California

Benefits Documents

2026 Benefits

2026 Benefits Brochure 

2026 OE Flyer Changes 

2026 Premium Discount Form

Domestic Partner Declaration

Medical Provider Search (Pre-Member)

Merchants SmartID Theft

Quit for Life

 

 
Summary of Benefits & Coverage


2026 HMO Summary

2026 PPO Plan Summary

2026 PPO HDHP Summary 

2026 HMO SBC

2026 PPO SBC

2026 PPO HDHP SBC


Supplemental Benefits

Accident - $50 Wellness

Accident Benefit Summary Bi-Weekly

Accident Benefit Summary Semi-Monthly

Beneficiary Designation for Life Insurance

Benefit Assist Flier

Critical Illness- $50 Wellness

Critical Illness Benefit Summary Bi-Weekly

Critical Illness Benefit Summary Semi-Monthly

EOI ALL States other than NJ and NY

EOI NJ

EOI NY

Hospital Indemnity Benefit Summary Bi-Weekly

Hospital Indemnity Benefit Summary Semi-Monthly

Life- Value Added Services

LTD Employer Paid Summary

Class 3- Bi-Weekly Life Benefit Summary

Class 3- Semi-Monthly Life Benefit Summary

STD Buy-up Summary Bi-Weekly

STD Employer Paid Summary

UHC STD Buy-up Summary Semi Monthly

High Deductible Health Plan Overview

How Does an HDHP Work?
Health Savings Account (HSA)

Optum HSA User Guide

2026 HSA Election Form

2025 HSA Election Form


Flexible Savings Account (FSA)

2026 Flores Debit Card info flyer

2026 Flores Health FSA flyer

2026 Flores Limited FSA flyer

2026 Flores Dependent Care FSA flyer



How to Select the Medical Plan
that's Right For You


Life Stage Medical Plan Considerations

Dental & Vision Benefits

2025-2026 Dental ENDP Benefit Summary

2025-2026 Dental ENDP Welcome Guide

2026 Dental PPO Benefit Summary 

Dental ID Cards

Vision Benefit Summary

Vision ID Cards

How to look up a UHC Dental and Vision provider

Employee Assistance Program 

EAP- Member Assistance Program

Compliance

2026 Compliance Packet
Pharmacy (Rx)

Vital Medication Program List

HDHP-HSA Core Plus Preventive List

All plans 4 tier Essential Drug List

Pharmacy Home Delivery ORDER FORM

Pharmacy Home Delivery Overview

Pharmacy Search Online Essential 4 Tier

Vital Medication Program Member Flyer

UHC Program Flyers

Activate Your myuhc.com Account 

Disabled Dependent Child Certification Form 4-2023 Version - PDF Fillable

MyUHC Member Flyer

One Pass Select Fitness Program

Quit for Life

Transition of Care and Continuity of Care form

UHC Rewards Wellness Program

UHC Rewards FAQ (help on how to link device)

UHC Welcome Brochure

UnitedHealthcare App

Virtual Visits 24-7

Virtual Visit Flyer

Value Adds (Will Prep Beneficiary Services, Travel Assist)

Claims Forms

Accident, Critical Illness, and Hospital Indemnity Claim Form
UHC Life Claim Form

UHC LTD Claim Form

UHC STD Claim Form

Wellness Benefit Claim Form for Accident Insurance

Wellness Benefit Claim Form for Critical Illness Insurance

Wellness Benefit Claim Form for Hospital Indemnity

Portability & Conversion

Hospital Indemnity Request for Portability Form

Accident Insurance Request for Portability Form

Critical Illness Request for Portability Form

Life Portability Form

Life Portability Flyer

Life Conversion Form

Life Conversion Flyer

Individual Life Conversion Form