Microsoft Word _525_9_Brochure_v2-CH.doc

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1 SHIP UCLA University of California - Los Angeles 06-BR-CA

3 UnitedHealthcare X AIDS (PKU) Scholastic Emergency Services

.. 10... 10 (PKU)... 10... 10... 11... 11... 11... 11... 11... 14.

4 UCLA SHIP ( ) ( ) SHIPSHIP SHIP PPO / 30 UnitedHealthcare StudentResources SHIP SHIP 14 UnitedHealthcare StudentResources 1

12 2010 7 1-30 2010 6 1-30 12 1-30 2010 8 1-30 12 1-30 2010 9 1-30 2010

5 90 UMR Care Management UMR Care Management 8:00 6:

6 $150,000 ( ) $750 () $1,500 () () 80% 50% $150,000 $2,500 / $7,500 () 100% $150,000 UnitedHealthcare Choice Plus PA = = PA X () ( PA ) () PA 50% 50% PA PA PA PA 3 PA 30 PA 3

7 ( 9 ) PA 50% 50% PA X PA PA PA ( ) ( PA $1,170 $3,000) 6 X PA 72 80% PA 80 % 80 % X PA PA PA X PA UnitedHealthcare ( $10,000 )( ) UnitedHealthcare 31 $50 90 UnitedHealthcare $25 1 $50 2 $75 3 $50 1 $100 2 $

8 40 ( 9 ) PA / $30 80% 80% 80% 80% ( ) 80% 80% / $1, PA PA 80% 80% $4, / $25 PA / $600 PA (CT) / (MRI) PA PA 1) 2) 3) 4) 5) PA 5

9 PA 80% 80% PA 80% 80% ( ) PA ( 6 ) PA B PA ( A B 10 ) PA 80% 80% UCLA (525-9) $150,000 UnitedHealthcare (PDL) UnitedHealthcare ( 31 ) PDL UnitedHealthcare StudentResources PDL $50 1 $ $ $75 31 $10, $ UnitedHealthcare * Ashe UnitedHealthcare 6

10 * * SHIP 90 (Insurance) SHIP (SHIP Student Rx Mail Order Program) Medco (Getting Started with Mail Order) ( ) Medco / Medco by Mail * Medco, PO Box , Cincinnati, OH ( ) ( UnitedHealthcare Insurance Company ) * Medco, PO Box , Cincinnati, OH (877) ( ) 14 (877) ( (800) ) UnitedHealthcare 24 UnitedHealthcare Choice Plus ( ) UnitedHealthcare Choice Plus 7

UnitedHealthcare Insurance Company ) * Medco, PO Box 747000, Cincinnati, OH 45274-7000 (877) 417-7345 www.366wellst.com.

11 PPO 1) 2) (HCG) RH A (PAPPA) () (hcg) () B HBsAg RPR HIV HIV-ab ( ) (AFP) hcg (AFP) hcg a 35 (CVS) 50 ( 1 ) B $5,000 X X 1. ( ) X 2. X X 3. X 8

12 $1,250 (1) (2) (1) (2) (3) (4) (1) (2) (3) () (4) (5) (6) (7) (8) (9) (A) (i) (ii) 6 (B) (C)

13 AIDS (AIDS) ( ) (1) (2) (3) (4) (5) (6) (7) (8) (9) ( ) (PKU) (PKU) a) b) I II III IV 10

14 (PSA) ) 2) ( ) 31 1) 2) 3) 4) 1) 2) 3) 4) 5) 6) ( ) 1) 2) 11

15 ( ) 1) 2) (19) 23 1) 2) 1) 2) 31 (1) (2) (1) (2) (3) (4) 18 (5) (A) (B) ( (a) ) ( ) 62 (6) 1) 2) 1) 2) 3) 4) 24 5) 6) 18 1) 2) 3) 4) 30 5) 1) 2) 1) 2) 1) 2) 1) 2) 1) 2) 3) 4) 5) 6) 1) 2) 3) 12

16 4) 5) 1) 2) 3) 4) 5) 1) 2) () 1) 2) 31 ( ) ) 2) ( ) 31 1) 2) 3) 4) (R.N.) 1) 2) 13

17 a) b) (a) (b) (c) ( ) ( ) ( ) a) b) (Caution - limited by federal law to investigational use) c) d) e) f) Parlodel Pergonal Clomid Profasi Metrodin Serophene g) h) (1) 14

18 21. / ( ) () Scholastic Emergency Services Scholastic Emergency Services (SES) SES SES Scholastic Emergency Services (SES) SES 100 SES SES 911 SES SES SES * * * * * * * * * * SES 15

19 (877) ( ) (609) ( ) medservices@assistamerica.com SES 1. () () SES SES SES SES SES UnitedHealthcare StudentResources, PO Box , Dallas, TX HELP (4357) California Department of Insurance, Consumer Communications Bureau, 300 South Spring Street, South Tower, Los Angeles, CA ( ) UnitedHealthcare Insurance Company UnitedHealthcare StudentResources P.O. Box Dallas, Texas customerservice@uhcsr.com claims@uhcsr.com 16

30 90 800-980-4698 UnitedHealthcare StudentResources, PO Box 809025, Dallas, TX 75380-9025 800-927-HELP (4357) 213-897-8921California

20 UnitedHealthcare StudentResources (My Account) (My Account) (Create an Account) v2 17

Microsoft Word Brochure v4.doc

Microsoft Word Brochure v4.doc 2010-2011 Vanguard University 06-BR-CA 04-923-1 Vanguard University / Vanguard Vanguard University (SHIP) Vanguard University UnitedHealthcare Insurance Company Metlife Dental Vanguard Vanguard 7 Vanguard