Plan Summary

Deductible: $5,500 Individual / $11,000 Family

Out-of-Pocket: $6,350 Individual / $12,700 Family

Office Visit: 30% once medical deductible is satisfied

Inpatient Hospital: 30% once medical deductible is satisfied

UC / ER/ Major Diag Copay: 30% once medical deductible is satisfied

Pharmacy: Tier 1 $15 / Tier 2 $40 / Tier 3 $60 / 2x Mail Order

Select Plus

Flexible Plans with Network Advantages

UnitedHealthcare provides network and non-network benefits, plans for single-site, multi-site and multi-state businesses and variable options for deductibles, coinsurance and pharmacy plans that help meet employers’ needs. Our new Select Plus plan designs include a per- occurrence deductible, which is applied to inpatient hospital and certain outpatient services such as outpatient surgery, standard lab/X-ray, and complex imaging (e.g., MRI, CT, PET). Members with these plans have the option to avoid the per-occurrence deductible when accessing these outpatient benefits by receiving services from an in-network independent, non-hospital-affiliated provider.

These benefit plan designs offer employers:

Affordability – Low-cost alternatives for premiums

Choice – Popular combinations of benefits and pricing

Network – Access to more than 726,000 physicians, 5,600 hospitals, and 64,000 pharmacies across the country

Select Plus Select Plus plans give members the freedom to see any doctor in or outside the Select Plus network without a referral. A limited number of Select (in-network only) plans, which are modeled after the Covered California State Exchange standard plans, are also available.

Benefits of the Select Plus plan include:

Members visit any participating network physician or facility (including specialist) without a referral

When members visit participating network physicians and hospitals, there aren’t any claim forms or bills to worry about

Range of plan designs with different deductible levels, copayments, coinsurance and out-of-pocket amounts

Consumer-Driven Health

UnitedHealthcare Health Savings Account (HSA)

HSA Overview

UnitedHealthcare’s HSA plans are designed with the new health care consumer in mind. Our HSA plans offer a medical plan, coverage for preventive care and a health care account that members control and access themselves to cover some of the costs of qualified medical expenses. Account-based consumer solutions initiate the transformation from passive health plan members into value-conscious consumers.

HSA features

• Members can manage their medical claims and HSA together online or with a customer care professional.

• Three account types offer balance of interest, account fees and spending. Non-proprietary mutual fund investing is available.

• For greater member convenience, HSAs include a debit card and online bill payment.

• Accounts are administered by Optum Bank,SM Member FDIC. OptumHealth Financial ServicesSM provides educational tools that help both employers and individuals successfully engage in their financial health.

UnitedHealthcare HSA plans help members become more-informed and active health care consumers. By taking ownership of their health and health care spending, employees can also help their employers have more control of their health care costs. Recent studies support the value of HSA-eligible plans in reducing costs and promoting a healthier workplace.

• HSA-eligible plans have shown 20 percent to 30 percent lower-cost-than-average premiums, helping U.S. businesses save money. (1)

• Premium savings for employees with an HSA-eligible plan amount to an average of $852.(2)

• HSA plan members are two to three times more likely to participate in wellness programs than those in non-consumer-driven health plans. (3)

Our wellness offerings include worksite wellness programs, a confidential,(*) personalized health assessment, online and telephonic coaching and personal support.

(1) HSA Insider, HSA Road Rules for Employers, Seventh Edition, May 2008.

(2) 14th Annual National Business Group on Health/Watson Wyatt Survey Report – 2009, “The Effect of the Economic Crisis on Health Care Programs”.

(3) 2006 survey of 212,000 UnitedHealthcare members enrolled in UnitedHealthcare Health Savings Accounts for the full year of 2006.

(*) Confidential to the fullest extent permitted by law.