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
New Group Submission
New Business Checklist
08/01/2022 Download
Employer Application for Small Business
01/01/2022 Download
Employer Application for Standalone Dental & Vision
01/01/2022 Download
Employer Application for Small Group Life and Disability
01/01/2022 Download
Product and Benefit Selection Form 1.23
01/01/2023 Download
Product and Benefit Selection Form 4.23
04/01/2023 Download
Direct Debit Authorization Form
01/01/2023 Download
Participation & Floor Certification Form (for groups situs in California)
07/01/2022 Download
Participation & Floor Certification Form (for groups situs outside of California)
06/01/2022 Download
Common Ownership Certification
01/01/2020 Download
In Force Group Forms
Group Acceptance/Change Form (GAF) 1.23
01/01/2023 Download
Group Acceptance/Change Form (GAF) 4.23
04/01/2023 Download
Group Information Change Form
01/01/2022 Download
Employee Open Enrollment Changes Spreadsheet
01/01/2020 Download
Employer Group Reporting Form
01/01/2022 Download
Plan Year Change Request Form
01/01/2020 Download
Administration
Employer Administration Guide Medical
01/01/2020 Download
Employer eServices Reference Guide
08/01/2022 Download
Employer eServices Online Renewal Quick Reference Guide
08/01/2022 Download
Employer eServices Login Help
01/01/2020 Download
Employer eServices Website Tips
01/01/2020 Download
Group Life Administration Guide
08/01/2022 Download
Form Name Effective Date Download Form
Enrollment and Change Forms
Employee Application
02/01/2022 Download
Employee Application - Standalone Dental & Vision
01/01/2022 Download
Employee Application - Life and Disability
01/01/2022 Download
Employee - Statement of Dependent Eligibility Beyond Limiting Age Due to Mental or Physical Disability
01/01/2020 Download
Life Beneficiary Form
01/01/2022 Download
Transition of Care Form
01/01/2020 Download
Claim Forms
Authorization for the Release of Health Information
08/01/2022 Download
Medical Claim Form
08/01/2022 Download
International Claim Form
08/01/2022 Download
Pharmacy Claim Form
08/01/2022 Download
Mail Order Pharmacy Form
08/01/2022 Download
Dental Claim Form
08/01/2022 Download
Vision Claim Form (out of network reimbursement)
08/01/2022 Download
Form Name Effective Date Download Form
2023 Medical HMO Choice Simplified
Signature HMO Network
Signature Platinum 20-40/300d (CW-XY)
01/01/2023 Summary SBC
Signature Platinum 25-50/10% (CW-X6)
01/01/2023 Summary SBC
Signature Platinum 25-50/20% (CP-SM)
01/01/2023 Summary SBC
Signature Platinum 25-50/400d (CW-X3)
01/01/2023 Summary SBC
Signature Gold 35-70/20%/500ded (CW-YF)
01/01/2023 Summary SBC
Signature Gold 35-70/600d (CW-X9)
01/01/2023 Summary SBC
Signature Gold 35-70/700d (CW-YC)
01/01/2023 Summary SBC
Signature Gold 35-70/30%/1500ded (CW-YI)
01/01/2023 Summary SBC
Signature Silver 60-95/40%/2400ded (CW-YK)
01/01/2023 Summary SBC
Alliance HMO Network
Alliance Platinum 20-40/300d (CW-XZ)
01/01/2023 Summary SBC
Alliance Platinum 25-50/10% (CW-X7)
01/01/2023 Summary SBC
Alliance Platinum 25-50/20% (CP-SU)
01/01/2023 Summary SBC
Alliance Platinum 25-50/400d (CW-X4)
01/01/2023 Summary SBC
Alliance Gold 35-70/20%/500ded (CW-YG)
01/01/2023 Summary SBC
Alliance Gold 35-70/600d (CW-YA)
01/01/2023 Summary SBC
Alliance Gold 35-70/700d (CW-YD)
01/01/2023 Summary SBC
Alliance Gold 35-70/30%/1500ded (CW-YJ)
01/01/2023 Summary SBC
Alliance Silver 60-95/40%/2400ded (CW-YM)
01/01/2023 Summary SBC
Harmony HMO Network
Harmony Platinum 20-40/300d (CW-XX)
01/01/2023 Summary SBC
Harmony Platinum 20-40/300d Canopy (CW-XX)
01/01/2023 Summary SBC
Harmony Platinum 25-50/10% (CW-X5)
01/01/2023 Summary SBC
Harmony Platinum 25-50/10% Canopy (CW-X5)
01/01/2023 Summary SBC
Harmony Platinum 25-50/20% (CP-SG)
01/01/2023 Summary SBC
Harmony Platinum 25-50/20% Canopy (CP-SG)
01/01/2023 Summary SBC
Harmony Platinum 25-50/400d (CW-X2)
01/01/2023 Summary SBC
Harmony Platinum 25-50/400d Canopy (CW-X2)
01/01/2023 Summary SBC
Harmony Gold 35-70/20%/500ded (CW-YE)
01/01/2023 Summary SBC
Harmony Gold 35-70/20%/500ded Canopy (CW-YE)
01/01/2023 Summary SBC
Harmony Gold 35-70/600d (CW-X8)
01/01/2023 Summary SBC
Harmony Gold 35-70/600d Canopy (CW-X8)
01/01/2023 Summary SBC
Harmony Gold 35-70/700d (CW-YB)
01/01/2023 Summary SBC
Harmony Gold 35-70/700d Canopy (CW-YB)
01/01/2023 Summary SBC
Harmony Gold 35-70/30%/1500ded (CW-YH)
01/01/2023 Summary SBC
Harmony Gold 35-70/30%/1500ded Canopy (CW-YH)
01/01/2023 Summary SBC
Harmony Silver 40%/2400ded (CW-YN)
01/01/2023 Summary SBC
Harmony Silver 40%/2400ded Canopy (CW-YN)
01/01/2023 Summary SBC
Harmony Silver 60-95/40%/2400ded (CW-YL)
01/01/2023 Summary SBC
Harmony Silver 60-95/40%/2400ded Canopy (CW-YL)
01/01/2023 Summary SBC
2023 Medical PPO Choice Simplified
Select Plus PPO Network
Select Plus Platinum 15/10% (CV-QN)
01/01/2023 Summary SBC
Select Plus Platinum 15/250/10% (CV-QT)
01/01/2023 Summary SBC
Select Plus Platinum 15 250 20% (CV-QO)
01/01/2023 Summary SBC
Select Plus Platinum 5/250/20% (CV-QR)
01/01/2023 Summary SBC
Select Plus Gold 30/30% (CV-QS)
01/01/2023 Summary SBC
Select Plus Gold 35/500/20% (CV-QU)
01/01/2023 Summary SBC
Select Plus Gold 35/1000/20% (CV-QV)
01/01/2023 Summary SBC
Select Plus Gold 5/1500/30% (CV-QZ)
01/01/2023 Summary SBC
Select Plus Silver 55/1950/40% (CV-QW)
01/01/2023 Summary SBC
Select Plus Silver 55/2450/40% (CV-QX)
01/01/2023 Summary SBC
Select Plus Bronze 5500/40% w/Prem Rewards (CV-QP)
01/01/2023 Summary SBC
Select Plus Bronze 7500/50% w/Care Cash (CV-2P)
01/01/2023 Summary SBC
Select Plus Bronze 7500/50% w/Prem Rewards (CV-PU)
01/01/2023 Summary SBC
Select Plus Silver HDHP w/Prem Rewards 2800/40% (CV-QQ)
01/01/2023 Summary SBC
Select Plus Bronze HDHP w/Prem Rewards 6000/40% (CV-QY)
01/01/2023 Summary SBC
Core PPO Network
Core Platinum 15/10% (CV-QA)
01/01/2023 Summary SBC
Core Platinum 15/250/10% (CV-QG)
01/01/2023 Summary SBC
Core Platinum 15/250/20% (CV-QB)
01/01/2023 Summary SBC
Core Platinum 5/250/20% (CV-QE)
01/01/2023 Summary SBC
Core Gold 30/30% (CV-QF)
01/01/2023 Summary SBC
Core Gold 35/500/20% (CV-QH)
01/01/2023 Summary SBC
Core Gold 35/1000/20% (CV-QI)
01/01/2023 Summary SBC
Core Gold 5/1500/30% (CV-PV)
01/01/2023 Summary SBC
Core Silver 55/1950/40% (CV-QJ)
01/01/2023 Summary SBC
Core Silver 55/2450/40% (CV-QK)
01/01/2023 Summary SBC
Core Silver HDHP w/Prem Rewards 2800/40% (CV-QD)
01/01/2023 Summary SBC
Core Bronze 5500/40% w/Prem Rewards (CV-QC)
01/01/2023 Summary SBC
Core Bronze 7500/50% w/Care Cash (CV-2O)
01/01/2023 Summary SBC
Core Bronze 7500/50% w/Prem Rewards (CV-PS)
01/01/2023 Summary SBC
Core Bronze HDHP w/Prem Rewards 6000/40% (CV-QL)
01/01/2023 Summary SBC
2023 Medical EPO Choice Simplified
Doctors Plan Platinum 15/10% (CV-PZ)
01/01/2023 Summary SBC
Doctors Plan Platinum 15/250/10% (CV-QM)
01/01/2023 Summary SBC
Doctors Plan Platinum 15/250/20% (CV-PX)
01/01/2023 Summary SBC
Doctors Plan Platinum 5/250/20% (CV-PY)
01/01/2023 Summary SBC
Doctors Plan Gold 30/30% (CV-P9)
01/01/2023 Summary SBC
Doctors Plan Gold 35/500/20% (CV-P3)
01/01/2023 Summary SBC
Doctors Plan Gold 35/1000/20% (CV-P4)
01/01/2023 Summary SBC
Doctors Plan Gold 5/1500/30% (CV-P5)
01/01/2023 Summary SBC
Doctors Plan Silver 55/1950/40% (CV-P6)
01/01/2023 Summary SBC
Doctors Plan Silver 55/2450/40% (CV-P7)
01/01/2023 Summary SBC
Doctors Plan Silver HDHP w/Prem Rewards 2800/40% (CV-PW)
01/01/2023 Summary SBC
Doctors Plan Bronze 5500/40% w/Prem Rewards (CV-P8)
01/01/2023 Summary SBC
Doctors Plan Bronze 7500/50% w/Prem Rewards (CV-PR)
01/01/2023 Summary SBC
Doctors Plan Bronze HDHP w/Prem Rewards 6000/40% (CV-P2)
01/01/2023 Summary SBC
2023 Medical HMO State Package
Alliance HMO Network
State Alliance Platinum 90 HMO 0/15 (CE-OK)
01/01/2023 Summary SBC
State Alliance Gold 80 HMO 350/25 (CE-OL)
01/01/2023 Summary SBC
State Alliance Silver 70 HMO 2500/55 (CW-YO)
01/01/2023 Summary SBC
2023 Medical EPO State Package
Navigate EPO Network
State Navigate Platinum 15/10% (CD-FB)
01/01/2023 Summary SBC
State Navigate Gold 25/350/20% (CD-FC)
01/01/2023 Summary SBC
State Navigate Silver 55/2500/35% (CU-VI)
01/01/2023 Summary SBC
State Navigate Bronze 65/6300/40% (CD-FE)
01/01/2023 Summary SBC
2023 Medical PPO State Package
Core PPO Network
State Core Platinum 15/10% (CE-MA)
01/01/2023 Summary SBC
State Core Gold 25/350/20% (CE-MB)
01/01/2023 Summary SBC
State Core Silver 55/2500/35% (CV-PT)
01/01/2023 Summary SBC
State Core Bronze 65/6300/40% (CE-MD)
01/01/2023 Summary SBC
2023 Non-Differential PPO - for employees residing outside a Select Plus or Core service area
Non-Differential PPO Silver 2250/30% (CE-MI)
01/01/2023 Summary SBC
2022 Choice Simplified Packages - refer to the guide below to confirm allowed plan pairings
Choice Simplified Packages 1.22
01/01/2022 Summary
2022 Medical HMO Choice Simplified
Signature HMO Network
Signature Platinum 20-40/400d (CP-SK)
01/01/2022 Summary SBC
Signature Platinum 25-50/20% (CP-SM)
01/01/2022 Summary SBC
Signature Platinum Primary Advantage 0-80/20% (CP-SL)
01/01/2022 Summary SBC
Signature Gold 35-70/800d (CP-SN)
01/01/2022 Summary SBC
Signature Gold 35-70/20%/500ded (CP-SO)
01/01/2022 Summary SBC
Signature Gold 35-70/30%/1250ded (CP-SQ)
01/01/2022 Summary SBC
Signature Gold Primary Advantage 0-85/40%/2000ded (CP-SP)
01/01/2022 Summary SBC
Signature Silver 55-95/40%/2350ded (CP-SR)
01/01/2022 Summary SBC
Alliance HMO Network
Form Name Effective Date Download Form
General Information
Overview Flyer
01/01/2020 Download
Product Catalog 1.23
01/01/2023 Download
Product Catalog 1.22
01/01/2022 Download
Underwriting Guidelines 7.22
07/01/2022 Download
Bundled Pricing Flyer (groups of 2 - 100)
02/01/2023 Download
COVID-19 At Home Testing FAQ
01/01/2022 Download
Packaged Savings Flyer (groups of 2 - 99)
01/01/2022 Download
2023 Producer Performance Guide
01/01/2023 Download
2022 Producer Performance Guide
12/01/2022 Download
Health Management One Pass Flyer
01/01/2022 Download
Helpful Information & Resources Flyer
01/01/2022 Download
MLR 2019 FInal Payout Report
01/01/2020 Download
Mobile App Health4Me for HMO Members
08/01/2022 Download
Mobile App Member Flyer for PPO Members
08/01/2022 Download
Mobile App Employer Flyer
01/01/2020 Download
Wellness - Apple Fitness+ Membership
01/01/2023 Download
Wellness - Care Cash Rewards Flyer
01/01/2023 Download
Wellness - Premium Rewards Program Flyer
01/01/2023 Download
Wellness - Core Rewards Program Flyer
01/01/2023 Download
Wellness - One Pass Broker/Employer Flyer
01/01/2023 Download
Wellness - One Pass Member Flyer
01/01/2023 Download
Wellness - Real Appeal Member Flyer
01/01/2023 Download
Wellness - Sanvello Behavioral Health App Member Flyer
01/01/2023 Download
Medical
Medical Product Grid 1.23
01/01/2023 Download
Medical Product Grid 1.22
01/01/2022 Download
Detailed Benefit Grids 1.22
08/01/2022 Download
Plan Benefit Changes 1.22
08/01/2022 Download
Choice Simplified Package 1.23
04/01/2023 Download
Choice Simplified Package 1.22
01/01/2022 Download
EAP Member Overview Flyer (PPO Plans Only)
05/01/2023 Download
How to Find a UHC Contracted Freestanding Facility for Outpatient Services
01/01/2020 Download
How to Print and Order ID Cards
01/01/2020 Download
How to Register on myuhc.com
01/01/2020 Download
HSA Best Practices Guide
08/01/2022 Download
New Member Checklist
01/01/2020 Download
Nurseline Flyer
01/01/2020 Download
Online Provider Search Instructions
01/01/2023 Download
Plan Code Reference Tool 2023
01/01/2023 Download
Small Group Pharmacy Drug List (HMO & PPO)
01/01/2022 Download
Small Group Pharmacy Drug List (Navigate)
01/01/2022 Download
Standard Select Pharmacy Network with CVS
11/01/2022 Download
Standard Select Pharmacy Network with Walgreens
11/01/2022 Download
Preventive Care Services Brochure
08/01/2022 Download
Primary Advantage CA HMO Flyer
08/01/2022 Download
Primary Advantage CA PPO Flyer
08/01/2022 Download
Save Money by Using Freestanding Facilities
01/01/2020 Download
Select Plus PPO PCP Election Flyer
01/01/2022 Download
HMO Network Comparison Tool 4.23
04/01/2023 Download
HMO Medical Group Website Links
01/01/2020 Download
Advantage HMO Network Flyer
08/01/2022 Download
Alliance HMO Network Brochure
08/01/2022 Download
Alliance HMO Network List
04/01/2023 Download
Harmony HMO Statewide Brochure
08/01/2022 Download
Harmony HMO Network List
04/01/2023 Download
Harmony Southern California Flyer
08/01/2022 Download
Harmony & Canopy HMO Northern California Brochure
08/01/2022 Download
Canopy Health Overview Flyer
02/01/2020 Download
Select Plus PPO Flyer
02/01/2020 Download
Core PPO Brochure
08/01/2022 Download
Navigate EPO Brochure
01/01/2020 Download
Navigate EPO FAQs
01/01/2020 Download
Virtual Visits Overview Flyer
08/01/2022 Download
Dental
Dental Simplified 2.0 Flyer
03/01/2022 Download
Dental Combo Flyer - SmileDirect, Dialcare, Jetdental & Quip
01/01/2022 Download
Dental & Vision Member Discount Flyer
01/01/2022 Download
Dental Consumer MaxMultiplier Flyer
01/01/2022 Download
Dental FlexAppeal Enhanced Flyer
01/01/2022 Download
How to Search for a UHC Dental or Vision Provider
08/01/2022 Download
SmileDirectClub FAQ
08/01/2022 Download
SmileDirectClub Employer Flyer
08/01/2022 Download
SmileDirectClub PPO Member Flyer
08/01/2022 Download
Virtual Dental Visits Flyer - Teledentistry
01/01/2022 Download
Vision
Vision Simplified Flyer
01/01/2022 Download
Vision Provider Network Flyer
04/01/2022 Download
EyeSafe Flyer
08/01/2022 Download
EyeSafe Dell Discount Flyer
01/01/2022 Download
Hearing Discounts Through UHC Vision Flyer
09/01/2022 Download
How to Print Your Vision ID Card
08/01/2022 Download
Laser Vision Correction Flyer
01/01/2022 Download
Lens Formularies Flyer [effective 5/1/2021]
08/01/2022 Download
Lens Options Flyer
08/01/2022 Download
Vision Benefits at Warby Parker
01/01/2022 Download
Vision FAQs
08/01/2022 Download
Vision Coverage Overview
09/01/2022 Download
Life & Disability
Life Benefits Overview
08/01/2022 Download
Life Quick Reference Guide
08/01/2022 Download
Life Member Welcome Guide
08/01/2022 Download
Combined Life and Value Added Services Flyer
09/01/2022 Download
Disability Quick Reference Guide
08/01/2022 Download
Form Name Effective Date Download Form
Ancillary Rate Guides
Q1 2023
DHMO Dental Rate Card - California [effective 1/1/2023 to 3/1/2023]
01/01/2023 Download
PPO Dental Rate Card - Southern California [effective 1/1/2023 to 3/1/2023]
01/01/2023 Download
PPO Dental Rate Card - Northern California [effective 1/1/2023 to 3/1/2023]
01/01/2023 Download
PPO Dental Rate Card - San Francisco Metro [effective 1/1/2023 to 3/1/2023]
01/01/2023 Download
Small Business Vision Card - California [effective 1/1/2023 to 3/1/2023]
01/01/2023 Download
Q2 2023
DHMO Dental Rate Card - California [effective 4/1/2023 to 6/1/2023]
04/01/2023 Download
PPO Dental Rate Card - Southern California [effective 4/1/2023 to 6/1/2023]
04/01/2023 Download
PPO Dental Rate Card - Northern California [effective 4/1/2023 to 6/1/2023]
04/01/2023 Download
PPO Dental Rate Card - San Francisco Metro [effective 4/1/2023 to 6/1/2023]
04/01/2023 Download
Small Business Vision Card - California [effective 4/1/2023 to 6/1/2023]
04/01/2023 Download