Employee forms can be faxed to our office at (303) 721-1085. Please confirm that application was received by calling (303) 721-1145. Please call with any questions regarding eligibility or waiting periods.

Current Plans 1-1-2012

Plan
Office Visit Copay
In-Network Deductible
In-Network Coinsurance Rate
$25/$50

$500
20%
$25/$50
$1000
20%
$30/$60
$1000
30%
$25/$50
$1500
20%
$25/$50
$2000
30%
$30/$60
$2000
30%
$30/$60
$3000
30%
$30/$60
$5000
0%
Ded & Coins.
$2000
20%
Ded & Coins
$3500
0%
Ded & Coins
$5000
0%
Ded & Coins
$3000
20%
$30/$60
$5000
0%
$25/$50
$1000
20%
$30/$60
$1000
20%
$30/$60
$1500
20%
$30/$60
$2000
20%
$30/$60
$2000
20%
$35/$70
$2500
30%
$35/$70
$500
20%
$35/$70
$1000
20%
$35/$70
$2000
30%
$25/$50
$2000
20%
$30/$50
NA
NA
$40/$60
NA
NA
$30/$50
$1500
20%
$40/$60
$4000
30%
 
Old/Discontinued Plans prior to 1-1-2011
$30/$60
$3000
0%
Ded & Coins.
$2000
0%
Ded & Coins
$2850
0%
 
 
 
 
 
Old/Discontinued Plans prior to 1-1-2011
$25/$50
$2000
20%
$30/$60
$3000
20%
Ded & Coins.
$2000
20%
Ded & Coins.
$3000
20%
C2I (discontinued)
$25/$50
$2500
0%
C2J (discontinued)
$25/$50
$250
10%
$25/$50
$500
20%
$25/$50
$1000
20%
C2M (discontinued)
$25/$50
$1500
20%
C2N (discontinued)
$25/$50
$2500
20%
$25/$50
$1000
30%
C2P (discontinued)
$25/$50
$1500
30%
C2Q (discontinued)
$25/$50
$2000
30%
C2R (discontinued)
$25/$50
$2500
30%
$30/$60
$1000
30%
$30/$60
$1500
30%
$30/$60
$2000
30%
$30/$60
$3000
30%
$30/$60
$5000
30%
$30/$60
$3000
0%
$30/$60
$4000
0%
$30/$60
$5000
0%
1EB (discontinued)
$25/$50
$8000
20%
1EG (discontinued)
$25/$50
$3000
20%
2EA (discontinued)
$25/$50
$3000
20%
$25/$50
$1000
30%
$25/$50
$1000
20%
$25/$50
$1000
20%
$30/$60
$1000
20%
$30/$60
$1500
20%
$30/$60
$2000
20%
$35/$70
$2500
30%
Ded & Coins.
$2000
20%
Ded & Coins.
$2850
20%
Deductible
$2000
0%
Deductible
$2850
0%
Deductible
$5000
0%
$30/$60
$2000
0-30%
$30/$60
$1000
0-30%
$30/$60
$1000
0-20%
$30/$60
$1500
0-30%
Deductible
$1500
0-40%
Deductible
$2000
0-40%
$25/$40
$1500
20%
$40/$60
$4000
30%
$25/$40
$0
NA
$40/$60
$0
NA
Plan
Office Visit Copay
In-Network Deductible
In-Network Coinsurance Rate

1A-L
$25/$50
$250
10%
$25/$50
$500
20%
$25/$50
$1000
0%
$25/$50
$1000
20%
$20/$35
$1000
30%
$25/$50
$1000
30%
$25/$50
$1500
0%
$25/$50
$1500
20%
$25/$50
$1500
30%
Deductible
$2000
0%
$25/$50
$2000
0%
$25/$50
$2000
20%
$25/$50
$2000
30%
$25
$2000
30%
$25/$50
$2500
0%
$25
$2500
20%
$25/$50
$2500
30%
$25/$50
$3000
0%
Deductible
$3000
0%
$30
$3000
20%
$25/$50
$3000
30%
$25/$50
$4000
0%
$25/$50
$5000
30%
$25/$50
$5000
0%
$30/$60+30%
$1000
0%
$30/$60+30%
$1500
0%
$30/$60+30%
$2000
0%
$30/$60+40%
$1000
20%
$30/$60+40%
$1500
20%
$30/$60
$2000
20%
$30/$60
$1000
20%
$25/$50*
$8000
20%
$25/$50*
$8000
20%
$25/$50*
$3000
20%
$25/$50*
$3000
20%
$25/$50*
$3000
20%
$25/$50*
$3000
20%
$25/$50
$3000
20%
Deductible
$2000/$4000
0%
Deductible
$2850/$5700
0%
Deductible
$3500/$7000
0%
Deductible
$5000/$10,000
0%
Deductible & Coins.
$2000/$4000
20%
Deductible & Coins.
$2850/$5600
20%
Dental Plan Grid      
Vision Plans      

 

 

Dental Plan Descriptions

 

For comparison of all United Healthcare dental plans, click here.