Guided Care and a Robust Suite of Online Tools and Resources

UnitedHealthcare Navigate plans offer comprehensive, patient-centered health care benefits. Members will choose a primary care physician (PCP) as their trusted partner in health care who also grants referrals for specialists’ services.

What makes this plan different: Navigate provides traditional benefits with the security and guidance of a primary care physician. 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 Navigate Offers:

Choice and convenience ✔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 multi state-based employees ✔Online eligibility, enrollment, billing and reporting tools ✔Coverage for catastrophic health events as well as high prescription, physician and hospital costs ✔

UnitedHealthcare HMO Portfolio | Georgia

UnitedHealthcare Navigate®

Coverage for a Variety of ServicesUnitedHealthcare Navigate provides coverage for a wide variety of services:

• Doctor office 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

Understanding the Details

In-NetworkIndividual/Family

Deductible $500 - $5,000 / $1,000 - $10,000

Coinsurance 90% - 60%

Copayment

Primary care physician office visit $15 - $40, 90% - 60%

Specialist office visit $30 - $80, 90% - 60%

Out-of-Pocket Maximum (including deductible) $1,250 - $6,250 / $2,500 - $12,500

Covered Services

Outpatient Surgery 90% - 60%

Inpatient Hospital (per-occurrence copayment) $250 - $500, 90% - 60%

Emergency room service (if not admitted) $0 - $500, 90% - 60%

Urgent care services $75 - $100, 90% - 60%

Outpatient Services (includes lab/X-ray, major diagnostics, scopic procedures, and outpatient surgery)

Hospital-based facility (per-occurrence copayment) $250 - $500

Freestanding facility* 90% - 60%

* Freestanding facilities are any of the following: outpatient facility, diagnostic or ambulatory center, or independent laboratory. At a freestanding facility, deductible and coinsurance still apply. See plan benefit information for further details.

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.

UnitedHealthcare Navigate

UnitedHealthcare Portfolio

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.

All UnitedHealthcare members can access a cost estimator online tool at myuhc.com. Depending on your specifi c benefi t 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 benefi ts. Your actual costs and/or benefi ts 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 specifi c benefi ts.

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 confl ict of interest, legal consultation will not be provided on issues that may involve legal action against UnitedHealthcare or its affi liates, 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 specifi c 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.

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

Insurance coverage provided by or through United HealthCare Insurance Company, United HealthCare Insurance Company of Georgia or their affiliates. Administrative services provided by United HealthCare Insurance Company, United HealthCare Services, Inc. or their affiliates. Health Plan coverage provided by or through United HealthCare of Georgia, Inc.

©2013 United HealthCare Services, Inc.8/13 Employer/Broker Choice Plus - Product Brochure UHCGA647808-000

With Navigate plans, you can choose from a variety of deductible, coinsurance, copayment and out-of-pocket maximums. The grid below highlights a sample of benefit options available to you and your employees.

UnitedHealthcare HMO

Choice Plus Advanced Navigate

Network Coverage

Non-Network Coverage ✔

Level of Member Involvement

Account-based Plan

UnitedHealth Premium® Designation Program Tiering ✔

Place of Service Benefits ✔ ✔Hospital Tiering ✔PCP Selection ✔Referrals Required ✔Employer Premium $$ $$

Network Deductible

Network Coinsurance

Network Out-of- Pocket Maximum

Primary care physician office visit

Specialist office visit

Urgent Care Services

Emergency Room

Inpatient Hospital Services

Outpatient Surgery

Major Diagnostics

Metallic Tier

$500 80% $2,000 $15 $30 $100 $125 80% 80% 80% Platinum

$1,000 80% $6,000 $25 $50 $100 $500 80% 80% 80% Gold

$2,000 100% $4,000 $25 $50 $100 $200 100% 100% 100% Gold

$2,000 70% $6,250 $35 $70 $100 $500 70% 70% 70% Silver

$5,000 90% $6,250 90% 90% 90% N/A 90% 90% 90% 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.

Please note: The above plans do not represent the entire portfolio. Please refer to the complete Navigate plan grid for all available benefit plan options.

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

✔

You Have Options