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
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 Advantage 0 - AVMB
01/01/2018 Summary
Platinum Advantage 0 - AKQ4
01/01/2017 Summary SBC
Platinum Alliance 0 - AVMJ
01/01/2018 Summary
Platinum Alliance 0 - AKRE
01/01/2017 Summary SBC
Platinum Focus 0 - AVMF
01/01/2018 Summary
Platinum Focus 0 - AKQ9
01/01/2017 Summary SBC
Platinum Signature 0 - AVL7
01/01/2018 Summary
Platinum Signature 0 - AKQY
01/01/2017 Summary SBC
Gold Advantage 0 - AVMC
01/01/2018 Summary
Gold Advantage 0 - AKQ5
01/01/2017 Summary SBC
Gold Alliance 0 - AVMK
01/01/2018 Summary
Gold Alliance 0 - AKRF
01/01/2017 Summary SBC
Gold Focus 0 - AVMG
01/01/2018 Summary
Gold Focus 0 - AKRA
01/01/2017 Summary SBC
Gold Signature 0 - AVL8
01/01/2018 Summary
Gold Signature 0 - AKQZ
01/01/2017 Summary SBC
Gold Advantage 1000 - AVMD
01/01/2018 Summary
Gold Advantage 1000 - AKQ6
01/01/2017 Summary SBC
Gold Alliance 1000 - AVML
01/01/2018 Summary
Gold Alliance 1000 - AKRG
01/01/2017 Summary SBC
Gold Focus 1000 - AVMH
01/01/2018 Summary
Gold Focus 1000 - AKRB
01/01/2017 Summary SBC
Gold Signature 1000 - AVL9
01/01/2018 Summary
Gold Signature 1000 - AKQ1
01/01/2017 Summary SBC
Silver Advantage 2250 - AVME
01/01/2018 Summary
Silver Advantage 2000 - AKQ7
01/01/2017 Summary SBC
Silver Alliance 2250 - AVMM
01/01/2018 Summary
Silver Alliance 2000 - AKRH
01/01/2017 Summary SBC
Silver Alliance 2000 - 2 - AKRI
01/01/2017 Summary SBC
Silver Focus 2250 - AVMI
01/01/2018 Summary
Silver Focus 2000 - AKRC
01/01/2017 Summary SBC
Silver Signature 2250 - AVMA
01/01/2018 Summary
Silver Signature 2000 - AKQ2
01/01/2017 Summary SBC
Bronze Alliance 6250 - AVMZ
01/01/2018 Summary
Bronze Alliance HSA 6500 - AKRJ
01/01/2017 Summary SBC
Medical HMO - State Plans
Platinum 90 Advantage 0/15 Network 3 + Child Dental
01/01/2018 Summary
Platinum 90 Alliance 0/15 Network 3 + Child Dental - AVMW
01/01/2018 Summary
Platinum 90 Alliance 0/15 Network 3 + Child Dental - AKRQ
01/01/2017 Summary SBC
Platinum 90 Focus 0/15 Network 2 + Child Dental - AVMT
01/01/2018 Summary
Platinum 90 Focus 0/15 Network 2 + Child Dental - AKRN
01/01/2017 Summary SBC
Platinum 90 Signature 0/15 Network 1 + Child Dental - AVMN
01/01/2018 Summary
Platinum 90 Signature 0/15 Network 1 + Child Dental - AKRK
01/01/2017 Summary SBC
Gold 80 Advantage 0/25 Network 4 + Child Dental - AVMR
01/01/2018 Summary
Gold 80 Alliance 0/25 Network 3 + Child Dental - AVMX
01/01/2018 Summary
Gold 80 Alliance 0/30 Network 3 + Child Dental - AKRR
01/01/2017 Summary SBC
Gold 80 Focus 0/25 Network 2 + Child Dental - AVMU
01/01/2018 Summary
Gold 80 Focus 0/30 Network 2 + Child Dental - AKRO
01/01/2017 Summary SBC
Gold 80 Signature 0/25 Network 1 + Child Dental - AVMO
01/01/2018 Summary
Gold 80 Signature 0/30 Network 1 + Child Dental - AKRL
01/01/2017 Summary SBC
Silver 70 Advantage 2000/45 Network 4 + Child Dental - AVMS
01/01/2018 Summary
Silver 70 Alliance 2000/45 Network 3 + Child Dental - AVMY
01/01/2018 Summary
Silver 70 Alliance 2000/45 Network 3 + Child Dental - AKRS
01/01/2017 Summary SBC
Silver 70 Focus 2000/45 Network 2 + Child Dental - AVMV
01/01/2018 Summary
Silver 70 Focus 2000/45 Network 2 + Child Dental - AKRP
01/01/2017 Summary SBC
Silver 70 Signature 2000/45 Network 1 + Child Dental - AVMP
01/01/2018 Summary
Silver 70 Signature 2000/45 Network 1 + Child Dental - AKRM
01/01/2017 Summary SBC
Bronze 60 Alliance HDHP 4800/40 Network 3 + Child Dental - AX2G
01/01/2018 Summary
Bronze 60 HSA Alliance 4800/40 Network 3 + Child Dental - AKRT
01/01/2017 Summary SBC
Medical PPO
Platinum Core 0 - AUSL with 403
01/01/2018 Summary
Platinum Core 0 - AUSM with 403
01/01/2018 Summary
Platinum Core 0 - AKRY with 403
01/01/2017 Summary SBC
Platinum Navigate 0 - AUL7 with 403
01/01/2018 Summary
Platinum Navigate 0 - AUSS with 403
01/01/2018 Summary
Platinum Navigate 0 - AKSF with 403
01/01/2017 Summary SBC
Platinum Select Plus 0 - AUSI with 403
01/01/2018 Summary
Platinum Select Plus 0 - AUSJ with 403
01/01/2018 Summary
Platinum Select Plus 0 - AKRV with 403
01/01/2017 Summary SBC
Gold Core 500 - AUTB with 636
01/01/2018 Summary
Gold Core 250 - AKSB with 404
01/01/2017 Summary SBC
Gold Navigate 500 - AUSY with 636
01/01/2018 Summary
Gold Navigate 250 - AKSN with 404
01/01/2017 Summary SBC
Gold Select Plus 500 - AUS5 with 636
01/01/2018 Summary
Gold Select Plus 250 - AKR7 with 404
01/01/2017 Summary SBC
Gold Core 1000 - AUTC with 636
01/01/2018 Summary
Gold Core 750 - AKSC with 404
01/01/2017 Summary SBC
Gold Navigate 1000 - AUSZ with 636
01/01/2018 Summary
Gold Navigate 750 - AKSO with 404
01/01/2017 Summary SBC
Gold Select Plus 1000 - AUS6 with 636
01/01/2018 Summary
Gold Select Plus 750 - AKR8 with 404
01/01/2017 Summary SBC
Gold Core 1500 - AUTD with 636
Summary
Gold Core Direct 1000 - AKSD with 404
01/01/2017 Summary SBC
Gold Navigate 1500 - AUS1 with 636
01/01/2018 Summary
Gold Navigate 1000 - AKSP with 404
01/01/2017 Summary SBC
Gold Select Plus 1500 - AUS7 with 636
01/01/2018 Summary
Gold Select Plus 1000 - AKR9 with 404
01/01/2017 Summary SBC
Silver Core HSA 2000 - AXFL with 551
01/01/2018 Summary
Silver Core HSA 6500 - ATAN with 551
07/01/2017 Summary SBC
Silver Core 2250 - AUTF with 405
01/01/2018 Summary
Silver Core 2000 - AKRZ with 405
01/01/2017 Summary SBC
Silver Core 1500 - AUTE with 405
01/01/2018 Summary
Silver Core 2000 - AKSE with 405
01/01/2017 Summary SBC
Silver Navigate HSA 2000 - AXFM with 551
01/01/2018 Summary
Silver Navigate HSA 6500 - ATAP with 551
07/01/2017 Summary SBC
Silver Navigate 2250 - AUS3 with 405
01/01/2018 Summary
Silver Navigate 2000 - AKSG with 405
01/01/2017 Summary SBC
Silver Navigate 1500 - AUS2 with 405
01/01/2018 Summary
Silver Navigate 2000 - AKSQ with 405
01/01/2017 Summary SBC
Silver Select Plus HSA 2000 - AXFK with 551
01/01/2018 Summary
Silver Select Plus HSA 6500 - ATAM with 551
07/01/2017 Summary SBC
Silver Select Plus 1500 - AUS8 with 405
01/01/2018 Summary
Silver Select Plus 2000 - AKSA with 405
01/01/2017 Summary SBC
SiIver Select Plus 2250 - AUS9 with 405
01/01/2018 Summary
Silver Select Plus 2000 - AKRW with 405
01/01/2017 Summary SBC
Bronze Core HSA 4800 - AUSN with 399
01/01/2018 Summary
Bronze Core HSA 6500 - AKR1 with 396
01/01/2017 Summary SBC
Bronze Navigate HSA 4800 - AUST with 399
01/01/2018 Summary
Bronze Navigate HSA 6500 - AKSH with 396
01/01/2017 Summary SBC
Bronze Select Plus HSA 4800 - AUSK with 399
01/01/2018 Summary
Bronze 60 Select Plus HSA 4800 - ATAO with 551
07/01/2017 Summary SBC
Bronze Select Plus HSA 6500 - AKRX with 396
01/01/2017 Summary SBC
Medical PPO - State Plans
Platinum 90 Select Plus - AV68 with 354
01/01/2018 Summary
Platinum 90 Core - AUSO with 354
01/01/2018 Summary
Platinum 90 Core - AKR2 with 354
01/01/2017 Summary SBC
Platinum 90 EPO Navigate - AUSU with 354
01/01/2018 Summary
Platinum 90 EPO Navigate - AKSI with 354
01/01/2017 Summary SBC
Gold 80 Select Plus - AV69 with 397
01/01/2018 Summary
Gold 80 Core - AUSP with 397
01/01/2018 Summary
Gold 80 Core - AKR3 with 397
01/01/2017 Summary SBC
Gold 80 EPO Navigate - AUSV with 397
01/01/2018 Summary
Gold 80 EPO Navigate - AKSJ with 397
01/01/2017 Summary SBC
Silver 70 Select Plus - AV7A with 637
01/01/2018 Summary
Silver 70 Core - AUSQ with 637
01/01/2018 Summary
Silver 70 Core - AKR4 with 398
01/01/2017 Summary SBC
Silver 70 EPO Navigate - AUSW with 637
01/01/2018 Summary
Silver 70 EPO Navigate - AKSK with 398
01/01/2017 Summary SBC
Silver Non-Differential 2250 - AUSH with 405
01/01/2018 Summary
Silver Non-Differential 2000 - AKRU with 405
01/01/2017 Summary SBC
Bronze 60 HSA Select Plus - AV7C with 399
01/01/2018 Summary
Bronze 60 Select Plus - AV7B with 733
01/01/2018 Summary
Bronze 60 Core - AUSR with 733
01/01/2018 Summary
Bronze 60 Core - AKR5 with 353
01/01/2017 Summary SBC
Bronze 60 Core HSA - AKR6 with 399
01/01/2017 Summary SBC
Bronze 60 EPO Navigate - AUSX with 733
01/01/2018 Summary
Bronze 60 EPO Navigate - AKSL with 353
01/01/2017 Summary SBC
Bronze 60 Navigate HSA - AKSM with 399
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
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 Network Comparison
05/01/2017 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
UHC Provider Search
Download
Form Name Effective Date Download Form
CA SB Employer Contact Sheet
Download