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
Broker Checklist
01/01/2017 Download
Change Form for UnitedHealthcare
Download
Proof of Ownership Guidelines
Download
Product and Benefit Selection Form
07/01/2017 Download
Product and Benefit Selection Form
01/01/2017 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
Download
Form Name Effective Date Download Form
RX Claim Form
Download
RX Claim Mail-In Form
Download
Life Beneficiary Form
Download
Employee Change Form
01/01/2017 Download
Employee Application
Download
Claim Form Medical
Download
Form Name Effective Date Download Form
Medical HMO
Platinum Adv 0_AK-Q4
01/01/2017 Summary SBC
Platinum Alliance 0_AK-RE
01/01/2017 Summary SBC
Platinum Focus 0_AK-Q9
01/01/2017 Summary SBC
Platinum SigValue 0_AK-QY
01/01/2017 Summary SBC
Gold Adv 0_AK-Q5
01/01/2017 Summary SBC
Gold Alliance 0_AK-RF
01/01/2017 Summary SBC
Gold Focus 0_AK-RA
01/01/2017 Summary SBC
Gold SigValue 0_AK-QZ
01/01/2017 Summary SBC
Gold Adv 1000_AK-Q6
01/01/2017 Summary SBC
Gold Alliance 1000_AK-RG
01/01/2017 Summary SBC
Gold Focus 1000_AK-RB
01/01/2017 Summary SBC
Gold SigValue 1000_AK-Q1
01/01/2017 Summary SBC
Silver Adv 2000_AK-Q7
01/01/2017 Summary SBC
Silver Alliance 2000_AK-RH
01/01/2017 Summary SBC
Silver Alliance 2000_AK-RI
01/01/2017 Summary SBC
Silver Focus 2000_AK-RC
01/01/2017 Summary SBC
Silver SigValue 2000_AK-Q2
01/01/2017 Summary SBC
Bronze Alliance HSA 6500_AK-RJ
01/01/2017 Summary SBC
Medical HMO -State Plans
Platinum 90 Alliance_AK-RQ
01/01/2017 Summary SBC
Platinum 90 Focus_AK-RN
01/01/2017 Summary SBC
Platinum 90 SigValue_AK-RK
01/01/2017 Summary SBC
Gold 80 Alliance_AK-RR
01/01/2017 Summary SBC
Gold 80 Focus_AK-RO
01/01/2017 Summary SBC
Gold 80 SigValue_AK-RL
01/01/2017 Summary SBC
Silver 70 Alliance_AK-RS
01/01/2017 Summary SBC
Silver 70 Focus_AK-RP
01/01/2017 Summary SBC
Silver 70 SigValue_AK-RM
01/01/2017 Summary SBC
Bronze 60 HSA Alliance_AK-RT
01/01/2017 Summary SBC
Medical PPO
Platinum Core 0_AK-RY w403
01/01/2017 Summary SBC
Platinum Navigate 0_AK-SF w403
01/01/2017 Summary SBC
Platinum Select Plus 0_AK-RV w403
01/01/2017 Summary SBC
Gold Core 250_AK-SB w404
01/01/2017 Summary SBC
Gold Navigate 250_AK-SN w404
01/01/2017 Summary SBC
Gold Select Plus 250_AK-R7 w404
01/01/2017 Summary SBC
Gold Core 750_AK-SC w404
01/01/2017 Summary SBC
Gold Navigate 750_AK-SO w404
01/01/2017 Summary SBC
Gold Select Plus 750_AK-R8 w404
01/01/2017 Summary SBC
Gold Core Direct 1000_AK-SD w404
01/01/2017 Summary SBC
Gold Navigate 1000_AK-SP w404
01/01/2017 Summary SBC
Gold Select Plus 1000_AK-R9 w404
01/01/2017 Summary SBC
Silver Core HSA 6500_AT-AN w551
07/01/2017 Summary SBC
Silver Core 2000_AK-RZ w405
01/01/2017 Summary SBC
Silver Core 2000_AK-SE w405
01/01/2017 Summary SBC
Silver Navigate HSA 6500_AT-AP w551
07/01/2017 Summary SBC
Silver Navigate 2000_AK-SG w405
01/01/2017 Summary SBC
Silver Navigate 2000_AK-SQ w405
01/01/2017 Summary SBC
Silver Select Plus HSA 6500_AT-AM w551
07/01/2017 Summary SBC
Silver Select Plus 2000_AK-SA w405
01/01/2017 Summary SBC
Silver Select Plus 2000_AK-RW w405
01/01/2017 Summary SBC
Bronze Core HSA 6500_AK-R1 w396
01/01/2017 Summary SBC
Bronze Navigate HSA 6500_AK-SH w396
01/01/2017 Summary SBC
Bronze 60 Select Plus HSA 4800_AT-AO w 551
07/01/2017 Summary SBC
Bronze Select Plus HSA 6500_AK-RX w396
01/01/2017 Summary SBC
Medical PPO - State Plans
SBC
Platinum 90 Core_AK-R2 w354
01/01/2017 Summary SBC
Platinum 90 Navigate_AK-SI w354
01/01/2017 Summary SBC
Gold 80 Core_AK-R3 w397
01/01/2017 Summary SBC
Gold 80 Navigate_AK-SJ w397
01/01/2017 Summary SBC
Silver 70 Core_AK-R4 w398
01/01/2017 Summary SBC
Silver 70 Navigate_AK-SK w398
01/01/2017 Summary SBC
Silver Non-Differential_AK-RU w405
01/01/2017 Summary SBC
Bronze 60 Core_AK-R5 w353
01/01/2017 Summary SBC
Bronze 60 Core HSA_AK-R6 w399
01/01/2017 Summary SBC
Bronze 60 Navigate_AK-SL w353
01/01/2017 Summary SBC
Bronze 60 Navigate HSA_AK-SM w399
01/01/2017 Summary SBC
Dental
DHMO Laguna 110C
Summary
DHMO Malibu 130C
Summary
DHMO Malibu 130
Summary
DHMO Newport 120C
Summary
DHMO Newport 120
Summary
DHMO Pismo140C
Summary
DHMO Pismo 140
Summary
DHMO Santa Cruz 150C
Summary
DHMO Santa Cruz 150
Summary
PPO 1P050
Summary
PPO A1211
Summary
PPO A7976
Summary
PPO A7984
Summary
PPO A8016 MAC
Summary
PPO A8016
Summary
PPO A8019
Summary
PPO P0042
Summary
PPO P0061
Summary
PPO P0206
Summary
PPO P0208
Summary
PPO P1211
Summary
PPO P2377
Summary
PPO P3305
Summary
PPO P3337
Summary
PPO P3345 Voluntary
Summary
PPO P3346
Summary
PPO P3350 Voluntary
Summary
PPO P3377
Summary
PPO P3432
Summary
PPO P3433
Summary
PPO P3436
Summary
PPO P3486
Summary
PPO P4210
Summary
PPO P4213
Summary
PPO P4260 Voluntary
Summary
PPO P4877
Summary
PPO P4878
Summary
PPO P4881
Summary
PPO P4883
Summary
PPO P4884
Summary
PPO P4966
Summary
PPO P5344
Summary
PPO P7984
Summary
PPO P8257
Summary
PPO PIN16
Summary
PPO PIN18
Summary
PPO PIN19
Summary
PPO PIN55
Summary
PPO PIN57
Summary
Vision
Vision V008 & V0012
Summary
Vision V0022
Summary
Vision V0031
Summary
Vision V1001
Summary
Vision V1010
Summary
Vision V1012
Summary
Vision V1018
Summary
Vision V1020
Summary
Vision V1025, V1031, V1036 & V1048
Summary
Vision V1026, V1037, V1043 & V1049
Summary
Vision V1365
Summary
Vision VH370
Summary
Vision 0007 Voluntary
Summary
Vision 1008 Voluntary
Summary
Vision V0007 Voluntary
Summary
Vision V1004, V1008 & V1012 Voluntary
Summary
Vision V1006 Voluntary
Summary
Vision V1007 Voluntary
Summary
Vision V1031 Voluntary
Summary
Vision V1043 Voluntary
Summary
Vision VH008 Voluntary
Summary
Vision VH107 Voluntary
Summary
Life
Basic $15K
Form Name Effective Date Download Form
3rd Quarter Dental Rate Card - CA DHMO
07/01/2017 Download
UHC HMO Network Comparison
05/01/2017 Download
UHC HMO RX Formulary
07/01/2017 Download
UHC PPO RX Formulary
07/01/2017 Download
UHC Overview Flyer
06/01/2017 Download
Provider Search
Download
Form Name Effective Date Download Form
CA SB Employer Contact Sheet
Download