Page 9 - TCM EE Guide 2019 v2 FINAL
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Medical Plan Choices
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.
United Healthcare | HSA PPO
With the HSA PPO 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
(please see page 13). In addition, Teacher Created Materials will make contributions totaling $500 toward your
employee health savings or $1,000 for your family, annually. 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 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.
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. Educational Video
HMO Full: Refer to the “SignatureValue Health Insurance Terms
HMO” network when prompted. http://video.burnhambenefits.com/terms
PPO and HSA PPO: Refer to the High Deductible Health Plans and
“UnitedHealthcare Select Plus” network Health Savings Accounts
when prompted. http://video.burnhambenefits.com/hdhp/
Employee Benefits 9
