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Benefit Detail API Overview

1. Purpose​

  • This service provides authorized partners with access to health plan benefit details offered under the UnitedHealthcare and Oxford brands. It enables real-time retrieval of plan information—such as what benefits are included and how they are organized—so partners can present accurate, up-to-date details in their own applications or websites without manual effort.

2. Who Can Use This Service​

  • Business Partners: Brokers, aggregators, and third-party vendors with established relationships.
  • Implementation Teams: Developers and integrators working on behalf of these partners to connect their systems to the service.

3. What Information is Available​

  • The service provides high-level benefit details across major categories, including:
  • Plan Identification: Basic descriptive elements like plan name and product family.
  • Coverage Categories:
    • Medical
    • Prescription (Rx)
    • Vision
    • Dental
    • Basic Life and Dependent Life
    • Accidental Death & Disability
  • Summary of Benefits: Broad descriptions of services, copay structures, allowances, and supplemental offerings.
  • Applicability: Covers multiple business sizes and funding arrangements (fully insured and level-funded).

4. Benefits of This Service​

  • Timely Access: Always up-to-date benefit information delivered on demand.
  • Efficiency: Reduces manual work and minimizes errors.
  • Integration-Friendly: Supports seamless experiences in partner tools and portals.
  • Versatility: Serves small and large group markets across multiple coverage lines.

5. Example Uses​

  • A broker’s website displays medical, dental, vision, and life coverage details for employer groups shopping for plans.
  • An aggregator’s quoting tool returns a clear summary of a plan’s features when an identifier is entered.
  • A partner portal allows HR professionals to quickly check what major categories of care are covered.
  • A multi-brand quoting system uses the same source for UnitedHealthcare and Oxford plans, ensuring consistency.

6. Important Notes​

  • Information May Change: Benefit details evolve over time.
  • Access Is Restricted: Only available to approved partners under formal agreements.
  • Security Is Maintained: Behind-the-scenes controls ensure privacy and compliance.
  • This Is an Overview: Technical specifications and operational details are provided separately through partner-only channels.