United Group Programs


OptiMed Offers Limited-Medical, GAP, Major Medical Coverages and Dental, Vision


What are Limited-Medical Plans?United Group Programs

Limited-medical plans are limited benefit plans, meaning they pay a limited benefit for a covered service at an affordable premium for both employers and employees alike. These plans provide a basic level benefit for employees that do not have access to traditional coverage. Limited-medical plans are not to be confused with major medical insurance and they are not meant to replace major medical plans.

Why are Limited-Medical Plans Important in Today’s Marketplace?

Limited-medical plans fill a rapidly growing niche in the group health insurance marketplace by assisting employers to provide their non-covered employees real benefits that can help with employee retention and morale without causing serious financial pain. The OptiMed Limited-Medical program provides a reasonable low cost employee benefit plan that the employer may or may not elect to contribute. Premiums in most states begin around $55 a month.

Voluntary and Non-Voluntary Groups Accepted

The OptiMed limited-medical plans may be offered to employees with or without employer contribution, allowing employers much greater flexibility.

Customized Quotes Available Upon Request

OptiMeds needs.

Electronic Eligibility Accepted

OptiMed has the ability to accept electronic eligibility files, simplifying the enrollment and rollover process. We have the ability to accept a wide range of file formats and we also offer a simplified excel format.

What is the Target Market?

  1. Employer groups who currently have a major medical plan in place but have part time and hourly employees who do not qualify to participate.
  2. Employer groups who can no longer afford the escalating costs of a traditional plan or who have never considered offering benefits.
  3. Franchisor groups who are looking to offer a program to their franchisees to assist retention rates and employee morale.

What Types of Employers are Typical for the OptiMed Limited Medical Program:

  • Restaurants
  • Hotels
  • Retail
  • Factories
  • Franchises
  • Staffing Companies
  • Schools
  • Universities
  • Maid Services
  • Catering Services
  • Realtors
  • Car Rental Services
  • Freight
  • Government Entities


What is OptiMed GAP?

OptiMed GAP is specifically designed to help fill the hole for deductibles and out of pocket plan expenses allowing employers greater freedom in selecting lower cost major medical health plans with higher deductibles and out of pocket maximum levels. Simply put, by plugging in OptiMed Group GAP, employers may be able to raise deductibles and out of pocket maximums to obtain lower cost coverage while still providing quality coverage to help retain key employees.

Why offer OptiMed GAP?

The increasing costs of health insurance premiums combined with the current down turn in the economy have many employers hurting and looking for creative approaches to help keep costs reasonable while providing quality coverage for their key employees. OptiMed GAP is a guaranteed issue product with multiple plan options available, allowing employers to pick and choose the best fit.

Are you having to raise deductibles and out of pocket maximums to keep cost down? OptiMed Gap might be the product to help you assist your clients with cost control and savings. In addition, by approaching your renewals in a creative way you can differentiate yourself from the pack.

  • A Rated Carrier
  • Coverage for Deductibles and Out of Pocket Maximums
  • Guaranteed Issue
  • No Pre-Existing Limitation
  • First Dollar Payment
  • In-Patient Coverage Amounts from $500 to $10,000
  • Composite Rating for Groups over 50 Eligible Employees
  • May be offered on a Voluntary Basis
  • May be written down to 5 Lives in Most States
  • Electronic Eligibility Accepted

Major Medical

OptiMed is pleased to announce our comprehensive major medical specialty program with a CASH Refund for good claim experience.

OptiMed provides a comprehensive, affordable major medical program for employer based groups. The CMMP program provides an extensive selection of plan options with nationwide access to physicians and hospitals.

In addition, the OptiMed CMMP program is fully customizable to help brokers meet the diverse needs of their clients. This program is fresh approach to employee benefits, allowing brokers to bring an exciting partially self-funded alternative to the table which can provide employers piece of mind while at the same time making it possible to manage current health expenses.
How the CMMP Program Works

The CMMP program is based upon a partially self-funded platform with reinsurance protection that eliminates excessive uncertain liability and high cost prohibitive specific deductibles. The CMMP program allows the employer to budget, as with a conventional program, a premium that is billed and collected in the same fashion as that of a fully insured program. The CMMP premium will be fixed and guaranteed for a 12 month contract period and should claims exceed the amount of premium paid the reinsurer steps in and pays. The CMMP program will have no additional liability than with a regular conventional fully insured program.

The Refund

The most exciting feature of the OptiMed Comprehensive Major Medical Partner Program is the refund. At the end of the 15th month after the first contract period, an accounting is performed of paid premium (minus fixed costs) vs. claims and any claim amounts not paid during the 15th month period are refunded in full to the employer within 30 days.

Please check with your OptiMed sales representative to confirm that OptiMed is available in the state or states in which you may have an interest in offering OptiMed. The CMMP program is not available in New York, Montana and the state of Washington.