Page 10 - Lyon Benefits Guide 01-18 CA - FINAL

EMPLOYEE BENEFITS

MEDICAL INSURANCE

UNITED HEALTHCARE | SELECT NETWORK HMO
With the Select Network Health Maintenance Organization (HMO) plan, you must choose a Primary Care Physician (PCP) or medical
group within the United Healthcare “SignatureValue 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 SignatureValue Advantage HMO Network.

UNITED HEALTHCARE | FULL NETWORK HMO
This plan works just like the Select Network plan but uses a larger network of providers in the “SignatureValue” HMO network. Since
this plan offers more provider options, you will experience higher per paycheck premiums.

UNITED HEALTHCARE | PPO
The United Healthcare Preferred Provider Organization (PPO) plan allows you to direct your own care. If you receive care from a
physician who is a member of the “Select Plus” PPO network, a greater percentage of the entire cost will be paid by the insurance plan,
however, you are not limited to the physicians within the network and you may self-refer to specialists. If you obtain services using a
non-network provider, please note that you will be responsible for the difference between the covered amount and the actual charges,
and you may be responsible for filing claims.

UNITED HEALTHCARE | HDHP WITH HSA
With the HDHP with HSA plan through United Healthcare, you can pay for qualified healthcare expenses now and grow your savings
for future healthcare needs. This plan combines a High Deductible Health Plan (HDHP) with a special, tax-qualified Health Savings
Account (HSA). You can contribute tax-free money to your HSA up to IRS maximums. In addition, Lyon Living will make contributions
toward your account annually. The money in your account is yours to pay for current healthcare expenses - or you can save toward
future healthcare expenses. Similar to the PPO plan, you have the freedom to choose your doctor without the requirement of selecting
a PCP and you may self-refer to specialists. You may use a “Select Plus” PPO 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 the difference between the covered amount and the actual charges and you may be responsible for filing claims. For
additional information on how the HDHP with HSA plan works, see page 14.

FINDING A MEDICAL PROVIDER
Recognize the Go to www.myuhc.com. Select “Find a Physician, Laboratory or Facility.” From the “To search for doctors, clinics
or facilities, choose a type of plan” screen, select “All United Healthcare Plans.”
value of quality. • Select Network HMO: Refer to “SignatureValue Plans” and the “SignatureValue Advantage” network when prompted.
Full Network HMO: Refer to “SignatureValue Plans” and the SignatureValue” network when prompted.
•
PPO and HDHP with HSA: Refer to the “Select Plus” plan when prompted.
•

10 10 11