UNIVERSAL HEALTH CARE INSURANCE COMPANY, INC.
Company Information
| Company Demographic Information | |
| Name of Company: | UNIVERSAL HEALTH CARE INSURANCE COMPANY, INC. |
|---|---|
| Case Number: | 2013 CA 00358 |
| Guaranty Association: | NOLHGA- National Association |
| Type of Coverage: | Life and Health |
| State of Domicile: | Florida |
| Status of Receivership: | Liquidation |
| Important Receivership Dates | |
| Date of Rehabilitation: | March 22, 2013 |
| Date of Liquidation: | April 01, 2013 |
| Policy Cancellation Date: | April 01, 2013 |
| Claims Filing Deadline: | June 30, 2014 |
| Objection Deadline: | See Below |
Notice of Receivership
Effective March 22, 2013, Universal Health Care Insurance Company, Inc. (“UHCIC”) was ordered into receivership for purposes of rehabilitation by the Second Judicial Circuit Court in Leon County, Florida. The Florida Department of Financial Services, Division of Rehabilitation and Liquidation, is the court appointed Receiver of UHCIC. Effective April 1, 2013, pursuant to the Court Order, UHCIC automatically moved into receivership for purposes of liquidation.
Background Information
UHCIC was licensed as a life and health insurance company to write accident and health insurance. The company provided health care coverage to approximately 37,500 Medicare recipients as of February 2013. It was a Florida corporation which was licensed in May 2006 and was headquartered in St. Petersburg, Florida. UHCIC was licensed to write business in Florida and in 24 other states: Alabama, Arizona, Arkansas, District of Columbia, Georgia, Illinois, Indiana, Kentucky, Louisiana, Maryland, Mississippi, Missouri, Nevada, New Jersey, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Texas, Utah, and Virginia.
Medicare contracts and premiums are administered through the federal Centers for Medicare and Medicaid Services (CMS). The Florida Department of Financial Services worked with CMS to assist CMS in its efforts to provide a smooth transition for Universal Health Care Insurance Company's members to other Medicare providers.
Please Note: Universal Health Care Insurance Company has an affiliated HMO – Universal Health Care (UHC) – which is also subject to this receivership action. See Frequently Asked Questions for UHC.
Distributions
3,109 of 3,148 Distribution checks were mailed on July 19, 2018. Distributions were made at 100% of the recommended amounts in the following classes; Secured Claims, class 2 (Loss), class 4 (Federal Government), class 5 (Employees), class 6 (General Creditors), class 7 (State and Local Government), and class 8 (Late Filed). Refer to Florida Statute 631.271 for additional information on the Priority of Classes. These checks are dated July 19, 2018 and are valid for 90 days from that date. Payees are strongly encouraged to cash their checks as soon as possible. A letter of instructions accompanies each check with information on how to request a correction in name or address. The deadline date to request such change, and or reissue of a check is Wednesday, October 17, 2018. If you receive inquiries from providers regarding the check, ask them to refer to the Remittance Advice mailed by PayerFusion in 2016. If the provider needs additional information regarding the check, you may refer them to the Receiver’s website for further instructions. This is the first of planned distributions.
Second Distribution
125 distribution checks were mailed on February 20, 2019.
These checks are dated February 15, 2019, and are valid for 90 days from that date. Payees are strongly encouraged to cash their checks as soon as possible.
Distributions were made at 100% of the recommended amounts in the following classes; class 2 (Loss) and class 8 (Late Filed). Refer to Florida Statute 631.271 for additional information on the Priority of Classes.
A letter of instructions accompanies each check with information on how to request a correction in name or address. The deadline date to request such change, and or reissue of a check is May 29, 2019.
Third Distribution
On February 18, 2021, the Court entered an Order approving the third Final Claims Report and Authorizing the third distribution. This distribution will pay two provider claims and the claims of the National Organization of Life and Health Insurance Guaranty Associations. "NOLHGA"
Assignment of Claims
Assignment of Claims
Such companies may submit public records requests asking for claims data which includes medical providers' claims information if they comply with the provisions of Florida Statute 631.195.
The decision of whether or not to accept the offer is entirely that of the claimant. The Receiver does not instruct, offer advice or make any comments to influence the claimant's decision. Financial information regarding claims distributions and payments published on the Receiver's website can assist the claimant in making an independent and informed decision regarding the sale of the claim. The purchase price being offered in exchange for the assignment may differ from the amount ultimately distributed in the receivership proceeding with respect to the claim.
Once the claim has been properly assigned, the Receiver's records will be permanently changed and the claimant will no longer have any title, interest or rights to the claim including future mailings and distributions, if they occur. The forms required to assign the claim are available here.
Should you have any questions regarding this information or regarding the claim process, please visit our website at www.myfloridacfo.com/division/receiver or call Consumer Services at (800) 882-3054 (Florida calls only) or (850) 413-3132 (if outside of Florida).
Claim Evaluation Codes
Claim Evaluation Codes
Claim Evaluation Codes are located on the division website.
Claims Information
Court Ordered Claims Filing Bar Date Established.
No new claims will be accepted by the Receiver effective March 14, 2019. See Related Documents to review Motion and Order.
Notices of Determination
Third Interim Claims Report: On September 14, 2018, the Receiver sent 4 Notices of Determination (NODs) to claimants with Class 1, Class 2, and Class 8 claims. The NODs were sent via the US Postal Service. Please note: These NODs are for claims filed in the Universal Health Care Insurance Company, Inc., receivership and not for claims filed against Universal Health Care, Inc.
The Objection Filing Deadline is October 31, 2018.
Second Interim Claims Report: On June 11, 2018 the Department mailed 1,121 Notices of Determination (NODs) to medical providers and other claimants with Class 2 through Class 8 claims. For information regarding the evaluation code on the NOD, click here.
The Objection Filing Deadline was August 10, 2018.
First Interim Claims Report: On May 26, 2016, the Receiver sent 6,762 Notices of Determination (NODs) to medical providers and other claimants with Class 2 through Class 8 claims. Approximately 6,250 of these NODs are being sent to medical providers. The NODs were sent via email address (if one was provided to the Receiver) and/or US postal service. Please note: these NODs are for claims filed in the Universal Health Care Insurance Company, Inc., receivership and not for claims filed against Universal Health Care, Inc.
The Objection filing deadline was July 11, 2016.
I am a provider and need to file a claim. Where do I obtain a Proof-of-Claim form and filing instructions?
Please complete the Contact Us Form and the Receiver will mail you a Proof-of-Claim form. For information on how providers should file a claim, click here.
I am a former subscriber and need to file a claim. Where do I obtain a Proof-of-Claim form and filing instructions?
Please complete the Contact Us Form and the Receiver will mail you a Proof-of-Claim form.
I am owed money for services provided before UHCIC was ordered into liquidation. What is the procedure for payment of these claims?
Claims occurring in all states in which UHCIC had members which were not paid, will be considered as claims against the estate and processed by the Receiver.
Please complete the Contact Us Form and the Receiver will mail you a Proof-of-Claim form.
If my company can’t pay my claim, is there a guaranty association that will pay it for me?
This type product, Medicare, is not covered under Florida's Life and Health Insurance Guaranty Associations. These claims will be considered as claims against the estate of UHCIC and processed by the Receiver.
Special information for providers with policyholders in the following states: Arizona, Mississippi, North Carolina, Ohio and Pennsylvania. Those states' Guaranty Associations have been triggered by the insolvency of UHCIC. They will be relying on information provided through the Receiver's POC process for evaluating claims and potential covered obligations. The five affected Guaranty Associations will evaluate and pay claims as submitted subject to GA coverage limits, and those state Guaranty Associations will then have a claim against the estate in place of the claimant to the extent of the affected GA's payment.
Please complete the Contact Us Form and the Receiver will mail you a Proof-of-Claim form.
I have been authorized for medical service. Will the authorization be honored?
Medical authorizations issued to or for UHCIC policyholders will be honored.
Can Providers seek payment from former members for debt owed by UHCIC for medical services?
No. This is called "balance billing". Beneficiaries cannot be held responsible (or balance billed) to pay any amount more than the co-payment, deductible, and/or co-insurance outlined in their benefit summary. Medical services rendered to Medicare recipients are governed by the federal law pertaining to Medicare contracts. If you've received a bill from your doctor or other medical provider for claims that should have been paid by the insurance company, contact the Centers for Medicare and Medicaid Services (CMS) for assistance with the balance billing issue.
The Receiver will mail Proof of Claim forms to all known providers so that they may file a claim in the receivership estate of UHCIC, for covered services rendered to Medicare beneficiaries before April 1, 2013.
For Medicare information: Consumers needing more information regarding Medicare or other Medicare Advantage plans, should visit www.medicare.gov or call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.
Contact Information
For Medicare information:
Consumers needing more information regarding Medicare or other Medicare Advantage plans, should visit www.medicare.gov or call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.
For Receivership information:
Information regarding the receivership of Universal Health Care Insurance Company including copies of all relevant court orders, is available on the Receiver's website, www.myfloridacfo.com/division/receiver. Consumers may also call the Florida Department of Financial Services at 1-800-882-3054 (Florida only) or 850-413-3081.
For Consumers in States with Guaranty Association coverage:
Pennsylvania Life & Health Insurance Guaranty Association:
http://www.palifega.org/
Phone Number: 610-975-0572
Ohio Life and Health Insurance Guaranty Association:
http://www.olhiga.org
Phone Number: 614-442-6601
North Carolina Life and Health Insurance Guaranty Association:
http://www.nclifega.org/
Phone Number: 919-833-6838
Mississippi Life and Health Guaranty Association:
http://www.mslifega.org/
Phone Number: 601-981-0755
Arizona Life & Disability Insurance Guaranty Fund:
mailto:msurguine@azinsurance.gov
Phone Number: 602-364-3863
Coverage Information
Do I have health care coverage now?
Yes. Beneficiaries currently enrolled in UHC and UHCIC will not experience a gap in their Medicare coverage. Effective April 1, 2013, CMS automatically enrolled beneficiaries who were UHC and UHCIC enrollees in Original Medicare through which they were able to obtain Original Medicare (Part A and B) coverage. Those beneficiaries who also had prescription drug coverage through UHC or UHCIC were enrolled into a comparable Prescription Drug Plan, either Coventry Health Care, Inc., Envision Insurance Company, Humana Insurance Company or United Healthcare. Beneficiaries can learn which Prescription Drug Plan they are enrolled in by contacting 1-800-MEDICARE.
Beneficiaries impacted by the contract termination were mailed a notice explaining the changes in coverage and providing information about their new prescription drug coverage. They will also receive a letter from their new Prescription Drug Plan. Beneficiaries will be able to continue to see their current primary and specialty care providers under Original Medicare. Those currently in the hospital or receiving skilled nursing care or other medical treatments will continue with such care without interruption.
Other options open to beneficiaries:
Affected beneficiaries can choose to enroll in another Medicare Advantage or Prescription Drug Plan, if they do not want to remain in Original Medicare or the newly assigned Prescription Drug Plan. They have been granted a special election period during which they may make one change in their Medicare health care and prescription drug coverage. This special election period is in effect now through May 31, 2013. Coverage in the new plan is effective the first of the month following their plan selection.
If you or your patients need more information regarding Medicare, other Medicare Advantage plans, or coverage options from 12:01 a.m. on April 1, 2013, please visit www.medicare.gov or call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.
If I need to go to the hospital or need to seek other emergency care, who will authorize my medical treatment?
If you have a medical emergency (you believe your health is in serious danger):
- Get medical help as quickly as possible. Call 911 for help or go to the nearest emergency room. You do not need to get permission or authorization from your provider.
- Make sure that your provider knows about your emergency so that they can be involved in following up on your emergency care. You or someone else should call to tell your provider about your emergency care as soon as possible, preferably within 48 hours.
- Please refer to the letter you receive from CMS for details regarding your continued health care coverage from 12:01 a.m. on April 1, 2013.
Who is SHINE and how can they assist me?
SHINE is a statewide, volunteer-based program offering free Medicare and health insurance education, counseling and assistance to people with Medicare and their families and caregivers. SHINE is funded through a grant from the Centers for Medicare & Medicaid Services (CMS) and administered by the Florida Department of Elder Affairs.
For additional information, go to their website at www.floridashine.org or call 1-800-963-5337 to request services.
Frequently Asked Questions
I am a Medical Provider and have received a Distribution Check from the Department. What is this check for?
Your claim was adjudicated by a third party administrator (PayerFusion). The administrator sent out remittance advices monthly as the claims were adjudicated. The check is a cumulative total of the individual claims submitted. If claims were submitted with multiple NPIs and/or multiple billing addresses, they may have been evaluated separately and you may receive more than one check.
Is there a deadline for cashing the Distribution check?
Yes. The deadline for cashing the check is 90 days after the issuance date.
Funds related to any uncashed check after the deadline will be submitted to the Bureau of Unclaimed Property.
Do I receive interest for my distribution?
Please note that distributions are made through-out the life cycle of the Estate.
How do I file a Proof of Claim with the Receiver?
If you are a medical provider, please click here for information about filing your claim.
What checks were mailed on February 20, 2019?
On February 20, 2019 the Florida Department of Financial Services mailed 125 distribution checks paying 100% of remaining Class 2 and Class 8 claims.
I have claims for both Universal Health Care, Inc. (UHC) and Universal Health Care Insurance Company, Inc. (UHCIC). Can I use the same Proof of Claim form for both companies?
No. Separate Proof-of-Claim forms are required for each company.
What checks were mailed on July 19, 2018?
On July 19, 2018 the Florida Department of Financial Services mailed 3109 distribution checks paying 100% of evaluated claims in classes 2,5,6,7,8.
I do not know if my claims are for UHC or UHCIC, do I need to use separate forms?
If the member ID number prefix begins with PF, PM, UD or UA, you should file your claim on the UHCIC (542) POC.
If the member ID number prefix begins with MM , HM, HR, MP, FP,SN, SA, SC, SE, UF, UR, DV and CM, you should file your claim on the UHC (543) POC.
Your claim must be filed on the appropriate company POC form.
What if I don’t know the exact amount of my claim or don’t have all the documentation at the time I submit my Proof of Claim?
In the amount claimed field on the proof of claim form, enter "$1.00" if you don't know the exact amount of the claim. Be sure to put your NPI number on the documentation so that it can be identified and matched to your proof of claim.
I am a medical provider in one of the five states whose Guaranty Associations were triggered by the insolvency. How do I file a Proof of Claim with them?
Special information for providers with policyholders in the following states: Arizona, Mississippi, North Carolina, Ohio and Pennsylvania. Those state's Guaranty Associations have been triggered by the insolvency of UHCIC. They will be relying on information provided through the Receiver's POC process for evaluating claims and those states Guaranty Associations potential covered obligations. The five affected Guaranty Associations will evaluate and pay claims as submitted subject to Guaranty Association coverage limits and those states Guaranty Associations will then have a claim against the estate in place of the claimant to the extent of the affected Guaranty Association's payment.
I was paid incorrectly on several of my claims, can I file for the correct payment amount?
The balance of your outstanding claims may be submitted and must reflect any prior payment, credit or offset.
I received a Proof of Claim form but the NPI listed was incorrect. How do I correct this information?
The NPI number was obtained from the records of The Centers for Medicare & Medicaid Services (CMS). You may manually correct the number on the Proof-of-Claim form. Each Proof-of-Claim form NPI number should match the corresponding NPI number on the medical claims submitted.
When will my claim be paid and how much will I receive?
The amount of any potential payment is unknown until after the amount of all liabilities has been established and all reasonable efforts to recover and liquidate assets have been exhausted. Please be advised that it may take several years before a distribution of assets, if any, is made in this receivership, due to collection efforts and litigation.
The Proof of Claim form mentions a “Secured Claim”. What does that mean?
"Secured claim" means any claim secured by mortgage, trust deed, pledge, deposit as security, escrow, or otherwise but does not include a special deposit claim, a claim against general assets, or a claim based on mere possession. In other words, if a claim is secured by some form of collateral, it is considered a secured claim.
I have several claims for the Proof of Claim form, how do I file a Master Claim?
My claim is in the name of my business. What do I enter under “Date of Birth”?
This field may be left blank.
I did not receive a Proof of Claim form in the mail and did not receive an email. How do I obtain a Proof of Claim form?
Please complete the Contact Us Form and the Receiver will mail you a Proof-of-Claim form.
Special information for providers with policyholders in the following states:
Arizona, Mississippi, North Carolina, Ohio and Pennsylvania. Those state's Guaranty Associations have been triggered by the insolvency of UHCIC. They will be relying on information provided through the Receiver's POC process for evaluating claims and those states Guaranty Associations potential covered obligations. The five affected Guaranty Associations will evaluate and pay claims as submitted subject to Guaranty Association coverage limits and those states Guaranty Associations will then have a claim against the estate in place of the claimant to the extent of the affected Guaranty Association's payment.
What happens if I fail to file the Proof of Claim form by the deadline? Will it be considered late-filed?
Claims may be filed past the claims filing deadline but may be classified at a lower "late-filed" priority.
Can you verify receipt of my Proof of Claim form?
I am an Agent who owes unearned commission. Where should I send the payment?
Payments made prior to October 12, 2021 should be sent to the following address:
Division of Rehabilitation & Liquidation
P.O. Box 865694
Orlando, FL 32886-5694
Effective October 12, 2021,payments should be sent to the following address:
For Standard Payments Only:
State of Florida
Division of Rehabilitation & Liquidation
P.O. Box 946694
Atlanta, GA 30394-6694
For Express Payments Only:
Lockbox Services - #0865694
State of Florida
Division of Rehabilitation & Liquidation
3585 Atlanta Ave.
Hapeville, GA 30354
Premium Refund Information
My contract with Universal cancelled April 1, 2013 and I previously paid the April premium. Will I get a refund?
When will I receive my premium refund?
Policy Information
POLICY CANCELLATION EFFECTIVE 12:01 A.M. ON APRIL 1, 2013
By Court Order, effective at 12:01 a.m. on April 1, 2013, all contracts for health care coverage provided by UHCIC that have not already expired are automatically cancelled. Policies or contracts of coverage with normal expiration dates prior to April 1, 2013, or which are terminated by insureds or lawfully cancelled by the Receiver or insured before April 1, 2013, are considered cancelled as of the earlier date.
IMPORTANT: UHCIC Medicare policyholders will receive continued health care coverage from 12:01 a.m. on April 1, 2013, through arrangements made by CMS.
The Florida Department of Financial Services, as Receiver of UHCIC, is working with CMS to assist in its efforts to provide a smooth transition for UHCIC's members to other health care coverage beginning on April 1, 2013. UHCIC members are urged to carefully read any letters they receive from the Receiver and CMS. These letters will provide members with extremely important information regarding the continuation of their health care coverage from April 1, 2013, including arrangements made for continued prescription drug coverage, as well as explain their other Medicare options.
Please Note: UHCIC has an affiliated HMO – Universal Health Care (UHC) – which has been ordered into a separate receivership. See the Receiver's UHC website for more details.
Please Also Note: The Texas and Nevada based HMOs owned by UHCIC's parent organization, Universal Health Care Group, are ongoing entities and are NOT part of these receivership proceedings.
Provider Information
Important Notice to Providers Regarding Universal Health Care Insurance Company, Inc. (UHCIC), in Receivership
The claim filing deadline has passed
The claim filing deadline was 11:59 P.M. June 30, 2014
Proof-of-Claim Filing Instructions
Please remember that pursuant to state and federal law and/or the terms of your contract, providers are prohibited from balance billing managed care enrollees.
The Claim Filing Deadline has passed.
The claim filing deadline was 11:59 P.M. June 30, 2014
Additional information concerning the receivership process is available at http://www.myfloridacfo.com/Division/Receiver
Medical Claims Evaluation Equitable Methodology:
In an effort to apply an equitable and cost efficient methodology to every claim and to treat all medical provider claims equally, the rates used represent standard Medicare rates. Regardless of any other prior existing contracts or fee schedules all eligible medical claims were evaluated at 100% of 2013 applicable regional Medicare rates and Medicare coverage and billing guidelines. Unbundled line items in a claim that do not meet Medicare Correct Coding Initiative Guidelines will be repriced to zero.
Special information for providers with policyholders in Arizona, Mississippi, North Carolina, Ohio and Pennsylvania:
These states' Guaranty Associations have been triggered by the insolvency of UHCIC. They will be relying on information provided by the Receiver's POC process for evaluating claims and those states' Guaranty Associations potential covered obligations. The five affected Guaranty Associations will evaluate and pay claims as submitted subject to GA coverage limits; those states' Guaranty Associations will then have a claim against the estate in place of the claimant in the amount of the affected GA's payments to providers.
Financial Statements
The following documents are provided as Adobe Acrobat PDF files and are best viewed using the free Adobe Acrobat reader software.
Related Documents
The following documents are provided as Adobe Acrobat PDF files and are best viewed using the free Adobe Acrobat reader software.
Court Documents
Notices
| Date | Title | Size |
|---|---|---|
| 06/23/2016 | Notice to Medical Providers Concerning Assignment of Claims | 122K |
| 05/01/2014 | Pennsylvania - Notice to Managed Care Enrollees on behalf of PLHIGA | 114K |
| 05/01/2014 | Ohio - Notice to Managed Care Enrollees on behalf of OLHIGA | 114K |
| 05/01/2014 | North Carolina - Notice to Managed Care Enrollees on behalf of NCLHIGA | 114K |
| 05/01/2014 | Arizona - Notice to Managed Care Enrollees on behalf of ALDIGF | 114K |
| 05/01/2014 | Mississippi- Notice to Managed Care Enrollees on behalf of MLHIGA | 114K |
| 12/20/2013 | Interim Notice to Providers | 41K |
| 08/07/2013 | Notice To Claimants (including Providers) | 45K |
| 04/05/2013 | Notice to Agents Regarding Liquidation | 90K |
| 04/05/2013 | Notice to Agents - Spanish Version | 142K |
| 03/29/2013 | Notice to Providers Regarding Liquidation | 86K |
| 03/29/2013 | Notice to Providers - Spanish Language Version | 68K |
| 03/26/2013 | Notice to Policyholders - Spanish Language Version | 132K |
| 03/26/2013 | Notice to Policyholders Regarding Liquidation | 85K |