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Colorado Commercial Health Plans

The following Commercial Health Plans are offered in Colorado. Open the section below to view more information.

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All Savers®

The All Savers® Alternate Funding Plans are self-funded health plans that can help employees pay everyday health care expenses before they meet their deductible. Employers can also purchase UnitedHealthcare dental and vision plans and fully insured group life insurance.

  • A health savings account (HSA) may be available to pay for qualifying medical expenses, including the annual deductible.
  • The UnitedHealthcare Motion™ program provides a financial reward (in the form of a reimbursement for out-of pocket medical expenses or an HSA deposit) for meeting daily activity goals. The UnitedHealthcare Motion program is not available in all states.

Members with All Savers Plans have access to the UnitedHealthcare® Choice, UnitedHealthcare Choice Plus and UnitedHealthcare Core networks with the exception of Mayo Clinic facilities.

All Savers Insurance Company (ASIC) is a UnitedHealthcare company.

To check member eligibility and claims status for a patient enrolled in an All Savers Plan, go to provider-allsavers.optum.com/.

Surest is a UnitedHealthcare company that administers health plans without deductibles or coinsurance. Members have access to the nationwide UnitedHealthcare and Optum® Behavioral Health networks and can check costs and care options in advance.

If you participate in UnitedHealthcare commercial plans, you automatically participate in Surest benefit plans at the existing commercial reimbursement rates per your participation agreement.

A small number of members have the Surest Flex plan, which includes the feature of flexible coverage. For a fixed list of plannable tests, procedures or treatments, the member must activate coverage at least 3 business days in advance of the service, or the member may not have coverage for the service.

Claims: Please send claims to us electronically using Surest Payer ID 25463 or by mail to Surest, P.O. Box 211758, Eagan, MN 55121. Include the subscriber ID and rendering address on the claim to help us confirm the copay/member price. Check the status of your claims in the UnitedHealthcare Provider Portal.

Eligibility and benefits: To check member eligibility and benefits, visit the provider portal or call Surest Provider Services at 844-368-6661. If you’re requesting information about a dependent, we’ll need the subscriber ID.

Variable copays: You can receive variable copay information through electronic data interchange (EDI) 270/1 transaction responses. For more information, see the 270/271 EDI Surest guide and Digital Solutions page.

For more information, please visit UHCprovider.com/surest.

UnitedHealthcare Charter health plans encourage members to use their primary care provider (PCP) to coordinate care across a wide spectrum of health services and enter electronic referrals to network specialists. The UnitedHealthcare Charter network is narrowed in states where the product is sold.

  • UnitedHealthcare Charter members must receive a referral from their PCP to see a network specialist for services to be covered. There is out-of-network coverage for emergency services only.
  • UnitedHealthcare Charter Balanced members may see a network specialist at a reduced benefit level when there is no referral. There is out-of-network coverage for emergency services only.
  • UnitedHealthcare Charter Plus members may see a network specialist at a reduced benefit level when there is no referral.  Charter Plus also provides out-of-network coverage.

Changes to PCP selection are permitted once per month. Changes submitted on or before the 31st of the month will be effective on the first day of the following month.

Tools & Resources

The UnitedHealthcare Choice and Choice Plus health plans allow members to choose a physician or specialist from the UnitedHealthcare Choice networks but do not need a referral to receive benefits.

  • UnitedHealthcare Choice members must receive care from network care providers for benefits to be covered. There is out-of-network coverage for emergency services only.
  • UnitedHealthcare Choice Plus members are covered at a lower benefit level for services provided by out-of-network care providers.

Preventive care, including immunizations and preventive exams and health screenings, is covered at 100 percent in our UnitedHealthcare Choice and UnitedHealthcare Choice Plus networks.

UnitedHealthcare Choice Advanced health plans allow members to choose a physician or specialist in the UnitedHealthcare Choice networks and do not need a primary care physician or referral to receive benefits. There is out-of-network coverage for emergency services only.

  • UnitedHealthcare Choice Advanced members must receive care from network care providers for benefits to be covered. Members are encouraged to choose lower cost, freestanding network health care facilities rather than hospitals for radiology services and outpatient surgery.
  • UnitedHealthcare Choice Advanced Plus members are encouraged to seek care from the network care providers but don’t need a referral to receive benefits; members are covered for out-of-network care provider visits at a lower benefit level.

UnitedHealthcare Choice Advanced members have lower copays and/or greater coinsurance when they use Tier 1 UnitedHealth Premium® Care Physicians.

UnitedHealthcare Choice Advanced and UnitedHealthcare Choice Advanced Plus build on Choice and Choice Plus plans with additional features for both members and employers.

UnitedHealthcare® Core and Core Essential

UnitedHealthcare Core health plans allow members to choose a network physician or specialist without a referral (open access). The UnitedHealthcare Core network is narrowed in some states.

  • UnitedHealthcare Core Essential members must receive care from network providers for benefits to be covered.
  • UnitedHealthcare Core plans cover out-of-network providers at a lower benefit level.

An array of health and wellness resources are available to members including the Online Health Assessment, Personal Health Record and Online Health Coaching modules.

Tools & Resources

UnitedHealthcare Doctors Plan is a new open access commercial benefit plan that was developed as a partnership between UnitedHealthcare and some of our accountable care organization (ACO) contractors. We created the plan to help our members access care that results in the best possible health outcomes.

. The plan offers:

  • More affordable care for members, including for non-HSA plans:
    • $0 copay for primary care provider (PCP) visits
    • $0 copay for urgent care visits
    • $0 copay for virtual visits
    • $0 copay for convenience care visits
  • Deeper engagement between the PCP and the member through more proactive and complete preventive care, and better coordination across the health system
  • Robust data and analytics for care teams, allowing for actionable insights that result in more effective health outcomes
  • 24/7 convenience for members, including:        
    • 24-hour virtual doctor visits
    • 24-hour access to a nurse phone line  

PCP Selection

Doctors Plan members are required to select a PCP when they enroll, and are encouraged to use their PCP for care coordination. Members don’t need a referral when seeing any in-network specialist or other physician. Please note that the Doctors Plan network is smaller in some states.

Plan Benefits

Here’s how the plan works. For non-HSA plans, members have: 

  • No out-of-pocket costs for in-network convenience care visits, virtual visits or urgent care visits
  • Out-of-network coverage for emergency care only
  • A copay, plus deductible and coinsurance for emergency room visits and office visits with network specialists
  • Preventive care – including immunizations, preventive exams and health screenings – covered at 100 percent when received from an in-network provider  

We’re Here to Help

For more information about Doctors Plan, please contact your Provider Advocate or call Network Management at 866-574-6088 between 8 a.m. and 5 p.m. local time, Monday through Friday.

UnitedHealthcare EDGE health plans allow members to choose a network physician or specialist but don’t need a referral (open-access).

Some UnitedHealthcare EDGE plans provide access to network and non-network care providers so members can seek care from any care provider they choose, but at a lower co-insurance/deductible level for network care providers.

By seeking care from Tier 1 care providers, members can maximize their in-network benefits based on UnitedHealthcare’s evaluation.

UnitedHealthcare EDGE plans provide medication benefit coverage through a four-tier pharmacy plan. UnitedHealthcare EDGE plans include health and wellness programs, services and discounts from UnitedHealth Wellness®.

UnitedHealthcare Navigate®

The UnitedHealthcare Navigate health plans encourage members to use their primary care provider (PCP) to coordinate care across a wide spectrum of health services and enter electronic referrals to network specialists. The UnitedHealthcare Navigate network is narrowed in some states.

  • UnitedHealthcare Navigate members must receive a referral from their PCP to see a network specialist for benefits to be covered. There is out-of-network coverage for emergency services only.
  • UnitedHealthcare Navigate Balanced members may see a network specialist at a reduced benefit level when there is no referral.   There is out-of-network coverage for emergency services only.
  • UnitedHealthcare Navigate Plus members may see a network specialist at a reduced benefit level when there is no referral.  Navigate Plus also provides out of network coverage.

Changes to PCP selection are permitted once per month. Changes submitted on or before the 31st of the month will be effective on the first day of the following month.

Tools & Resources

UnitedHealthcare® NexusACO®

The UnitedHealthcare NexusACO suite of products offers cost-saving opportunities to members when they seek care providers from a select group of Accountable Care Organizations (ACO) nationwide. There is out-of-network coverage for emergency services only.

UnitedHealthcare NexusACO Plans – Open Access

  • UnitedHealthcare NexusACO OA plans offer network-only coverage for care providers.
  • UnitedHealthcare NexusACO OAP plans offer both network and non-network coverage.

UnitedHealthcare NexusACO Plans – Referral Required

  • UnitedHealthcare NexusACO R plans offer network-only coverage for care providers.
  • UnitedHealthcare NexusACO RB plans offer network coverage when the PCP refers a member to a network specialist, and lower coverage applies when there is no referral.
  • UnitedHealthcare NexusACO RP plans offer network coverage when the PCP refers a member to a network specialist, and lower coverage applies when there is no referral or with an out-of-network specialist.

All UnitedHealthcare NexusACO members are required to select a primary care provider (PCP) within the network to provide their preventive care, treat chronic conditions, manage medications and enter specialist referrals.

Changes to PCP selection are permitted once per month. Changes submitted on or before the 31st of the month will be effective on the first day of the following month.

Tools & Resources

UnitedHealthcare Options PPO health plans allow members to choose a network physician or specialist without a referral (open-access).

  • It is the member's responsibility to obtain prior approvals for both network and non-network services. No referral is required to see a specialist.
  • If a non-network physician is chosen, out-of-pocket member costs will be higher and it is the member’s responsibility to obtain approvals and submit claims.

UnitedHealthcare Options PPO offers two levels of coverage: a higher level of benefits for in-network services, and a lower level of benefits for non-network services, with somewhat higher deductibles and coinsurance.