Choice, Convenience and a Robust Suite of Online Tools and Resources

The Choice Plus plan is a comprehensive plan that is easy to understand and provides members with a high level of choice and flexibility.

What makes this plan different: Choice Plus provides access to any doctor at any facility within our network without a referral. Robust online tools for both employers and employees help manage administration and promote wellness and wise health choices.

Typical Employer Size: 2-2,999 employees

Delivering on What You Value Most

You Value: UnitedHealthcare Choice Plus Offers:

A broad national network ✔Choice and convenience ✔Freedom to see any physician at any facility without a referral ✔An easy-to-use health plan ✔Preventive care and wellness programs to help keep costs lower ✔A robust suite of online tools to encourage quality, cost-effective health care choices ✔

Integrated health and wellness resources, including pharmacy, behavioral health, transplant programs ✔

A health plan that accommodates multistate-based employees ✔Online eligibility, enrollment, billing and reporting tools ✔Coverage for catastrophic health events as well as high prescriptions, and physician and hospital costs ✔

UnitedHealthcare Insurance Portfolio | Alabama

UnitedHealthcare Choice Plus

Coverage for a Variety of ServicesUnitedHealthcare Choice Plus provides coverage for a wide variety of services: • Doctor offi ce visits • Ambulatory patient services • Emergency services • Hospital care • Lab services • Pregnancy and newborn care • Mental health and substance

use disorder services

• Prescription drugs • Rehabilitative services

and devices • Habilitative services and devices • Preventive care services • Wellness services • Pediatric oral and vision services • Chronic disease management

Online Resources, Services and Mobile Apps• myuhc.com®

• myHealthcare Cost Estimator• Health Savings Checkup • myClaims Manager• Smart Patient app• Medication pricing tools • Filling prescriptions through mail-order • Personalized messages • UnitedHealthcare Health4MeTM mobile app

Support Programs• Care24®

• Employee Assistance Program

Wellness Programs• Personalized Health Assessments• Healthy Pregnancy Program • Source4Women™• Disease management programs • Health and wellness discounts

For a description of the programs and services listed above, refer to the UnitedHealthcare plans portfolio brochure.

Resources That Encourage Health and Wellness UnitedHealthcare Choice Plus members have access to the following resources and services, designed to promote wise health care choices and healthy living:

UnitedHealthcare Choice Plus

UnitedHealthcare Insurance Portfolio

Understanding the Details In-Network

Individual/FamilyNon-Network

Individual/Family

Deductible $0 – $6,250 / $0 – $12,500$500 – $12,500 / $1,000 – $25,000

Coinsurance 100% – 70% 80% – 50%

Primary care physician office visit $15 – $40

100% – 70%80% – 50%

Specialist office visit$30 – $80

100% – 70%80% – 50%

Out-of-Pocket Maximum (including deductible)

$1,000 – $6,250 / $2,000 – $12,500

$2,000 – $12,500 / $4,000 – $20,000

Emergency room service (if not admitted)$100 – $500100% – 70%

$100 – $500100% – 70%

Urgent care services$75 – $125100% – 70%

80% – 50%

All plans have an unlimited lifetime maximum. All plans cover in-network preventive care at 100%. The information in this grid is provided for informational purposes only and is not intended for use as a contract. Please reference a benefit summary for benefit information on additional services/coverage (home health care, hospice care, skilled-nursing facility care, inpatient and outpatient mental health services, or substance abuse care, ambulatory surgery services, etc.). For a complete listing of coverage and exclusions please refer to the Certificate of Coverage or talk to your UnitedHealthcare representative for additional details that could impact the benefits. Different UnitedHealthcare plans may have varying approaches to whether pharmacy costs are included or excluded from the medical deductible.

With Choice Plus plans, you can choose from a variety of deductible, coinsurance, copayment and out-of-pocket maximums. Review the grid below to find the plan that’s right for you and your employees.

You Have Options

Plan Deductible Coinsurance Out-of- Pocket Maximum

PCP Copay Specialist Copay

Urgent Care

ER Inpatient Hospital

Outpatient Surgery

Metallic Tier

Choice Plus Plan 1 $250 90% $1,500 $15 $30 $75 $150 90% 90% Platinum

Choice Plus Plan 2 $1,000 80% $4,000 $30 $65 $100 $200 80% 80% Gold

Choice Plus Plan 3 $1,250 100% $2,000 $25 $50 $75 $200 100% 100% Gold

Choice Plus Plan 4 $2,000 80% $6,000 $40 $80 80% 80% 80% 80% Silver

Choice Plus Plan 5 $4,500 80% $6,000 80% 80% 80% 80% 80% 80% Bronze

The information in this grid is provided for informational purposes only and is not intended for use as a contract. For a complete listing of coverage and exclusions please refer to the Certificate of Coverage or talk to your UnitedHealthcare representative for additional details that could impact the benefits. Different UnitedHealthcare plans may have varying approaches to whether pharmacy costs are included or excluded from the medical deductible.

9/13 ©2013 United HealthCare Services, Inc. Employer/Broker Choice Plus-Product Brochure UHCAL657312-000

UnitedHealthcare Insurance

Choice Plus HSA/HRA

Network Coverage

Non-Network Coverage ✔ ✔

Level of Member Involvement

Account-Based Plan ✔UnitedHealth Premium® Designation Program TieringPlace of Service Benefits

Hospital Tiering

PCP Selection

Referrals Required

Employer Premium $$$$ $$$

What Do You Value in a Health Plan? To get the most from a health plan, consider what features give you the most value.

KEY

Best, Most

Better, More

Good BasicNot Available

Included

✔

All UnitedHealthcare members can access a cost estimator online tool at myuhc.com. Depending on your specific benefit plan and the ZIP code that is entered, either the myHealthcare Cost Estimator or the Treatment Cost Estimator will be available. A mobile version of myHealthcare Cost Estimator is available in the Health4Me mobile app, and additional ZIP codes and procedures will be added soon. This tool is not intended to be a guarantee of your costs or benefits. Your actual costs and/or benefits may vary. When accessing the tool, please refer to the Terms and Conditions of Use and Why Your Costs May Vary sections for further information regarding cost estimates. Refer to your health plan coverage document for information regarding your specific benefits.

The Care24® program integrates elements of traditional employee assistance and work-life programs with health information lines for a comprehensive set of resources. It is not a substitute for a doctor’s or professional’s care. Due to the potential for a conflict of interest, legal consultation will not be provided on issues that may involve legal action against UnitedHealthcare or its affiliates, or any entity through which the caller is receiving these services directly or indirectly (e.g., employer or health plan). This program and its components may not be available in all states or for all group sizes and are subject to change. Coverage exclusions and limitations may apply.

The Healthy Pregnancy Program follows national practice standards from the Institute for Clinical Systems Improvement. The Healthy Pregnancy Program can not diagnose problems or recommend specific treatment. The information provided is not a substitute for your doctor’s care.

Source4Women content and materials are for information purposes only, are not intended to be used for diagnosing problems and/or recommending treatment options, and are not a substitute for your doctor’s care. Lists of potential treatment options and/or symptoms may not be all inclusive.

Disease Management programs and services may vary on a location-by-location basis and are subject to change with written notice. UnitedHealthcare does not guarantee availability of programs in all service areas and provider participation may vary. Certain items may be excluded from coverage and other requirements or restrictions may apply. If you select a new provider or are assigned to a provider who does not participate in the Disease Management program, your participation in the program will be terminated. Self-Funded or Self-Insured Plans (ASO) covered persons may have an additional premium cost. Please check with your employer.