UnitedHealthcare Portfolio & Network Glossary

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UHC Small Group Plans & Networks

Description

HMO

HMO plans available in 4 networks:

  • SignatureValue HMO: Full HMO network with 62,590 physicians and health care professionals, and 273 hospitals
  • Advantage HMO: Narrow network, includes Canopy Health in the Bay Area, with 33,800 physicians and health care professionals, and 248 hospitals
  • Alliance HMO: Distinct subset of the SignatureValue HMO network in select counties with 36,200 physicians and health care professionals, and 258 hospitals
  • Harmony HMO: High-performing narrow network in Southern CA with 11,970 physicians and health care professionals, and 144 hospitals
PPO

PPO plans available in 2 networks:

  • Select Plus PPO: Full PPO network with 80,557 physicians and health care professionals, and 290 hospitals
  • Core PPO: Narrow PPO network with 47,105 physicians and health care professionals, and 280 hospitals
EPO

EPO plans available in 2 networks:

  • Doctors Plan EPO: Collaboration between Canopy Health and UHC in the Bay Area with 5,000 physicians and health care professionals, and 20 hospitals
  • Navigate EPO: Narrow EPO network (PCP selection and electronic referrals required) with 49,854 physicians and health care professionals, and 262 hospitals
HSA

HSA-compatible PPO or EPO plans available in 4 networks:

  • Select Plus PPO
  • Core PPO
  • Doctors Plan EPO
  • Navigate EPO
   

Other Important Information

Description

Choice Simplified Portfolio

Small group medical plans consisting of all metallic levels associated with all networks

Multi-Choice State Portfolio

State-mirror portfolio consisting of select plans

Formulary

  • California Small Group 4-Tier HMO and PPO Prescription Drug List: Formulary that applies to all UHC small group ACA plans except Navigate plans
  • California Small Group 4-Tier PPO Prescription Drug List: Formulary that applies to Navigate plans only

Rx Mail Order

OptumRx

Behavioral Health

United Behavioral Health network

Pediatric Dental

  • Dental network (CA Select Managed Care DHMO) for embedded HMO pediatric Dental benefits within Medical plans
  • Dental network (National Options 20) for embedded PPO pediatric Dental benefits within Medical plans

Pediatric Vision

Vision network (Spectera) for embedded pediatric Vision benefits within Medical plans.

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