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SHBP 2025 HMO and HDHP benefits guide

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2025 benefit plan options – SHBP 2025 HMO and HDHP benefits guide

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STATE HEALTH BENEFIT PLAN

Contents

Welcome letter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Take a look at what’s available . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Quality care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Pick your plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2025 SHBP benefits at a glance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Member scenarios . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Take these steps to earn . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Know where to go. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Get care from anywhere. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Take a fresh look at your health. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Helping you stay healthy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

Support for emotional well-being . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

Read the fine print . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

Prepare to enroll . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

*Be Well SHBP, the SHBP well-being program, is administered by Sharecare.

Like Georgia’s mountains and plains, your health has peaks and valleys. At UnitedHealthcare, we’re here

to help you navigate your health plan. For more than 22 years, we’ve provided State Health Benefit Plan

(SHBP) options designed with your best health in mind.

What’s inside this brochure:

Plan summary – Provides information about your plan options, UnitedHealthcare network providers,

clinical and disease management programs, resources and support to help you make an informed

2025 enrollment decision

Benefit grid – Provides detailed information about your plan coverage, including information about co-

pays, deductibles and out-of-pocket maximums

Learn more about:

The HDHP option with a Health Savings Account (HSA) is the least expensive plan offered by SHBP,

and you can use pretax money to pay for qualified expenses

Reducing your health care expenses – You and your covered spouse each can earn points that can be

applied to eligible medical and pharmacy expenses. You each also can earn a $250 reward card (up to

$500 per household) from UnitedHealthcare for completing certain Be Well SHBP* activities

Virtual care – Whether you need 24/7 Virtual Visits for urgent care needs in the middle of the night

or behavioral health appointments from the comfort of home, we have options so you can take an

appointment where you want, without traveling to a provider’s office

To learn more about how to get the most out of your plan and the advantages of UnitedHealthcare,

please review the enclosed information and visit whyuhc.com/shbp or call a dedicated SHBP advocate

at 888-364-6352 TTY 711.

Wishing you and your family well,

Kimberly A. McCurdy-Spence

Senior Account Vice President, UnitedHealthcare

Taking you in healthy directions

Health care terms

Co-insurance – Your share of the costs of a covered

health care service, calculated as a percentage of

the allowed amount for the service.

Co-pay – A fixed amount you pay for a covered health

care service, usually when you receive the service.

Deductible – The amount you owe for health care

services before your health plan begins to pay.

Out-of-pocket maximum – The most money you

have to pay for covered expenses in a plan year.

For more health care term definitions, visit the Just Plain Clear® English and Spanish Glossary at

glossary.justplainclear.com.

State Health Benefit Plan (SHBP) | 2025 Benefits Options

Personalized condition support

for over 100 chronic conditions

and catastrophic health events

$0 cost for eligible medications with

Co-pay/Co-insurance Waiver Program

Innovative technology

with myuhc.com® and the

UnitedHealthcare® app

Dedicated Customer Service

team to answer health and

benefit questions

Emotional support with

a variety of behavioral

health tools

Support, every step of the way

Find your perfect fit

Visit whyuhc.com/shbp to learn about

the UnitedHealthcare benefits and

services offered for 2025 from the

comfort of your own home or on the

go. Using your computer or mobile

device,** you can learn about your

health plans options, search for network

providers, and learn about the physical

and mental health programs available

with both plans.

24/7 access to a registered nurse to

help guide your health care decisions

Programs and resources that

can help with life’s challenges

*Be Well SHBP, the SHBP well-being

program, is administered by Sharecare.

**Data rates may apply.

*As of March 2024.

**As of May 2024

Check if your doctor is in network

1 Go to whyuhc.com/shbp > Search for a Provider

2 Click on the health plan you’re considering to see a list of

network providers

3 Once you’re a member, search for a provider at myuhc.com >

Find Care & Costs or search on the UnitedHealthcare app.

4 Members can sign in at myuhc.com/virtualvisits to talk to a

doctor by video 24/7

Where life takes you, we’re there

No matter which plan you choose, you’ll have access to our broad network of doctors and hospitals, including:

Access to our nationwide network of nearly 1.8 million physicians and health care professionals and 6,000 hospitals*

A local Georgia network that includes over 45,000 health care providers and 140 hospitals*

No referral needed for specialist visits, even when traveling outside of Georgia

Behavioral health support with nearly 9,700 behavioral health clinicians, over 100 behavioral health facilities and 350

group practices throughout Georgia**

Access to Centers of Excellence for specialty conditions, such as cancer and transplant

Virtual urgent care provider access with 24/7 Virtual Visits

Choose smart.

Look for the blue hearts.

As your health ally, we’re committed to helping you make

informed decisions when seeking out and choosing a provider.

The UnitedHealth Premium program helps make it easier

for you to find doctors who meet our quality care criteria,

which includes safe, timely, effective and efficient care to

help you choose care with confidence. To find a Premium

Care Physician near you, look for two blue hearts next to their

name on myuhc.com.

Provider access anywhere,

anytime with 24/7 Virtual Visits

Large nationwide network of

UnitedHealth Premium®

program providers

Additional $250 reward card from UnitedHealthcare

for completing Be Well SHBP* activities

State Health Benefit Plan (SHBP) | 2025 Benefits Options

Choose the path that’s right for you

You have two plan options from UnitedHealthcare.

They’re the same in some ways…

Quality care

Choice

HMO Plan

HDHP

with HSA

Access to a large national and local Georgia network

Coverage at 100% for preventive care*

You are not required to choose a primary care provider (PCP)

You can see a network specialist without a referral

Personalized customer service and clinical care tailored to your needs

Savings opportunities

You and your spouse each can earn up to 480 points to apply to eligible medical and

pharmacy expenses when you complete Be Well SHBP** activities

You and your spouse each can earn a $250 reward card from UnitedHealthcare when you

complete your Be Well SHBP** activities and redeem all 480 points

Medical and pharmacy expenses both count toward your out-of-pocket maximum

And different in others…

Quality care

Choice

HMO Plan

HDHP

with HSA

The lowest monthly premium of all plans offered by SHBP

Allows you to open a Health Savings Account (HSA) and deposit pre-tax dollars to pay for

medical costs

You can use any doctor or hospital you want — inside or outside the network; coverage is lower if

you go out of network and you may pay more

You can use any doctor or hospital in the Choice network; if you use a provider outside of the

network, you’ll be responsible for the entire cost of the service (except in an emergency)

Savings opportunities

Under a family tier, once an individual family member’s deductible and out-of-pocket maximum

have been met, all eligible medical and pharmacy expenses for that member are paid at 100%

for the plan year.*** You don’t have to wait for the entire family to meet the family deductible and

out-of-pocket maximum to receive cost sharing with the plan.

For more information about your plan options, visit whyuhc.com/shbp.

Only the HDHP gives you access to an HSA

When you choose the HDHP, you can open an Health Savings Account (HSA) through UnitedHealthcare

or at any financial institution of your choice. An HSA offers many benefits now and in the future.

What’s an HSA?

An HSA is a personal bank account to help you save money and pay for health care expenses, like deductibles

and co-insurance, while also giving you real tax savings.

It’s yours to keep

• There is no “use it or lose it” rule

• The balance can grow from

year to year

• If you leave your employer, you

can take your HSA with you

Use it now, or save it for later

• You can choose to use your HSA

for current health care expenses or save

it for the future--even into retirement

• Once you reach a balance threshold,

you can invest your HSA dollars

It’s not just for doctor

visits and prescriptions

• Use it to pay for vision exams,

eyeglasses, dental exams, hearing

aids, long-term care and more

For more information about opening an HSA, visit whyuhc.com/shbp.

Earn and save with your UnitedHealthcare plan

Whichever plan you choose, you can earn points and a reward card to reduce your costs. (See page 12 for more information.)

• With the HDHP plan, you’ll need to meet a minimum deductible threshold before the points you earn are automatically

used to reimburse you the cost of eligible medical and pharmacy expenses.**

• With the Choice HMO plan, the points you earn are automatically used to reimburse you the cost of eligible medical

and pharmacy expenses.

*The plans pay 100% of covered services provided by network providers that are properly coded as “preventive care” within the meaning of the Affordable Care Act (ACA).

**Be Well SHBP, the SHBP well-being program, is administered by Sharecare.

***Please note that each individual family member cannot contribute more than their own individual deductible and out-of-pocket maximum to the overall family deductible and out-of-pocket maximum.

*Be Well SHBP, the SHBP well-being program, is administered by Sharecare.

**For members enrolled in the HDHP, well-being credits cannot be used until the $1,650 (employee) or $3,300 (employee + spouse, employee + child(ren) or employee + family) threshold has been met.

You and your covered

spouse each can earn up

to 480 well-being credits

by completing Be Well

SHBP* activities

Apply these credits

to eligible medical and

pharmacy expenses such

as a co-pay, deductible or

co-insurance payment

After you’ve completed the Be

Well SBHP wellness activities

and redeemed your credits,

United Healthcare will give

each of you a $250 reward card

480

well-being

credits for

you

480

well-being

credits for your

spouse

$250

reward card

for you

$250

reward card

for your

spouse

$1,460

in potential

savings

State Health Benefit Plan (SHBP) | 2025 Benefits Options

*After the deductible.

Select generics, listed on the Federal Preventive Drug List, can be obtained for a co-insurance fee without having to meet the deductible first.

This information is a general description of your coverage. It is not a contract and does not replace the official benefit coverage documents, which may include a Summary Plan Description. If descriptions, percentages

and dollar amounts in this guide differ from what is in the official benefit coverage documents, the official benefits coverage documents prevail.

This policy has exclusions, limitations and terms under which the policy may be continued in force or discontinued. This outline is intended as a summary only. For a detailed description of the benefits available,

please refer to the official plan documents.

The UnitedHealthcare plan with Health Savings Account (HSA) is a high deductible health plan (HDHP) that is designed to comply with IRS requirements so eligible enrollees may open an HSA with a bank of their

choice or through Optum Bank, Member of FDIC. The HSA refers only and specifically to the Health Savings Account that is provided in conjunction with a particular bank, such as Optum Bank, and not to the

associated HDHP.

2025 SHBP benefits at a glance

For more coverage details for each of these plans, please visit

whyuhc.com/shbp or call 888-364-6352.

*After the deductible.

**Amount assumes member has earned and redeemed 480 points through the UnitedHealthcare HIA.

***For members enrolled in the HDHP, credits cannot be used until the $1,650 (employee) or $3,300 (employee + spouse, employee + child(ren), or employee + family) threshold has been met. Amount also

assumes member has earned and redeemed 480 points through the UnitedHealthcare HIA.

please refer to the official plan documents.

Choice HMO

HDHP with HSA

Medical

Network

Earned

well-being

credits reduce

cost to:**

Network

Earned

well-being

credits reduce

cost to:***

Out-of-

network

Earned

well-being

credits reduce

cost to:***

Deductible

You

$1,300

$820

$3,500

$3,020

$7,000

$6,520

You + child(ren)

$1,950

$1,470

$7,000

$6,520

$14,000

$13,520

You + spouse

$1,950

$990

$7,000

$6,040

$14,000

$13,040

You + family

$2,600

$1,640

$7,000

$6,040

$14,000

$13,040

Out-of-pocket maximum

You

$4,000

$3,520

$6,450

$5,970

$12,900

$12,420

You + child(ren)

$6,500

$6,020

$12,900

$12,420

$25,800

$25,320

You + spouse

$6,500

$5,540

$12,900

$11,940

$25,800

$24,840

You + family

$9,000

$8,040

$12,900

$11,940

$25,800

$24,840

Earned well-being incentive credit maximums

Your earned well-being incentive credits reduce your out-of-pocket costs by:

You – 480 | You + child(ren) – 480 | You + spouse – 960 | Family – 960

Co-insurance (plan pays)

80%

70%

50%

Covered services

Preventive care services

When provided by network providers and

properly coded as “preventive care” within the

meaning of the Affordable Care Act (ACA)

100%

Not covered

Non-preventive diagnostic colonoscopy

and mammogram

100%

100%*

Not covered

Eye exam – routine (limited to 1 exam every

24 months; no out-of-network coverage)

Dilated retinal eye exams for those with

diabetes covered 100%

100%

Not covered

Routine maternity care physician services

(prenatal, delivery and postpartum)

100%

70%*

50%*

Non-routine maternity care physician services

(prenatal, delivery and postpartum)

100% after $35 PCP co-pay

$45 specialist co-pay

70%*

50%*

PCP, specialist or clinic office visits

(treatment of illness or injury)

100% after $35 PCP co-pay

$45 specialist co-pay

70%*

50%*

Urgent care visit

100% after $35 co-pay

70%*

50%*

Emergency room (treatment of an

emergency medical condition or injury)

100% after $200 co-pay

(waived if admitted)

70%*

24/7 Virtual Visits

100% after $35 PCP co-pay

70%*

Not covered

Telemedicine

100% after $35 PCP co-pay

$45 specialist co-pay

70%*

50%*

Choice HMO

HDHP with HSA

Medical

Network

Out-of-

network

Ambulance (emergency only)

100%

70%*

Outpatient surgery

80%*

70%*

50%*

Hospital services (inpatient/outpatient facility/

outpatient professional)

80%*

70%*

50%*

Hospital services (inpatient professional)

100%*

70%*

50%*

Outpatient rehabilitation – physical, speech,

occupational, cardiac, pulmonary therapy

(40 visits per therapy per plan year)

100% after $25 co-pay

70%*

50%*

Chiropractic visit ‒ spinal manipulation only

(20 visits per plan year)

100% after $45 co-pay

70%*

50%*

Hearing – exam and fitting (office visit)

Hearing aid exam:

$35 PCP co-pay

$45 specialist co-pay per visit,

then 100% of eligible expenses

70%*

50%*

Hearing aid allowance

• Children (up to age 19) ‒

($3,000 per hearing-impaired ear/4 years)

• Adult ‒ ($1,500 max/5 years)

Hearing aid: 100%

Up to 4-year benefit maximum

for children and 5-year benefit

maximum for adults

Hearing aid: 100%*

Up to 4-year benefit maximum

for children and 5-year benefit

maximum for adults

Hearing aid: 100%*

Up to 4-year benefit maximum

for children and 5-year benefit

maximum for adults

Behavioral health

Mental health and substance use disorder

inpatient and outpatient facility, and

residential treatment centers

NOTE: Prior approval required

80%*

70%*

50%*

Mental health/substance use

(inpatient professional)

100%*

70%*

50%*

Mental health/substance use disorder

outpatient visits (professional and

methadone clinics)

100% after $35 co-pay

$10 co-pay for group/

family therapy

70%*

50%*

Pharmacy – administered by

CVS Caremark™

Retail pharmacy (up to a 31-day supply)

Tier 1 – $20

Tier 2 – $50

Tier 3 – $90

70%*

90-day mail order

Tier 1 – $50

Tier 2 – $125

Tier 3 – $225

70%*

Earn a $250

reward card ($500

per household) from

UnitedHealthcare for

completing healthy

activities.

State Health Benefit Plan (SHBP) | 2025 Benefits Options

Type of cost

Choice HMO

HDHP with HSA

4 sick visits to PCP

$140 co-pay

$640

3 preventive care visits

$0 co-pay

3 urgent care visits

$105 co-pay

$540

2 specialist visits

$90

$800

Emergency room visit

$200

$2,400

6 Tier 1 medications

$120

$180

Total cost before

deductible reached

$655

Deductible is $2,600

$4,560

Deductible is $7,000

Well-being credits

cost reduction*

(960 well-being credits)

(960 well-being credits

after meeting the

$3,300 threshold**)

UnitedHealthcare Rewards Cards

Two cards at $250 each

for a total of $500

Two cards at $250 each

for a total of $500

• Michelle and her husband complete the Be Well SBHP activities and each earn

480 well-being credits for a total of 960 credits

• The family’s 960 well-being credits automatically reimburse Michelle for the

cost of eligible medical and pharmacy bills

• Michelle and her covered spouse each receive a $250 reward card (for a total of

$500) from UnitedHealthcare

How Michelle pays $655 in medical expenses

Member scenarios

These member scenario examples walk you through different health care situations and estimated health

care costs, not including premiums.

John

Single coverage

• John is 27 years old, single and in

good health

• He’s looking for a plan with low

monthly premium payments

• The chart below shows how he uses

care and an estimate of what it may

cost him with each plan

• He decides to enroll in the HDHP

with HSA plan

Michelle

Employee plus family coverage

• Michelle is 45 years old, married

and has two children

• She’s interested in a family plan that

will help with her family’s care needs

— including diabetes and asthma

• Michelle considers her out-of-pocket

medical costs and reviews the

plan deductibles and the premiums

for 2025

• The chart below shows how the

family uses care and an estimate of

what it may cost with each plan

• She realizes that while the deductible

is less with the Choice HMO, the

monthly premium is higher than it is

for the HDHP with HSA

• Michelle decides that if she signs up

for a Diabetes Disease Management

Program and qualifies for a Co-pay/

Co-insurance Waiver Program, she

could save money on her diabetes

medications

• She decides to enroll in the

Choice HMO

Have questions?

If you want to talk to someone about your own coverage scenario, call 888-364-6352.

Type of cost

Choice HMO

HDHP with HSA

Preventive care visit

$0 co-pay

Emergency room visit

$200 co-pay

$1,150

3 therapy visits

$75 co-pay

$450

Tier 1 medication

$20 co-pay

$150

Total cost before

deductible reached

$295

Deductible is $1,300

$1,750

Deductible is $3,500

Well-being credits cost reduction*

(480 well-being credits)

(480 well-being credits

after meeting the

$1,650 threshold**)

UnitedHealthcare Reward Card

$250

John saves with the HDHP with HSA plan

• Because he has a low premium with the HDHP with HSA plan, John uses his

premium savings to fund his HSA so he is prepared for health care expenses now

or in the future.***

• John completes the Be Well SHBP activities and earns his 480 well-being credits.

• His medical expenses clear the $1,650 threshold, so he can apply part of his

480 well-being credits toward his eligible medical bills.

• After redeeming his well-being credits, John receives a $250 reward card from

UnitedHealthcare.

How John pays $1,750 in medical expenses

John’s HSA balance

John’s HSA contribution***

$2,400

Withdrawal for medical expenses

$1,650

HSA balance that will roll over to next year

$750

*Assumes member has earned and redeemed 480 points through the UnitedHealthcare HIA.

** For members enrolled in the HDHP, well-being credits cannot be used until the $1,650 (employee) or $3,300 (employee + spouse, employee + child(ren), or employee + family) threshold has been met.

*** Voluntary pretax employee HSA contributions can be used to pay for qualified medical, dental, vision and prescription drug expenses, including certain over-the-counter drugs and medications, as defined

in IRS Publications 502 and 969. And the HSA rolls over from year to year, so it can continue to grow to be used in the future — even into retirement.

*Assumes member has earned and redeemed 480 points through the UnitedHealthcare HIA.

**For members enrolled in the HDHP, well-being credits cannot be used until the $1,650 (employee) or $3,300 (employee + spouse, employee + child(ren), or employee + family) threshold has been met.

$1,650

from his

HSA

100

well-being

credits

$1,750

960

well-being

credits

Applied

to $655 in

eligible medical

expenses

305

well-being

credits

remain

John receives his $250 UnitedHealthcare Reward Card

Michelle & her spouse receive $500 in UnitedHealthcare

Reward Cards ($250 each)

State Health Benefit Plan (SHBP) | 2025 Benefits Options

What you need to do

What you can earn

Assess your health — complete the RealAge Test

120 points

Know your numbers with a biometric screening

+ 120 points

Take action

Take action with the Coaching Pathway, Online Pathway, Preventive Screening Exams

or a combination of all three.

+ 240 points

Total

= 480 points

Earn your UnitedHealthcare reward

When you and your covered spouse complete Be Well SHBP** wellness activities and redeem

your points, UnitedHealthcare will reward you by sending you each a $250 reward card.

+ $250

reward card

*No fee/expiry. One Reward Card each per member and covered spouse.

**Be Well SHBP, the SHBP well-being program, is administered by Sharecare.

Take these steps to earn

You and your covered spouse can each earn a $250 reward card*

($500 per household) from UnitedHealthcare. Here’s how:

• When you choose a UnitedHealthcare HMO or HDHP, you and your

covered spouse are each eligible to earn up to 480 points to use

toward eligible medical and pharmacy expenses by completing the

activities under Be Well SHBP**

• Because achieving your best health is an important personal goal,

UnitedHealthcare will also reward you with a $250 reward card when

you complete your Be Well SHBP** activities and redeem all 480 points

in the Sharecare Redemption Center

• To qualify for points with the Be Well SHBP** well-being program and

the UnitedHealthcare reward card, you must complete the activities

listed below between January 1, 2025, and December 1, 2025

Earn a $250

reward card ($500

per household) from

UnitedHealthcare.

Choose from two options to redeem points

There are two ways to redeem points earned in 2025

through the Sharecare Redemption Center:

• 480 well-being credits applied toward eligible medical

and pharmacy expenses in your UnitedHealthcare HIA

• A $150 Prepaid Visa® Card (all 480 points earned in 2024

needed for redemption)

Regardless of how you redeem your 480 points through the

Sharecare Redemption Center, UnitedHealthcare will reward

you and your covered spouse with a $250 reward card.

Rollover credits

All unused well-being incentive credits earned in 2024 will

automatically roll over to your 2025 plan option. SHBP

will deposit your unused credits in the incentive account

associated with your 2025 plan selection in April 2025. If

you remain with the same medical claims administrator and

in the same plan option in which you were enrolled in 2024,

rollover credits will be available January 1, 2025.

For details or questions, go to

BeWellSHBP.com or call 888-616-6411.

Quick-care options

Needs or symptoms

Cost

24/7 NurseLine

Call the number on your health

plan ID card for expert advice

• Deciding where to

get medical care

• Finding a provider

or hospital

• Health and wellness help

• Getting answers to

questions about medicines

additional

cost

PCP

Office or telemedicine visit via

provider’s platform

• Checkups

• Immunizations

• Minor illnesses

• Minor injuries

• Ongoing care for

conditions like asthma,

diabetes and more

24/7 Virtual Visits

Online doctor visits anytime,

anywhere via myuhc.com

or the UnitedHealthcare app

• Bladder infections

• Bronchitis

• Colds/flu

• Fevers

• Pink eye

• Sinus problems

Convenience care clinic

Nearby treatment

• Earaches

• Flu shots

• Minor injuries

• Skin rashes

Urgent care center

Quicker after-hours care

• Infections (e.g., skin,

eye, ear/nose/throat,

genital-urinary)

• Low back pain

• Minor injuries

(e.g., burns, stitches,

sprains, fractures)

• Respiratory issues (e.g.,

coughs, pneumonia,

asthma)

• Stomach issues (e.g.,

pain, vomiting, diarrhea)

$$$

Emergency room (ER)

For serious, immediate needs

• Chest pain

• Kidney stones

• Major burns

• Severe asthma attacks

• Severe injuries

• Shortness of breath

$$$$

Know where to go

When you need care,

call your PCP first

They have easy access to your records, know the bigger picture

of your health and may even offer same-day appointments.

If you can’t see them, it’s helpful to know your quick-care options

so you can find the right care and avoid financial surprises.

State Health Benefit Plan (SHBP) | 2025 Benefits Options

24/7 Virtual Visits

When you need care quickly, a 24/7 Virtual Visit is a

convenient way to help you start feeling better faster. Video

chat with a doctor on myuhc.com or the UnitedHealthcare

app* from the comfort of home. Doctors can diagnose

a wide range of medical conditions and even prescribe

medications, if needed.**

Commonly diagnosed and treated nonemergency medical

conditions include:

• Allergies

• Bladder infection/

urinary tract infection

• Bronchitis

• Cold/flu

• Fever

• Pink eye

• Sinus problems

• Sore throat

Use 24/7 Virtual Visits when:

• You are considering visiting a hospital emergency room

• Your doctor is not available

• You become ill while traveling

To get started, go to uhc.com/virtualvisits.

Network provider telehealth

Your PCP is the doctor who knows you best, yet office visits

aren’t always the most convenient. These are virtual visits

that save you the trouble of visiting your doctor in person.

Telehealth visits let you see any network provider who offers

a telehealth option.

• Video chat with a network provider of your choice —

including PCPs, specialists, behavioral health providers

and physical therapists

• The technology used to access the virtual visit is

determined by the provider, not UnitedHealthcare

Reach a nurse 24/7

NurseLine provides information from registered nurses

who are here to help guide your health care decisions. Get

immediate answers to your questions anytime, anywhere — at

no extra cost. Call 888-364-6352.

Virtual mental health care

Need a quicker, convenient way to get mental health

care? Virtual therapy offers confidential counseling from

a licensed therapist with private video sessions. So, you

can receive caring support from the privacy of home and

the convenience of your mobile device or computer. These

visits have a similar standard of care as in-person visits, and

you can see the same therapist with each appointment to

establish an ongoing relationship. Virtual therapy may also

be a great way for children and teens to get an appointment.

Virtual therapy is designed to help treat conditions like:

• ADD/ADHD

• Addiction

• Anxiety

• Depression

• Mental health disorders

Get started at myuhc.com > Virtual Care > Virtual Behavioral

Health Care

Get care from anywhere

*Data rates may apply.

**Certain prescriptions may not be available, and other restrictions may apply.

Download the app

Through myuhc.com and the UnitedHealthcare app,

you have easy access to tools to help you:

• Find care and compare costs for providers and

services in your network

• Connect with providers through 24/7 Virtual Visits

by phone or video to discuss common medical

conditions and get prescriptions, if needed**

• Check your plan balances and view your claims

• View your health plan ID card and download it to

your digital wallet

• View your HSA balance

• And more

Get the care you need

Regular preventive care is covered 100% by your health

plan when you see a network doctor.

Covered services include:

• An annual exam

• Cancer screenings

• Child and adult immunizations — including flu shots

and COVID-19 vaccines

• Cholesterol and blood pressure screenings

• Pap tests and mammography for women

• Prostate screenings for men

To see which preventive care screenings you need and

what’s covered, visit uhc.com/preventivecare.

Preventive vs. diagnostic care —

know the difference

Preventive care includes annual checkups, routine

screenings and immunizations that can help prevent health

problems before they even start. Diagnostic care includes

treatments for symptoms or existing health conditions. While

preventive care appointments are covered at 100% with both

the Choice HMO Plan and the HDHP, diagnostic treatments

performed during your preventive exam may cost extra.

Outpatient diagnostic services are covered at 100% with the

Choice HMO Plan.

These guidelines are provided for informational purposes only and do not constitute medical advice. Individuals with symptoms or at high risk for disease may need additional services or more frequent interventions.

Discuss with your doctor how these guidelines may be right for you, and always consult your doctor before making any decisions about medical care. These guidelines do not necessarily reflect the vaccines, screenings

or tests that will be covered by your benefit plan. Always refer to your plan documents for specific benefit coverage and limitations or call the toll-free member phone number on the back of your medical plan ID card.

*For a full list of recommended screenings by age and gender, plus tips on how to prepare for your visit and more, go to uhc.com/preventivecare.

**SHBP covers as a preventive screening starting at age 18.

Years of age

75+

Annual physical

Blood pressure screening

Cholesterol screening

Colorectal screening

Diabetes screening

Lung cancer screening

Breast cancer screening

(mammogram)

Cervical cancer screening,

including Pap smear

Recommended preventive screenings*

Men and women

Women only

Prioritize preventive care

Your body needs regular maintenance. Preventive care can help you catch health problems early

when they’re easier and less costly to treat.

Every year

At each annual physical

Every year

Ask your doctor about screening methods and intervals**

Every year**

Every year for those 50 to 80,

as recommended by your doctor

Every 1 to 2 years starting at age 40, as recommended by your doctor

Every 3 years for ages 21–65

Looking for a doctor?

Find one at myuhc.com or call the dedicated

advocate team at 888-364-6352, TTY 711.

State Health Benefit Plan (SHBP) | 2025 Benefits Options

Helping you

stay healthy

Support for managing chronic or

catastrophic conditions

If you or a loved one has a chronic health condition or has

experienced a catastrophic health event, you probably have

questions. A dedicated, personal nurse can help you and

your family explore care options and provide additional

support and resources for more than 100 chronic conditions

including the following conditions:

• Asthma

• Cancer

• COPD

• CAD

• Diabetes

• Heart failure

• Kidney disease

Personalized guidance

throughout your pregnancy

If you’re thinking about having a baby, or already have one

on the way, maternity support is here to provide information

and resources. Start by taking a maternity support

assessment, which only takes minutes to complete. You’ll

get 24/7 access to seven online maternity courses covering

topics from preconception through postpartum.

Based on your responses, a maternity nurse may reach out

to you and connect you with the care you need, answer your

questions and support you every step of the way.

New!

Flexible fitness options

Being healthy shouldn’t be a grind. It should involve trying

new things, pushing yourself to be slightly better than you

were the day before. With One Pass Select®, our mission

is to make being healthy fun for all. No matter your current

fitness level, we have a wide variety of activities to challenge

you. From strength training and swimming, to yoga and

spin classes, you can try new things and push yourself

physically and mentally.

Find your fit with One Pass Select starting at less than

$1 per day.

Access to the nation’s leading

health care facilities

Our Centers of Excellence network provides access to

leading health care facilities, physicians and services to

support safe, specialized and cost-effective care for services

such as transplant and cancer care.

Bariatric Resource

Services

If you are considering surgical treatment for obesity, you need

to make some difficult and important decisions. Among the

most important decisions are which treatment to get and

where to receive it. When you enroll in the Bariatric Resource

Services program, an experienced bariatric nurse will work

with you to help you make informed decisions and find a

Bariatric Center of Excellence for weight-loss surgery with

better outcomes and fewer complications.

Save on condition-related

prescriptions

With the Co-pay/Co-insurance Waiver Program, you

may not have to pay any co-pay or co-insurance for

certain medications. If you are participating in and

meet the requirements of a disease management

program for diabetes, asthma, CAD or medication

addiction treatment, the program may cover co-pays

or co-insurance for certain medications used to treat

that condition. That means you could save up to

hundreds of dollars per year, depending on which

medications you are taking over a 12-month period.

See your health plan documents for details or call us

at 888-364-6352.

*Pre-certification is required. If your child has already been diagnosed with

autism and is receiving treatment, your provider may already be approved.

Support for emotional well-being

From everyday stress to ongoing concerns like anxiety, depression and substance use, you have access to

a wide range of resources and ways to get support. Start by visiting myuhc.com to see all that’s available.

Behavioral health support

Get confidential help in person or virtually from a psychiatrist or therapist for:

• Depression, stress and anxiety

• Substance use and recovery

• Eating disorders

• Parenting and family problems

Calm Health

You may have heard about or even used the Calm Health app. Now you have

access to its most popular features and much more with Calm Health. Available

through your benefits at no additional cost to you, it includes content written by

licensed psychologists.

Work toward well-being goals like:

• Better sleep

• Building skills to manage stress

• Developing resiliency

• Starting and building a mindfulness habit

It’s all self-guided, so you can go at your own pace.

ABA therapy

Applied behavior analysis (ABA) therapy —

included as part of your benefits* — uses

behavioral principles to teach children skills

and behaviors they may not otherwise learn

on their own.

Substance use

treatment

If you or someone you love is

struggling with substance use,

call the Substance Use Treatment

Helpline. It’s available 24/7

as part of your benefits and is

completely confidential — you can

even remain anonymous.

To speak with a recovery advocate,

call 1-855-780-5955 or visit

liveandworkwell.com/recovery to

find care options and resources.

988 Suicide &

Crisis Lifeline

Free and confidential emotional

support 24 hours a day, 7 days a

week for anyone in suicidal crisis

or emotional distress.

Call or text 988. You can also visit

988lifeline.org.

Use the provider search tool to find

therapists, psychiatrists or other behavioral

health clinicians and facilities near you

Check out articles, podcasts,

videos and other tools on topics

you care about

Link to a variety of resources

State Health Benefit Plan (SHBP) | 2025 Benefits Options

If you think you weren’t treated fairly because of your sex, age, race,

color, disability or national origin, you can send a complaint to the Civil

Rights Coordinator:

Mail: UnitedHealthcare Civil Rights Grievance

P.O. Box 30608

Salt Lake City, UT 84130

Online: UHC_Civil_Rights@uhc.com

You must send the complaint within 60 days of when you found out

about it. A decision will be sent to you within 30 days. If you disagree

with the decision, you have 15 days to ask us to look at it again. If you

need help with your complaint, please call the toll-free member phone

number listed on your ID card.

You can also ﬁle a complaint with the U.S. Dept. of Health and

Human Services:

Online: https://ocrportal.hhs.gov/ocr/portal/lobby.jsf

Phone: Toll-free 1-800-368-1019, 1-800-537-7697 (TDD)

Mail: U.S. Dept. of Health and Human Services

200 Independence Avenue SW, Room 509F

HHH Building

Washington, DC 20201

We provide free services to help you communicate with us such

as letters in other languages or large print. You can also ask for an

interpreter. To ask for help, please call the toll-free member phone

number listed on your health plan ID card.

We do not treat members differently because of sex, age, race, color, disability or national origin.

ATTENTION: If you speak English, language assistance services, free

of charge, are available to you. Please call the toll-free phone number

listed on your identiﬁcation card.

ATENCIÓN: Si habla español (Spanish), hay servicios de asistencia

de idiomas, sin cargo, a su disposición. Llame al número de teléfono

gratuito que aparece en su tarjeta de identiﬁcación.

請注意：如果您說中文 (Chinese)，我們免費為您提供語言協助服

務。請撥打會員卡所列的免付費會員電話號碼。

XIN LƯU Ý: Nếu quý vị nói tiếng Việt (Vietnamese), quý vị sẽ được cung

cấp dịch vụ trợ giúp về ngôn ngữ miễn phí. Vui lòng gọi số điện thoại

miễn phí ở mặt sau thẻ hội viên của quý vị.

알림: 한국어(Korean)를 사용하시는 경우 언어 지원 서비스를

무료로 이용하실 수 있습니다. 귀하의 신분증 카드에 기재된 무료

회원 전화번호로 문의하십시오.

PAALALA: Kung nagsasalita ka ng Tagalog (Tagalog), may makukuha

kang mga libreng serbisyo ng tulong sa wika. Pakitawagan ang toll-

free na numero ng telepono na nasa iyong identiﬁcation card.

ВНИМАНИЕ: бесплатные услуги перевода доступны для

людей, чей родной язык является русским (Russian). Позвоните

по бесплатному номеру телефона, указанному на вашей

идентификационной карте.

تنبيه: إذا كنت تتحدث العربية (Arabic)، فإن خدمات المساعدة اللغوية

المجانية متاحة لك. يُرجى الاتصال برقم الهاتف المجاني المدرج على بطاقة

التعريف الخاصة بك.

ATANSYON: Si w pale Kreyòl ayisyen (Haitian Creole), ou kapab

beneﬁsye sèvis ki gratis pou ede w nan lang pa w. Tanpri rele nimewo

gratis ki sou kat idantiﬁkasyon w.

ATTENTION : Si vous parlez français (French), des services d’aide

linguistique vous sont proposés gratuitement. Veuillez appeler le

numéro de téléphone gratuit ﬁgurant sur votre carte d’identiﬁcation.

UWAGA: Jeżeli mówisz po polsku (Polish), udostępniliśmy darmowe

usługi tłumacza. Prosimy zadzwonić pod bezpłatny numer telefonu

podany na karcie identyﬁkacyjnej.

ATENÇÃO: Se você fala português (Portuguese), contate o serviço

de assistência de idiomas gratuito. Ligue gratuitamente para o número

encontrado no seu cartão de identiﬁcação.

ACHTUNG: Falls Sie Deutsch (German) sprechen, stehen Ihnen

kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Bitte

rufen Sie die gebührenfreie Rufnummer auf der Rückseite Ihres

Mitgliedsausweises an.

رایتخا رد ناگیار روط هب ینابز دادما تامدخ ،تسا (Farsi) یسراف امش نابز رگا :هجوت

.دیریگب سامت هدش دیق امش ییاسانش تراک یور هک یناگیار نفلت هرامش اب افطل .دشاب یم امش

ध्यान दें: यदि आप हिंदी (Hindi) बोलते है, आपको भाषा सहायता

सेबाएं, नि:शुल्क उपलब्ध हैं। कृपया अपने पहचान पत्र पर सूचीबद्ध

टोल-फ्री फोन नंबर पर कॉल करें।

DÍÍ BAA’ÁKONÍNÍZIN: Diné (Navajo) bizaad bee yániłti’go, saad bee

áka’anída’awo’ígíí, t’áá jíík’eh, bee ná’ahóót’i’. T’áá shǫǫdí ninaaltsoos

nitł’izí bee nééhozinígíí bine’dę́ę́’ t’áá jíík’ehgo béésh bee hane’í

biká’ígíí bee hodíilnih.

Here’s the fine print

Prepare to enroll

Open enrollment is October 15 - November 8, 2024

We know choosing a health plan can be confusing. We’re here to help you make informed decisions during open enrollment,

including helping you understand your benefits so you and your family can make the most out of them.

Learn more about the HMO and HDHP options, plus the tools and programs included with UnitedHealthcare coverage at no

additional cost. Visit whyuhc.com/shbp.

The UnitedHealth Premium® designation program is a resource for informational purposes only. Designations

are displayed in UnitedHealthcare online physician directories at myuhc.com. You should always visit myuhc.

com for the most current information. Premium designations are a guide to choosing a physician and

may be used as one of many factors you consider when choosing a physician. If you already have a

physician, you may also wish to confer with him or her for advice on selecting other physicians. You

should also discuss designations with a physician before choosing him or her. Physician evaluations

have a risk of error and should not be the sole basis for selecting a physician. Please visit myuhc.com for

detailed program information and methodologies.

The UnitedHealthcare plan with Health Savings Account (HSA) is a high deductible health plan (HDHP)

designed to comply with IRS requirements so eligible enrollees may open a Health Savings Account (HSA)

through Optum Bank®, Member FDIC. The “HSA” refers generally to the UnitedHealthcare HSA product,

which includes an HDHP, although at times “HSA” may refer only and specifically to the UnitedHealthcare

Health Savings Account, provided in conjunction with Optum Bank and not to the associated HDHP. Accounts

are offered by Optum Bank and are subject to eligibility. This communication is not intended as legal or tax

advice. Please contact a competent legal or tax professional for personal advice on eligibility, tax treatment

and restrictions. Federal and state regulations are subject to change. Please check your health benefit plan

materials to determine whether your employer will make supplemental contributions to your HSA.

Certain preventive care items and services, including immunizations, are provided as specified by applicable

law, including the Patient Protection and Affordable Care Act (ACA), with no cost-sharing to you. These

services may be based on your age and other health factors. Other routine services may be covered under

your plan, and some plans may require co-payments, co-insurance or deductibles for these benefits. Always

review your benefit plan documents to determine your specific coverage details.

24/7 Virtual Visits is a service available with a Designated Virtual Network Provider via video, or audio-only

where permitted under state law. Unless otherwise required, benefits are available only when services are

delivered through a Designated Virtual Network Provider. 24/7 Virtual Visits are not intended to address

emergency or life-threatening medical conditions and should not be used in those circumstances. Services

may not be available at all times, or in all locations, or for all members. Check your benefit plan to determine if

these services are available.

The Centers of Excellence (COE) program providers and medical centers are independent contractors

who render care and treatment to health plan members. The COE program does not provide direct health

care services or practice medicine, and the COE providers and medical centers are solely responsible for

medical judgments and related treatments. The COE program is not liable for any act or omission, including

negligence, committed by any independent contracted health care professional or medical center.

One Pass Select is a voluntary program. For self-funded participants nationally, it features a subscription-

based nationwide gym network, digital fitness and grocery delivery service. The information provided under

this program is for general informational purposes only and is not intended to be nor should be construed

as medical advice. Individuals should consult an appropriate health care professional before beginning any

exercise program and/or to determine what may be right for them. Purchasing discounted gym and fitness

studio memberships, digital fitness or grocery services may have tax implications. Employers and individuals

should consult an appropriate tax professional to determine if they have any tax obligations with respect to

the purchase of these discounted memberships or services under this program, as applicable.

The information provided under Maternity Support is for general informational purposes only and is not

intended to be nor should be construed as medical and/or nutritional advice. Participants should consult

an appropriate health care professional to determine what may be right for them. Employers are responsible

for ensuring that any wellness programs they offer to their employees comply with applicable state and/

or federal law, including, but not limited to, GINA, ADA and HIPAA wellness regulations, which in many

circumstances contain maximum incentive threshold limits for all wellness programs combined that are

generally limited to 30 percent of the cost of self-only coverage of the lowest-cost plan, as well as obligations

for employers to provide certain notices to their employees. Employers should discuss these issues with

their own legal counsel.

The UnitedHealthcare® app is available for download for iPhone® or Android®. iPhone is a registered

trademark of Apple, Inc. Android is a registered trademark of Google LLC.

Apple, App Store and the Apple logo are trademarks of Apple Inc., registered in the U.S. and other

countries. Google Play and the Google Play logo are registered trademarks of Google Inc.

Administrative services provided by United HealthCare Services, Inc. or their affiliates.

Questions?

Call us at 888-364-6352, TTY 711.

Ready to enroll?

Getting started is easy. Just visit

mySHBPga.adp.com.

State Health Benefit Plan (SHBP) | 2025 Benefits Options

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