What does UMR health insurance stand for?

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There are many types of health insurance coverage floating around out there, so it can be difficult to keep them all straight. UMR health insurance is an often misunderstood type of insurance.

As a self-funded insurance plan, the insured employers will assume the financial burden borne by most healthcare-related costs.

While it is true that some organizations will undoubtedly organize their own self-funded insurance plans, most will opt to make use of the third-party administrator that is United Medical Resources insurance.

It should also be noted that some companies that use a self-funded plan will have a stop-loss insurance policy designed to cover them for any medical treatment claims made over a set amount.

Self-funded health insurance plans are typically used when there is no employer contribution towards employee benefits or if the company does not wish to contribute toward its employees’ healthcare needs.

Third-party administrators provide services such as administration, billing, claim processing, etc. It does this on behalf of various insurers who offer group health policies. UMR insurance providers have hired the company to do this job

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Is UMR a UnitedHealthcare company?

Back in 2002, UnitedHealthcare bought Midwest Security Administration. This acquisition was the company’s first move into being a third-party administrator of healthcare-related insurance plans.

It was in 2005 that UnitedHealthcare actually expanded even further when it purchased United Medical resources. One other historical item of note is that UnitedHealthcare purchased Fiserv Health in 2008.

At this point, all three of the administrative arms of the company were combined under UMR. That is the way that it remains to this day.

What is UMR insurance?

To understand UMR healthcare and its overall impact on the health insurance industry, it is helpful to know some of the following statistics.

  • The main headquarters for UMR is in Cincinnati, but it also has local and regional offices across the country
  • Currently, more than 3,000 people are employed with UMB
  • Employees serve roughly 1,400 clients with self-funded health plans
  • Clients include individual companies, state governments, and employer formed groups
  • There are more than two million subscribers to UMR
  • UMR medical insurance currently processes roughly 14 million claims every year

These statistics help to highlight the scope of UMR, but it is also helpful to get a picture of the range of services that the organization is able to provide via these self-funded insurance plans.

What services are offered?

When UMR is utilized, self-funded plans can be more comprehensively managed. These plans include not only medical insurance, but plans for disability, vision, and dental as well.

UMR effective works to tailor the services that it offers to the specific needs of each company that becomes its client including handling the claims process from start to finish, reporting issues, and cost control analysis.

Some clients will have several types of self-funded insurance plans under the UMR organization, while others will make use of just one or two.

For example, a company might offer a health insurance plan through an HMO, but self-fund its dental and vision insurance using UMB as its third-party administration.

UMR coverage includes the following:

  • a host of pharmacy benefits
  • programs aimed at wellness
  • stop-loss coverage

It is also important to note that UMR provides its clients with certain discounts on in-network health services with UnitedHealthcare’s PPO Network is utilized. It also offers more than 100 other partner networks that employer insurance plans can utilize.

Is UMR a good place to work?

There are mixed reviews about working at UMR. Some employees have commented that the customer service jobs are difficult because you are dealing with medical issues and insurance claims and it’s a high-stress environment with lots of incoming calls from angry customers.

However, others have noted that the job offers flexible scheduling and a benefits plan that includes fertility benefits and mental health benefits.

There is an extensive training program to prepare you for a job at UMR, and several reviews noted that there were good opportunities for advancement.

What are UMR’s policies and procedures?

In theory, UMR works like any other medical insurance company. The employer will provide a list of covered benefits to the employee, along with possible deductible and co-insurance requirements that need to be met.

In deference to an actual HMO plan, however, the employer will fund the plan on their own.

Any claims that are made against the policy will be paid out of this fund, and all of the expenses are organized by UMR.

It is a third party that governs the administration of the plan and ensures that each employee is adequately covered and receives the health care that they are entitled to.

In Conclusion

Keep in mind that UMR is essentially a third-party administrator.

UMR is hired by an employer and its sole aim is to help ensure the claims made by the insured are paid correctly. This hiring is done in an effort to keep healthcare-related expenses to a minimum and enable the individual to focus on his or her own well-being.

It is important to remember that UMR is not a health insurance company by any stretch of the imagination. You cannot purchase any kind of medical plan directly from UMR.

The employer under this arrangement will agree to pay a certain portion of the health care costs that are not paid by the insured. Finally, remember that UMR is now a part of the UnitedHealthcare Company. This means it works closely together to create programs that benefit both parties involved.

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