UnitedHealthcare

UnitedHealthcare is an operating division of UnitedHealth Group, the largest single health carrier in the United States. As a recognized leader in the health and well-being industry, we strive to improve the quality and effectiveness of health care for all Americans, enhance access to health benefits, creative products and services that make health care more affordable, and use technology to make the health care system easier to navigate.

Provider Finder

Form Name Effective Date Download Form
Change Form for UnitedHealthcare
Download
Group Acceptance/Change Form
01/01/2018 Download
New Business Checklist
07/01/2017 Download
Proof of Ownership Guidelines
Download
Product and Benefit Selection Form
01/01/2018 Download
Product and Benefit Selection Form
07/01/2017 Download
Participation & Floor Certification
Download
SSN Attestation Form
Download
Employer Group Reporting Form
Download
Employer Application for Small Business
Download
Scheduled Direct Debit
01/01/2017 Download
Employer Administration Guide Medical
Download
Employer Plan Policy Year Change Request Form Attestation - Renewal Date
Form Name Effective Date Download Form
RX Claim Form
Download
RX Claim Mail-In Form
Life Beneficiary Form
Download
Employee Change Form
01/01/2017 Download
Employee Application
Download
Claim Form Medical
Download
Form Name Effective Date Download Form
2018 Medical HMO Choice Simplified Packages
Signature HMO Network
Signature Platinum 20-40/30% (AV-L7)
01/01/2018 Summary SBC
Signature Gold 30-50/30% (AV-L8)
01/01/2018 Summary SBC
Signature Gold 30-50/30%/1000ded (AV-L9)
01/01/2018 Summary SBC
Signature Silver 50-75/40%/2250ded (AV-MA)
01/01/2018 Summary SBC
Advantage HMO Network
Advantage Platinum 20-40/30% (AV-MB)
01/01/2018 Summary SBC
Advantage Gold 30-50/30% (AV-MC)
01/01/2018 Summary SBC
Advantage Gold 30-50/30%/1000ded (AV-MD)
01/01/2018 Summary SBC
Advantage Silver 50-75/40%/2250ded (AV-ME)
01/01/2018 Summary SBC
Alliance HMO Network
Alliance Platinum 20-40/30% (AV-MJ)
01/01/2018 Summary SBC
Alliance Gold 30-50/30% (AV-MK)
01/01/2018 Summary SBC
Alliance Gold 30-50/30%/1000ded (AV-ML)
01/01/2018 Summary SBC
Alliance Silver 50-75/40%/2250ded (AV-MM)
01/01/2018 Summary SBC
Focus HMO Network
Focus Platinum 20-40/30% (AV-MF)
01/01/2018 Summary SBC
Focus Gold 30-50/30% (AV-MG)
01/01/2018 Summary SBC
Focus Gold 30-50/30%/1000ded (AV-MH)
01/01/2018 Summary SBC
Focus Silver 50-75/40%/2250ded (AV-MI)
01/01/2018 Summary SBC
2018 Medical EPO Choice Simplified Packages
Navigate EPO Network
Navigate Platinum 10/10% (AU-L7)
01/01/2018 Summary SBC
Navigate Platinum 15/20% (AU-SS)
01/01/2018 Summary SBC
Navigate Gold 25/500/20% (AU-SY)
01/01/2018 Summary SBC
Navigate Gold 25/1000/20% (AU-SZ)
01/01/2018 Summary SBC
Navigate Gold 25/1500/20% (AU-S1)
01/01/2018 Summary SBC
Navigate Silver 40/1500/30% (AU-S2)
01/01/2018 Summary SBC
Navigate Silver 40/2250/40% (AU-S3)
01/01/2018 Summary SBC
Navigate HSA Silver 2000/20% (AX-FM)
01/01/2018 Summary SBC
Navigate HSA Bronze 4800/40% (AU-ST)
01/01/2018 Summary SBC
2018 Medical PPO Choice Simplified Packages
Select Plus PPO Network
Select Plus Platinum 10/10% (AU-SI)
01/01/2018 Summary SBC
Select Plus Platinum 15/20% (AU-SJ)
01/01/2018 Summary SBC
Select Plus Gold 25/500/20% (AU-S5)
01/01/2018 Summary SBC
Select Plus Gold 25/1000/20% (AU-S6)
01/01/2018 Summary SBC
Select Plus Gold 25/1500/20% (AU-S7)
01/01/2018 Summary SBC
Select Plus Silver 40/1500/30% (AU-S8)
01/01/2018 Summary SBC
Select Plus Silver 40/2250/40% (AU-S9)
01/01/2018 Summary SBC
Select Plus HSA Silver 2000/20% (AX-FK)
01/01/2018 Summary SBC
Select Plus HSA Bronze 4800/40% (AU-SK)
01/01/2018 Summary SBC
Core PPO Network
Core Platinum 10/10% (AU-SL)
01/01/2018 Summary SBC
Core Platinum 15/20% (AU-SM)
01/01/2018 Summary SBC
Core Gold 25/500/20% (AU-TB)
01/01/2018 Summary SBC
Core Gold 25/1000/20% (AU-TC)
01/01/2018 Summary SBC
Core Gold 25/1500/20% (AU-TD)
01/01/2018 Summary SBC
Core Silver 40/1500/30% (AU-TE)
01/01/2018 Summary SBC
Core Silver 40/2250/40% (AU-TF)
01/01/2018 Summary SBC
Core HSA Silver 2000/20% (AX-FL)
01/01/2018 Summary SBC
Core HSA Bronze 4800/40% (AU-SN)
01/01/2018 Summary SBC
2018 Medical HMO State Package
Signature HMO Network
State Signature Platinum 15-30/10% (AV-MN)
01/01/2018 Summary SBC
State Signature Gold 25-55/20% (AV-MO)
01/01/2018 Summary SBC
State Signature Silver 45-75/20%/2000ded (AV-MP)
01/01/2018 Summary SBC
Advantage HMO Network
State Advantage Platinum 15-30/10% (AV-MQ)
01/01/2018 Summary SBC
State Advantage Gold 25-55/20% (AV-MR)
01/01/2018 Summary SBC
State Advantage Silver 45-75/20%/2000ded (AV-MS)
01/01/2018 Summary SBC
Alliance HMO Network
State Alliance Platinum 15-30/10% (AV-MW)
01/01/2018 Summary SBC
State Alliance Gold 25-55/20% (AV-MX)
01/01/2018 Summary SBC
State Alliance Silver 45-75/20%/2000ded (AV-MY)
01/01/2018 Summary SBC
State Alliance Silver 30%/2000ded (AK-RI)
01/01/2018 Summary SBC
State Alliance Bronze 30%/6250ded (AV-MZ)
01/01/2018 Summary SBC
State Alliance HSA Bronze 40%/4800ded (AX-2G)
01/01/2018 Summary SBC
State Alliance HSA Bronze 0%/6500ded (AK-RJ)
01/01/2018 Summary SBC
Focus HMO Network
State Focus Platinum 15-30/10% (AV-MT)
01/01/2018 Summary SBC
State Focus Gold 25-55/20% (AV-MU)
01/01/2018 Summary SBC
State Focus Silver 45-75/20%/2000ded (AV-MV)
01/01/2018 Summary SBC
2018 Medical EPO State Package
Navigate EPO Network
State Navigate Platinum 15/10% (AU-SU)
01/01/2018 Summary SBC
State Navigate Gold 25/20% (AU-SV)
01/01/2018 Summary SBC
State Navigate Silver 45/2000/20% (AU-SW)
01/01/2018 Summary SBC
State Navigate Bronze 75/6300/100% (AU-SX)
01/01/2018 Summary SBC
State Navigate HSA Bronze 4800/40% (AK-SM)
01/01/2018 Summary SBC
2018 Medical PPO State Package
Select Plus PPO Network
State Select Plus Platinum 15/10% (AV-68)
01/01/2018 Summary SBC
State Select Plus Gold 25/20% (AV-69)
01/01/2018 Summary SBC
State Select Plus Silver 45/2000/20% (AV-7A)
01/01/2018 Summary SBC
State Select Plus Bronze 75/6300/100% (AV-7B)
01/01/2018 Summary SBC
State Select Plus HSA Bronze 4800/40% (AV-7C)
01/01/2018 Summary SBC
Core PPO Network
State Core Platinum 15/10% (AU-SO)
01/01/2018 Summary SBC
State Core Gold 25/20% (AU-SP)
01/01/2018 Summary SBC
State Core Silver 45/2000/20% (AU-SQ)
01/01/2018 Summary SBC
State Core Bronze 75/6300/100% (AU-SR)
01/01/2018 Summary SBC
State Core HSA Bronze 4800/40% (AK-R6)
01/01/2018 Summary SBC
Non-Differential PPO - for employees residing outside a Select Plus Service area
Non-Differential PPO Silver 2250/30% (AU-SH)
01/01/2018 Summary SBC
2017 Medical HMO Choice Simplified Packages
Signature HMO Network
Signature Platinum 20-40/30% (AK-QY)
01/01/2017 Summary SBC
Signature Gold 30-50/30% (AK-QZ)
01/01/2017 Summary SBC
Signature Gold 30-50/30%/1000ded (AK-Q1)
01/01/2017 Summary SBC
Signature Silver 45-65/40%/2000ded (AK-Q2)
01/01/2017 Summary SBC
Advantage HMO Network
Advantage Platinum 20-40/30% (AK-Q4)
01/01/2017 Summary SBC
Advantage Gold 30-50/30% (AK-Q5)
01/01/2017 Summary SBC
Advantage Gold 30-50/30%/1000ded (AK-Q6)
01/01/2017 Summary SBC
Advantage Silver 45-65/40%/2000ded (AK-Q7)
01/01/2017 Summary SBC
Alliance HMO Network
Alliance Platinum 20-40/30% (AK-RE)
01/01/2017 Summary SBC
Alliance Gold 30-50/30% (AK-RF)
01/01/2017 Summary SBC
Alliance Gold 30-50/30%/1000ded (AK-RG)
01/01/2017 Summary SBC
Alliance Silver 45-65/40%/2000ded (AK-RH)
01/01/2017 Summary SBC
Alliance Silver 30%/2000ded (AK-RI)
01/01/2017 Summary SBC
Alliance HSA Bronze 0%/6500ded (AK-RJ)
01/01/2017 Summary SBC
Focus HMO Network
Focus Platinum 20-40/30% (AK-Q9)
01/01/2017 Summary SBC
Focus Gold 30-50/30% (AK-RA)
01/01/2017 Summary SBC
Focus Gold 30-50/30%/1000ded (AK-RB)
01/01/2017 Summary SBC
Focus Silver 45-65/40%/2000ded (AK-RC)
01/01/2017 Summary SBC
2017 Medical EPO Choice Simplified Packages
Navigate Platinum 15/20% (AK-SF)
01/01/2017 Summary SBC
Navigate Gold 20/250/20% (AK-SN)
01/01/2017 Summary SBC
Navigate Gold 20/750/20% (AK-SO)
01/01/2017 Summary SBC
Navigate Gold 20/1000/20% (AK-SP)
01/01/2017 Summary SBC
Navigate Silver 30/2000/30% (AK-SQ)
01/01/2017 Summary SBC
Navigate Silver 2000/30% (AK-SG)
01/01/2017 Summary SBC
Navigate HSA Silver 2000/20% (AT-AP)
07/01/2017 Summary SBC
Navigate HSA Bronze 6500/0% (AK-SH)
01/01/2017 Summary SBC
2017 Medical PPO Choice Simplified Packages
Select Plus PPO Network
Select Plus Platinum 15/20% (AK-RV)
01/01/2017 Summary SBC
Select Plus Gold 20/250/20% (AK-R7)
01/01/2017 Summary SBC
Select Plus Gold 20/750/20% (AK-R8)
01/01/2017 Summary SBC
Select Plus Gold 20/1000/20% (AK-R9)
01/01/2017 Summary SBC
Select Plus Silver 30/2000/30% (AK-SA)
01/01/2017 Summary SBC
Select Plus Silver 2000/30% (AK-RW)
01/01/2017 Summary SBC
Select Plus HSA Silver 2000/20% (AT-AM)
07/01/2017 Summary SBC
Select Plus HSA Bronze 4800/40% (AT-AO)
07/01/2017 Summary SBC
Select Plus HSA Bronze 6500/0% (AK-RX)
01/01/2017 Summary SBC
Core PPO Network
Core Platinum 15/20% (AK-RY)
01/01/2017 Summary SBC
Core Gold 20/250/20% (AK-SB)
01/01/2017 Summary SBC
Core Gold 20/750/20% (AK-SC)
01/01/2017 Summary SBC
Core Gold 20/1000/20% (AK-SD)
01/01/2017 Summary SBC
Core Silver 30/2000/30% (AK-SE)
01/01/2017 Summary SBC
Core Silver 2000/30% (AK-RZ)
01/01/2017 Summary SBC
Core HSA Silver 2000/20% (AT-AN)
07/01/2017 Summary SBC
Core HSA Bronze 6500/0% (AK-R1)
01/01/2017 Summary SBC
2017 Medical HMO State Package
Signature HMO Network
State Signature Platinum 15-40/10% (AK-RK)
01/01/2017 Summary SBC
State Signature Gold 30-55/20% (AK-RL)
01/01/2017 Summary SBC
State Signature Silver 45-75/20%/2000ded (AK-RM)
01/01/2017 Summary SBC
Alliance HMO Network
State Alliance Platinum 15-40/10% (AK-RQ)
01/01/2017 Summary SBC
State Alliance Gold 30-55/20% (AK-RR)
01/01/2017 Summary SBC
State Alliance Silver 45-75/20%/2000ded (AK-RS)
01/01/2017 Summary SBC
State Alliance HSA Bronze 40%/4800ded (AK-RT)
01/01/2017 Summary SBC
Focus HMO Network
State Focus Platinum 15-40/10% (AK-RN)
01/01/2017 Summary SBC
State Focus Gold 30-55/20% (AK-RO)
01/01/2017 Summary SBC
State Focus Silver 45-75/20%/2000ded (AK-RP)
01/01/2017 Summary SBC
2017 Medical EPO State Package
Navigate EPO Network
State Navigate Platinum 15/10% (AK-SI)
01/01/2017 Summary SBC
State Navigate Gold 30/20% (AK-SJ)
01/01/2017 Summary SBC
State Navigate Silver 45/2000/20% (AK-SK)
01/01/2017 Summary SBC
State Navigate Bronze 75/6300/100% (AK-SL)
01/01/2017 Summary SBC
State Navigate HSA Bronze 4800/40% (AK-SM)
01/01/2017 Summary SBC
2017 Medical PPO State Package
Core PPO Network
State Core Platinum 15/10% (AK-R2)
01/01/2017 Summary SBC
State Core Gold 30/20% (AK-R3)
01/01/2017 Summary SBC
State Core Silver 45/2000/20% (AK-R4)
01/01/2017 Summary SBC
State Core Bronze 75/6300/100% (AK-R5)
01/01/2017 Summary SBC
State Core HSA Bronze 4800/40% (AK-R6)
01/01/2017 Summary SBC
Non-Differential PPO - for employees residing outside a Select Plus Service area
Non-Differential PPO Silver 2000/30% (AK-RU)
01/01/2017 Summary SBC
2018 Dental Plans
Dental Simplified - DHMO Plans
Platinum D125C - Contributory
01/01/2018 Summary
Platinum D126C - Voluntary
01/01/2018 Summary
Gold D175C - Contributory
01/01/2018 Summary
Gold D176C - Voluntary
01/01/2018 Summary
Silver D250C - Contributory
01/01/2018 Summary
Silver D251C - Voluntary
01/01/2018 Summary
Dental Simplified - DPPO Plans
Platinum X4887/UCR90 - Contributory
01/01/2018 Summary
Platinum X4884/UCR90 - Contributory
01/01/2018 Summary
Platinum X3416/UCR85 - Contributory
01/01/2018 Summary
Platinum P7089/UCR90 - Voluntary
01/01/2018 Summary
Gold P4886/UCR90 - Contributory
01/01/2018 Summary
Gold P4883/UCR90 - Contributory
01/01/2018 Summary
Gold 1X754/MAC - Contributory
01/01/2018 Summary
Gold P7088/UCR90 - Voluntary
01/01/2018 Summary
Silver P3437/MAC - Contributory
01/01/2018 Summary
Silver P7308/MAC - Contributory
01/01/2018 Summary
Silver P5425/MAC - Voluntary
01/01/2018 Summary
Bronze A7976/MAC - Contributory
01/01/2018 Summary
Bronze A8016/MAC - Contributory
01/01/2018 Summary
Bronze A8012/MAC - Voluntary
01/01/2018 Summary
Form Name Effective Date Download Form
Canopy Health FAQ Flyer
01/01/2018 Download
Canopy Health Overview Flyer
01/01/2018 Download
HEAL Flyer
01/01/2018 Download
UHC Choice Simpflied Packages
01/01/2018 Download
UHC Plan Mapping Grid
01/01/2018 Download
UHC Product Catalog
01/01/2018 Download
UHC Product Grid
01/01/2018 Download
UHC Rate Guide
01/01/2018 Download
UHC Underwriting Guidelines
01/01/2018 Download
UHC HMO Network Comparison
01/01/2018 Download
UHC HMO RX Formulary
07/01/2017 Download
UHC PPO RX Formulary
07/01/2017 Download
UHC New Business Checklist
07/01/2017 Download
UHC Overview Flyer
Download
UHC Overview Flyer
06/01/2017 Download
Packaged Savings Flyer
01/01/2018 Download
UHC Provider Search
Download
Dental
Dental Simplified Flyer
04/01/2018 Download
Dental Consumer MaxMultiplier Brochure
01/01/2018 Download
How to Search for a UHC Dental or Vision Provider
01/01/2018 Download
Vision
Vision Provider Search Flyer
01/01/2018 Download
UHC Lens Options Brochure
01/01/2018 Download
Vision Benefits at Warby Parker
01/01/2018 Download
Form Name Effective Date Download Form
CA SB Employer Contact Sheet