Page 5 - Teacher Created Materials EE Guide 09-18 - CA

Benefits

Medical Insurance

United Healthcare | HMO Advantage
With the Advantage Health Maintenance Organization (HMO) plan, you must choose a Primary Care Physician (PCP) or medical
group within the “Signature Value Advantage HMO” network for all of your covered family members. All of your care must be
directed through your PCP or medical group. Any specialty care you need will be coordinated through your PCP and will generally
require a referral or authorization. You will receive benefits only if you use the doctors, clinics, and hospitals that belong to the
medical group in which you are enrolled, except in the case of an emergency. This plan uses a smaller network of the most cost-
effective providers to provide lower per paycheck premiums. Please note that it is your responsibility to ensure that all family
members choose providers from the “Signature Value Advantage HMO” network.

United Healthcare | HMO Full
This plan works just like the HMO Advantage plan but uses a larger network of providers in the “Signature Value HMO” network.
Since this plan offers more provider options, you will experience higher per paycheck premiums.

United Healthcare | PPO
With the United Healthcare Preferred Provider Organization (PPO) plan, you have the freedom to choose your doctor without using
a Primary Care Physician (PCP) and you may self-refer to specialists. You may use a “United Healthcare Select Plus” network
provider whose negotiated rates provide richer levels of benefits with claim forms filed by the providers. You may also obtain
services using a non-network provider; however, you will be responsible for paying the difference between the covered amount
and the actual charges, and you may be responsible for filing claims.

Plan Differences HMO Advantage HMO Full PPO

Employee Premiums $ $$ $$$
Out-of-Pocket Costs $ $ $$
Cost Sharing Contribution, Copay Contribution, Copay Contribution, Copay,
Deductible, Coinsurance
Network
- Network Size   
- Network Name Signature Value Advantage HMO Signature Value HMO United Healthcare Select Plus
- In-Network Benefits ✓ ✓ ✓
- Non-Network Benefits ✓

Access to Providers Managed by Your PCP Managed by Your PCP Managed by You
- Primary Care Physician Required Required Not Required
- Referral for Specialist Required Required Not Required

Finding a Medical Provider
Go to www.myuhc.com or call (800) 624-8822 for HMO or (866) 633-2446 for PPO.
• HMO Advantage: Refer to the “SignatureValue Advantage HMO” network when prompted.
• HMO Full: Refer to the “SignatureValue HMO” network when prompted.
• PPO: Refer to the “UnitedHealthcare Select Plus” network when prompted.

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