Cover Page

Page numbers referenced within this brochure apply only to the printed brochure

UnitedHealthcare Insurance Company, Inc.

www.uhcfeds.com
Customer Service: 877-835-9861

2023



IMPORTANT:
  • Rates
  • Changes for 2023
  • Summary of Benefits
A High Deductible Health Plan with Health Savings Account

This plan's coverage qualifies as minimum essential coverage and meets the minimum value standard for the benefits it provides. See page (Applies to printed brochure only)  for details. This plan is accredited. See page (Applies to printed brochure only).

Serving all of the following states: Alabama, Arizona ( Phoenix and Tucson), Arkansas, Colorado, District of Columbia, Florida, Iowa, Kentucky, Louisiana, Maryland, Mississippi, Nevada, North Carolina, Oregon, Pennsylvania, Tennessee, Virginia, Washington

Enrollment in this Plan is limited. You must live or work in our Geographic service area to enroll. See page 15 for specific geographic information /requirements.

Enrollment codes for this Plan:

Southeast: Alabama, Arkansas, Florida, Louisiana, Mississippi, North Carolina, & Tennessee

LS1 Self Only, LS3 Self Plus One, LS2 Self and Family

Central: Iowa, Kentucky

N71 Self Only, N73 Self Plus One, N72 Self and Family

West: Arizona (Phoenix and Tucson), Colorado, Nevada, Oregon, Washington State

LU1 Self Only, LU3 Self Plus One, LU2 Self and Family

Northeast - District of Columbia, Maryland, Pennsylvania, Virginia

V41 Self Only, V43 Self Plus One, V42 Self and Family

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