> For the complete documentation index, see [llms.txt](https://ideonapi.gitbook.io/quote-and-select/llms.txt). Markdown versions of documentation pages are available by appending `.md` to page URLs; this page is available as [Markdown](https://ideonapi.gitbook.io/quote-and-select/quote-groups/level-funded/unitedhealthcare.md).

# UnitedHealthcare

Details and requirements specific to UHC Level Funded quoting

## Overview

<table><thead><tr><th width="214.056884765625">Subject</th><th>Detail</th></tr></thead><tbody><tr><td>Ideon's Internal Issuer ID</td><td>110006</td></tr><tr><td>Quoted Rates Policy</td><td>Illustrative</td></tr><tr><td>Available States</td><td>34 total: AK, AL, AR, AZ, CA, CO, CT, IA, ID, IL, IN, KS, KY, ME, MI, MN, MO, MS, MT, ND, NE, NH, NJ, NM, NV, OH, OK, OR, PA, RI, SD, UT, WA, WY</td></tr><tr><td>Plan Inventory</td><td>UHC has an extensive plan catalogue, supporting around 5,000 plans nationally. There are typically 200-800 plans available in each state.</td></tr><tr><td>Quote Effective Date Restrictions</td><td><p>UHC requires quote effective dates to be the 1st day of the month; any effective dates quoted in Ideon's API that do not satisfy this requirement will be automatically pushed to the 1st day of the following month. </p><p></p><p>Quote effective dates must be no greater than 2 weeks prior to and 4 months in advance of the current date.</p></td></tr><tr><td>Additional Notes</td><td>UHC Level Funded SBCs are auto-generated with arbitrary coverage periods. Most plans will show 1/1/YY - 12/31/YY in the top-right of the SBC, where YY reflects the most current available year for quoting.</td></tr></tbody></table>

## Quoting Details

### Coordination of Benefits

For Level Funded quoting, UHC requires a coordination of benefits parameter to be passed. To support this, Ideon's API expects the `coordination_of_benefits` parameter to be included in the [Create Quote request](/quote-and-select/quote-groups/small-group-medical/quote-a-group.md). This enum parameter expects one of two values: *plan* or *medicare*, representing the which insurance plan pays first when there are multiple overlapping coverages for a member.

### Stop Loss Amounts

In level funded plans, stop loss coverage limits an employer’s financial exposure to high or unexpected claims. Specific stop loss sets a per-member claims threshold, while aggregate stop loss caps total claims for the group. Together, these amounts define the risk protection built into the plan and are a key factor in determining overall costs.&#x20;

UnitedHealthcare quotes plans with specific per-member stop loss amounts, pre-configured by state. Each state allows for 2-5 different stop loss amounts. Ideon's API automatically quotes all available plans for each stop loss amount.&#x20;

#### Stop Loss Results - v9

In v9, each UHC Level Funded plan is returned in the `rates` array as a single object. Per-variant premiums are nested in the `premiums.level_funded.variants` array, with one object per quoted stop loss amount. Each variant object includes the variant's `stop_loss_amount`, `claims_surplus_fraction`, and the premiums associated with that variant for each available rating methodology.

The relevant portion of the Display Rates response for a quoted UHC Level Funded plan:

{% code title="GET /quotes/\<quote.id>/rates" %}

```json
{
  "rates": [
    {
      // Plan identifiers,
      "premiums": {
        "level_funded": {
          "premium_type": "4_tier_composite",
          "variants": [
            {
              "stop_loss_amount": "25000.00",
              "claims_surplus_fraction": "2/3",
              "4_tier_composite": {
                "employee_only": "100.00",
                "employee_plus_spouse": "100.00",
                "employee_plus_children": "100.00",
                "employee_plus_family": "100.00",
                "total": "100.00"
              }
            }
          ]
        }
      },
      // quote_exceptions array (if applicable), 
      // member_exceptions array (if applicable)
    }
  ]
}
```

{% endcode %}

#### Stop Loss Results - v8

Separate objects are returned for each available plan and stop loss amount combination. For example, if there are 100 plans available and 3 stop loss amounts supported in the state, then 300 results would be expected in the Display Rates endpoint. In this endpoint response for UHC Level Funded, it is important to account for a single plan (unique by `plan_id`) being returned multiple times, with different `stop_loss_amount` values per the state's configuration.&#x20;

### Claims Surplus

Claims surplus fractions describe how unused claims funds are handled at the end of a level funded plan year. The fraction indicates what portion of any surplus may be returned or credited to the employer, with the remainder retained by the carrier. This structure helps balance predictable monthly costs with the potential for shared savings.

UnitedHealthcare defines a single, consistent claims surplus fraction for each state, returned in the `claims_surplus_fraction` field in the Show Rates endpoint response (GET /quotes/{quote\_id}/rates). Values are structured as a string - *"1/1"* or *"1/2"*, for example.