% and PPO Select Plus/Core plans at 4.9%). Additional information noted below for reference on SB729.
- Fertility and Infertility Services: UnitedHealthcare is working diligently with regulators to validate the effective date and coverage requirements for CA SB729, treatment for fertility and infertility services. Consistent with the Governor's ask to the legislature, it is possible that this bill's effective date may be delayed from 7/1/2025 to 1/1/2026. However, if there is no delay, UnitedHealthcare is prepared to offer the mandated coverage to small groups upon renewal effective 7/1/2025 and after.
Note: UnitedHealthcare is in the process of updating the optional benefit language for SB729.
Marketing Materials/Forms: The employee flyer for One Pass Select has also been updated to reflect 2025 pricing tiers.
Note: All gyms indicate which tier they participate in on the public-facing pre-login screen on OnePassSelect.com
Underwriting Guidelines: An extension of the relaxed participation guidelines for Choice Simplified and Staff Model through 07/31/2025.
There must be at least 25% participation between UnitedHealthcare and 2 staff model carrier(s) with 5 employees enrolling with UnitedHealthcare, excluding COBRA participants.
No minimum California employee enrollment required.
Upon submission a copy of the most recent billing statement from the current carriers reflecting employee census and applications and waivers from any employees not reflected on the billing statement.
Note: May not write alongside CaliforniaChoice and Covered CA for Small Business. Kaiser composite rates are permitted alongside Kaiser composite rates. See attached flyer for confirmation.
Cigna + Oscar: Relaxed underwriting promo including Kaiser wrap groups and out-of-state employees through December 2025 effective dates.
Small Group Level Funded: For small group level funded, UnitedHealthcare is reducing the participation to 25% of total eligible, regardless of waivers, effective July 1, 2025.
