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
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
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
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.
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.
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%
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%
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%*
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
Network
Out-of-
network
Ambulance (emergency only)
100%
70%*
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%*
70%*
90-day mail order
Tier 1 – $50
Tier 2 – $125
Tier 3 – $225
70%*
70%*
Earn a $250
reward card ($500
per household) from
UnitedHealthcare for
completing healthy
activities.
State Health Benefit Plan (SHBP) | 2025 Benefits Options
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
$0
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
$0
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
$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)
11
State Health Benefit Plan (SHBP) | 2025 Benefits Options
10
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
No
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.
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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
18
25
30
35
40
45
50
55
60
65
70
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.
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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
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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.
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