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HSA Benefit Summary

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This Benefit Summary is to highlight your Benefits. Don’t use this document to understand your exact coverage. If this Benefit Summary conflictswith the Certificate of Coverage (COC), Schedule of Benefits, Riders, and/or Amendments, those documents govern. Review your COC for an exactdescription of the services and supplies that are and are not covered, those which are excluded or limited, and other terms and conditions ofcoverage.UnitedHealthcare | Wisconsin | Choice Plus | DEZS | 2VChoice Plus plan details, all in one place.Use this benefit summary to learn more about this plan’s benefits, ways you can get help managing costs and how you may get more out of this health plan.Check out what’s included in the plan Choice PlusNetwork coverage onlyYou can usually save money when you receive care for covered health care services fromnetwork providers.Network and out-of-network benefitsYou may receive care and services from network and out-of-network providers andfacilities — but staying in the network can help lower your costs.Primary care physician (PCP) requiredWith this plan, you need to select a PCP — the doctor who plays a key role in helpingmanage your care. Each enrolled person on your plan will need to choose a PCP.Referrals requiredYou’ll need referrals from your PCP before seeing a specialist or getting certain healthcare services.Preventive care covered at 100%There is no additional cost to you for seeing a network provider for preventive care.Pharmacy benefitsWith this plan, you have coverage that helps pay for prescription drugs and medications.Tier 1 providersUsing Tier 1 providers may bring you the greatest value from your health care benefits.These PCPs and medical specialists meet national standard benchmarks for quality careand cost savings.Freestanding centersYou may pay less when you use certain freestanding centers — health care facilities thatdo not bill for services as part of a hospital, such as MRI or surgery centers.Health savings account (HSA)With an HSA, you’ve got a personal bank account that lets you put money aside, tax-free.Use it to save and pay for qualified medical expenses. 1

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Here's a more in-depth look at how Choice Plus works.Medical BenefitsIn Network Out-of-NetworkAnnual Medical DeductibleIndividual $3,000 $5,000Family $6,000 $10,000All individual deductible amounts will count toward the family deductible, but an individual will not have to pay more than the individual deductible amount.*After the Annual Medical Deductible has been met.You're responsible for paying 100% of your medical expenses until you reach your deductible. For certain covered services, you may be required to pay a fixed dollar amount - your copay.Annual Out-of-Pocket LimitIndividual $6,350 $12,700Family $12,700 $25,400All individual out-of-pocket maximum amounts will count toward the family out-of-pocket maximum, but an individual will not have to pay more than the individual out-of-pocket maximum amount.Once you’ve met your deductible, you start sharing costs with your plan - coinsurance. You continue paying a portion of the expense until you reach your out-of-pocket limit. From there, your plan pays 100% of allowed amounts for the rest of the plan year.What You Pay for ServicesCopays ($) and Coinsurance (%) for Covered Health Care ServicesDesignated Network NetworkOut-of-NetworkPreventive Care ServicesPreventive Care Services No copay 30%*Certain preventive care services are provided as specified by the Patient Protection and Affordable Care Act (ACA), with no cost-sharing to you. These services are based on your age, gender and other health factors. UnitedHealthcare also covers other routine services that may require a copay, co-insurance or deductible.Includes services such as Routine Wellness Checkups, Immunizations, and Lab and X-ray services for Mammogram, Pap Smear, Prostate and Colorectal Cancer screenings.Office Services - Sickness & InjuryPrimary Care PhysicianAll other covered persons $30 copay* 30%*Covered persons less than age 19 No copay* 30%*Additional copays, deductible, or co-insurance may apply when you receive other services at your physician’s office. For example, surgery and lab work.Telehealth is covered at the same cost share as in the office.*After the Annual Medical Deductible has been met.¹Prior Authorization Required. Refer to COC/SBN. 2

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What You Pay for ServicesCopays ($) and Coinsurance (%) for Covered Health Care ServicesDesignated Network NetworkOut-of-NetworkSpecialist $60 copay* 30%*Additional copays, deductible, or co-insurance may apply when you receive other services at your physician’s office. For example, surgery and lab work.Telehealth is covered at the same cost share as in the office.Urgent Care Center Services $100 copay* 30%*Virtual Care Services No copay 30%*Network Benefits are available only when services are delivered through a Designated Virtual Network Provider. You can find a Designated Virtual Visit Network Provider by contacting us at myuhc.com® or the telephone number on your ID card. Access to Virtual Visits and prescription services may not be available in all states or for all groups.Emergency CareAmbulance Services - Emergency AmbulanceAir Ambulance 10%* 10%*Ground Ambulance 10%* 10%*Ambulance Services - Non-Emergency Ambulance¹Air Ambulance 10%* 10%*Ground Ambulance 10%* 30%*Dental Services - Accident Only 10%* 10%*Emergency Health Care Services - Outpatient¹ $350 copay* $350 copay*Inpatient CareCongenital Heart Disease (CHD) Surgeries¹ 10%* 30%*Habilitative Services - Inpatient¹ The amount you pay is based on where the covered health care service is provided.Limit will be the same as, and combined with, those stated under Skilled Nursing Facility/Inpatient Rehabilitation Services.Hospital - Inpatient Stay¹ 10%* 30%*Skilled Nursing Facility/Inpatient Rehabilitation Facility Services¹10%* 30%*Limited to 30 days per Inpatient Stay in a Skilled Nursing Facility.Limited to 60 days per year in an Inpatient Rehabilitation Facility.*After the Annual Medical Deductible has been met.¹Prior Authorization Required. Refer to COC/SBN. 3

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What You Pay for ServicesCopays ($) and Coinsurance (%) for Covered Health Care ServicesDesignated Network NetworkOut-of-NetworkOutpatient CareHabilitative Services - OutpatientManipulative Treatment $30 copay* 30%*Other habilitative services $30 copay* 30%*Limits will be the same as, and combined with those stated under Rehabilitation Services - Outpatient Therapy and Manipulative Treatment.Home Health Care¹ 10%* 30%*Limited to 60 visits per year.One visit equals up to four hours of skilled care services. This visit limit does not include any service which is billed only for the administration of intravenous infusion.Lab, X-Ray and Diagnostic - Outpatient - Lab Testing¹ 10%* 50%* 30%*Limited to 18 Definitive Drug Tests per year.Limited to 18 Presumptive Drug Tests per year.For Designated Network Benefits, laboratory services must be received from a Designated Diagnostic Provider. Network Benefits include laboratory services received from a Network provider that is not a Designated Diagnostic Provider.Lab, X-Ray and Diagnostic - Outpatient - X-Ray and other Diagnostic Testing¹10%* 30%*Major Diagnostic and Imaging - Outpatient¹ 10%* You pay a $500 per occurrence deductible per service prior to and in addition to paying any Annual Deductible and any coinsurance amount. 50%*You pay a $500 per occurrence deductible per service prior to and in addition to paying any Annual Deductible and any coinsurance amount. 30%*For Designated Network Benefits, services must be received from a Designated Diagnostic Provider. Network Benefits include services received from a Network provider that is not a Designated Diagnostic Provider.You may have to pay an extra copay, deductible or coinsurance for physician fees or pharmaceutical products.Physician Fees for Surgical and Medical Services 10%* 30%**After the Annual Medical Deductible has been met.¹Prior Authorization Required. Refer to COC/SBN. 4

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What You Pay for ServicesCopays ($) and Coinsurance (%) for Covered Health Care ServicesDesignated Network NetworkOut-of-NetworkRehabilitation Services - Outpatient Therapy and Manipulative TreatmentManipulative Treatment $30 copay* 30%*Other rehabilitation services $30 copay* 30%*Limited to 20 visits of cognitive rehabilitation therapy per year.Limited to 20 visits of occupational therapy per year.Limited to 20 visits of physical therapy per year.Limited to 20 visits of pulmonary rehabilitation therapy per year.Limited to 20 visits of speech therapy per year.Limited to 30 visits of post-cochlear implant aural therapy per year.Limited to 36 visits of cardiac rehabilitation therapy per year.Scopic Procedures - Outpatient Diagnostic and Therapeutic 10%* 30%*Diagnostic/therapeutic scopic procedures include, but are not limited to colonoscopy, sigmoidoscopy and endoscopy.Surgery - Outpatient¹ 10%* 30%*Therapeutic Treatments - Outpatient¹ 10%* 30%*Therapeutic treatments include, but are not limited to dialysis, intravenous chemotherapy, intravenous infusion, medical education services and radiation oncology.Supplies and ServicesDiabetes Self-Management Items¹ The amount you pay is based on where the covered health care service is provided under Durable Medical Equipment (DME), Orthotics and Supplies or in the Prescription Drug Benefits Section.Diabetes Self-Management and Training/Diabetic Eye Exams/Foot Care¹The amount you pay is based on where the covered health care service is provided.Durable Medical Equipment (DME), Orthotics and Supplies¹ 10%* 30%*Limited to 1 insulin pump per year.Limited to a single purchase of a type of DME or orthotic every 3 years.Repair and/or replacement of DME or orthotics would apply to this limit in the same manner as a purchase. This limit does not apply to wound vacuums.Enteral Nutrition 10%* 30%*Hearing Aids 10%* 30%*Limited to a single purchase per hearing impaired ear every 3 years.Repair and/or replacement of a hearing aid would apply to this limit in the same manner as a purchase.*After the Annual Medical Deductible has been met.¹Prior Authorization Required. Refer to COC/SBN. 5

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What You Pay for ServicesCopays ($) and Coinsurance (%) for Covered Health Care ServicesDesignated Network NetworkOut-of-NetworkOstomy Supplies 10%* 30%*Pharmaceutical Products - Outpatient 10%* 30%*This includes medications given at a doctor's office, or in a covered person's home.Prosthetic Devices¹ 10%* 30%*Limited to a single purchase of each type of prosthetic device every 3 years.Repair and/or replacement of a prosthetic device would apply to this limit in the same manner as a purchase.Urinary Catheters 10%* 30%*PregnancyPregnancy - Maternity Services¹ The amount you pay is based on where the covered health care service is provided except that an Annual Deductible will not apply for a newborn child whose length of stay in the Hospital is the same as the mother's length of stay.Mental Health Care & Substance Related and Addictive Disorder ServicesInpatient¹ 10%* 30%*Outpatient and Transitional Care $30 copay* 30%*Partial Hospitalization and Transitional Care¹ 10%* 30%*Other ServicesAutism Spectrum Disorder Services¹ The amount you pay is based on where the covered health care service is provided.Cellular and Gene Therapy¹ The amount you pay is based on where the covered health care service is provided.For Network Benefits, Cellular or Gene Therapy services must be received from a Designated Provider.Clinical Trials¹ The amount you pay is based on where the covered health care service is provided.Dental/Anesthesia Services – Hospital Ambulatory Surgery Services¹The amount you pay is based on where the covered health care service is provided.Fertility Preservation for Iatrogenic Infertility¹ 10%* 30%*Limited to $20,000 per Covered Person per lifetime.Limited to $5,000 for Prescription Drug Products per Covered Person.This Benefit limit will be the same as, and combined with, those stated under Preimplantation Genetic Testing (PGT) and Related Services. Benefits are further limited to one cycle of fertility preservation for Iatrogenic Infertility per Covered Person during the entire period of time he or she is enrolled for coverage under the Policy.Gender Dysphoria¹ The amount you pay is based on where the covered health care service is provided or in the Prescription Drug Benefits Section.Hospice Care¹ 10%* 30%**After the Annual Medical Deductible has been met.¹Prior Authorization Required. Refer to COC/SBN. 6

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What You Pay for ServicesCopays ($) and Coinsurance (%) for Covered Health Care ServicesDesignated Network NetworkOut-of-NetworkKidney Disease Treatment¹ The amount you pay is based on where the covered health care service is provided.Preimplantation Genetic Testing (PGT) and Related Services¹ 10%* 30%*Benefit limits for related services will be the same as, and combined with, those stated under Fertility Preservation for Iatrogenic Infertility. This limit does not include Preimplantation Genetic Testing (PGT) for the specific genetic disorder. This limit includes Benefits for ovarian stimulation medications provided under the Outpatient Prescription Drug Rider.Benefits for related services are limited to one Assisted Reproductive Technology (ART) procedure during the entire period of time a Covered Person is enrolled under the Policy. This limit does not include the Preimplantation Genetic Testing (PGT) for the specific genetic disorder.Reconstructive Procedures¹ The amount you pay is based on where the covered health care service is provided.Temporomandibular Joint (TMJ) Disorder Services¹ The amount you pay is based on where the covered health care service is provided.Transplantation Services The amount you pay is based on where the covered health care service is provided.Not coveredNetwork Benefits must be received from a Designated Provider.*After the Annual Medical Deductible has been met.¹Prior Authorization Required. Refer to COC/SBN. 7

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Pharmacy Benefits* After the Annual Pharmacy Deductible has been met.** Only certain Prescription Drug Products are available through mail order; please visit myuhc.com® or call Customer Care at the telephone number on the back of your ID card for more information. You will be charged aretail Copayment and/or Coinsurance for 31 days or 2 times for 60 days based on the number of days supply dispensed for any Prescription Order or Refills sent to the mail order pharmacy. To maximize your Benefit, askyour Physician to write your Prescription Order or Refill for a 90-day supply, with refills when appropriate, rather than a 30-day supply with three refills.Your Copayment and/or Coinsurance is determined by the tier to which the Prescription Drug List (PDL) Management Committee has assigned the Prescription Drug Product. All Prescription Drug Products on thePrescription Drug List are assigned to Tier 1, Tier 2 or Tier 3.If you are a member, you can find individualized information on your benefit coverage, determine tier status, check the status of claims and search for network pharmacies by logging into your account on myuhc.com® orcalling the Customer Care number on your ID card. If you are not a member, you can view prescription information at welcometouhc.com > Benefits > Pharmacy Benefits.For an out-of-network Pharmacy, you may have to pay the difference between the out-of-network reimbursement rate and the pharmacy's usual and customary charge.Pharmacy Plan DetailsPharmacy Network NationalPrescription Drug List AdvantageIn NetworkAnnual Pharmacy DeductibleIndividual See the Annual Medical Deductible sectionFamily See the Annual Medical Deductible sectionAnnual Deductible - Network and Out-of-NetworkThe Pharmacy Deductible is the amount you pay for pharmacy expenses per year before you begin to receive Pharmacy Benefits.Up to a 31-day supply Up to a 90-day supplyPrescription Drug Product Tier LevelRetail and Specialty Pharmacy NetworkOut-of-Network PharmacyMail Order Network Pharmacy**Tier 1 $$10* $10* $25*Tier 2 $$$35* $35* $87.50*Tier 3 $$$$60* $60* $150* 8

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Here’s an example of how the plan’s costs come into play.More ways to help manage your health plan and stay in the loop.Search the network to find doctors.You can go to providers in and out of our network — but whenyou stay in network, you’ll likely pay less for care. To get started: . Go to welcometouhc.com > Benefits > Find a Doctor or Facility. . Choose Search for a health plan. . Choose Choice Plus to view providers in the health plan’s network.Manage your meds.Look up your prescriptions using the Prescription Drug List (PDL).It places medications in tiers that represent what you’ll pay, whichmay make it easier for you and your doctor to find options to helpyou save money. . Go to welcometouhc.com > Benefits > Pharmacy Benefits. . Select Advantage to view the medications that are covered under your plan.Access your plan online.With myuhc.com®, you’ve got a personalized health hub to helpyou find a doctor, manage your claims, estimate costs and more.Get on-the-go access.When you’re out and about, the UnitedHealthcare® app puts yourhealth plan at your fingertips. Download to find nearby care, videochat with a doctor 24/7, access your health plan ID card and more. 9

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Other important information about your benefits.Medical Exclusions• Acupuncture• Bariatric Surgery • Cosmetic Surgery• Dental Care (Adult/Child)• Glasses• Infertility Treatment• Long-Term Care• Non-emergency care when traveling outside the U.S.• Private-Duty Nursing• Routine Eye Care (Adult/Child)• Routine Foot Care• Weight Loss ProgramsOutpatient Prescription Drug BenefitsFor Prescription Drug Products dispensed at a retail Network Pharmacy, you are responsible for paying the lowest of the following: 1) Theapplicable Copayment and/or Coinsurance; 2) The Network Pharmacy’s Usual and Customary Charge for the Prescription Drug Product; and 3)The Prescription Drug Charge for that Prescription Drug Product. For Prescription Drug Products from a mail order Network Pharmacy, you areresponsible for paying the lower of the following: 1) The applicable Copayment and/or Coinsurance; and 2) The Prescription Drug Charge for thatPrescription Drug Product.See the Copayment and/or Coinsurance stated in the Benefit Information table for amounts. We will not reimburse you for any non-covered drugproduct.For a single Copayment and/or Coinsurance, you may receive a Prescription Drug Product up to the stated supply limit. Some products are subjectto additional supply limits based on criteria that we have developed. Supply limits are subject, from time to time, to our review and change.Specialty Prescription Drug Products supply limits are as written by the provider, up to a consecutive 31-day supply of the Specialty PrescriptionDrug Product, unless adjusted based on the drug manufacturer’s packaging size, or based on supply limits, or as allowed under the Smart FillProgram. Supply limits apply to Specialty Prescription Drug Products obtained at a Preferred Specialty Network Pharmacy, a Non-PreferredSpecialty Network Pharmacy, an out-of-Network Pharmacy, a mail order Network Pharmacy or a Designated Pharmacy.Certain Prescription Drug Products for which Benefits are described under the Prescription Drug Rider are subject to step therapy requirements. Inorder to receive Benefits for such Prescription Drug Products you must use a different Prescription Drug Product(s) first. You may find out whether aPrescription Drug Product is subject to step therapy requirements by contacting us at myuhc.com or the telephone number on your ID card.Before certain Prescription Drug Products are dispensed to you, your Physician, your pharmacist or you are required to obtain prior authorizationfrom us or our designee to determine whether the Prescription Drug Product is in accordance with our approved guidelines and it meets thedefinition of a Covered Health Care Service and is not an Experimental or Investigational or Unproven Service. We may also require you to obtainprior authorization from us or our designee so we can determine whether the Prescription Drug Product, in accordance with our approvedguidelines, was prescribed by a Specialist.Certain Preventative Care Medications may be covered at zero cost share. You can get more information by contacting us at myuhc.com or thetelephone number on your ID card.Benefits are provided for certain Prescription Drug Products dispensed by a mail order Network Pharmacy or Preferred 90 Day Retail NetworkPharmacy. The Outpatient Prescription Drug Schedule of Benefits will tell you how mail order Network Pharmacy and Preferred 90 Day RetailNetwork Pharmacy supply limits apply. Please contact us at myuhc.com or the telephone number on your ID card to find out if Benefits areprovided for your Prescription Drug Product and for information on how to obtain your Prescription Drug Product through a mail order NetworkPharmacy or Preferred 90 Day Retail Network Pharmacy. 10

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Other important information about your benefits.Pharmacy ExclusionsThe following exclusions apply. In addition see your Pharmacy Rider and SBN for additional exclusions and limitations that may apply.• A Pharmaceutical Product for which Benefits are provided in your Certificate.• A Prescription Drug Product with either: an approved biosimilar, a biosimilar and Therapeutically Equivalent to another covered Prescription DrugProduct.• Any Prescription Drug Product to the extent payment or benefits are provided or available from the local, state or federal government (forexample, Medicare).• Any product dispensed for the purpose of appetite suppression or weight loss.• Any product for which the primary use is a source of nutrition, nutritional supplements, or dietary management of disease, and prescriptionmedical food products even when used for the treatment of Sickness or Injury, except as required by state mandate.• Certain New Prescription Drug Products and/or new dosage forms until the date they are reviewed and placed on a tier by our PDL ManagementCommittee.• Certain Prescription Drug Products for tobacco cessation.• Certain Prescription Drug Products for which there are Therapeutically Equivalent alternatives available.• Certain Prescription Drug Products that are FDA approved as a package with a device or application, including smart package sensors and/orembedded drug sensors.• Certain compounded drugs.• Diagnostic kits and products, including associated services.• Drugs available over-the-counter.• Drugs which are prescribed, dispensed or intended for use during an Inpatient Stay.• Durable Medical Equipment, including certain insulin pumps and related supplies for the management and treatment of diabetes, for whichBenefits are provided in your Certificate. Prescribed and non-prescribed outpatient supplies. This does not apply to diabetic supplies and inhalerspacers specifically stated as covered.• Experimental or Investigational or Unproven Services and medications. This exclusion does not apply to Prescription Drug Products that areprescribed by a Physician for the treatment of HIV infection, illness or medical condition arising from or related to HIV infection, if the medication isapproved by the FDA and prescribed and administered in accordance with the treatment protocol approved for an investigational new drug.• General vitamins, except Prenatal vitamins, vitamins with fluoride, and single entity vitamins when accompanied by a Prescription Order or Refill.• Growth hormone for children with familial short stature (short stature based upon heredity and not caused by a diagnosed medical condition).• Medications used for cosmetic or convenience purposes.• Prescription Drug Products dispensed outside the United States, except as required for Emergency treatment.• Prescription Drug Products when prescribed to treat infertility. This exclusion does not apply to Prescription Drug Products prescribed to treatIatrogenic Infertility and Preimplantation Genetic Testing (PGT) as described in the Certificate.• Prescription Drug Products, including New Prescription Drug Products or new dosage forms, that we determine do not meet the definition of aCovered Health Care Service.• Publicly available software applications and/or monitors that may be available with or without a Prescription Order or Refill. 11

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UnitedHealthcare does not treat members differently because of sex, age, race, color, disability or national origin. If you think you weren’t treated fairly because of your sex, age, race, color, disability or national origin, you can send a complaint to the Civil Rights Coordinator:Online: UHC_Civil_Rights@uhc.comMail: Civil Rights Coordinator UnitedHealthcare Civil Rights Grievance P.O. Box 30608, Salt Lake City, UT 84130You must send the complaint within 60 days of when you found out about it. A decision will be sent to you within 30 days. If you disagree with the decision, you have 15 days to ask us to look at it again. If you need help with your complaint, please call the toll-free phone number listed on your ID card, TTY 711, Monday through Friday, 8 a.m. to 8 p.m. You can also file a complaint with the U.S. Dept. of Health and Human Services. Online: https://ocrportal.hhs.gov/ocr/portal/lobby.jsfComplaint forms are available at: http://www.hhs.gov/ocr/office/file/index.html.Phone: Toll-free 1-800-368-1019, 1-800-537-7697 (TDD)Mail: U.S. Dept. of Health and Human Services, 200 Independence Avenue, SW Room 509F, HHH Building Washington, D.C. 20201 We provide free services to help you communicate with us such as letters in others languages or large print. You can also ask for an interpreter. To ask for help, please call the toll-free member phone number listed on your health plan ID card.ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Please call the toll-free phone number listed on your identification card.ATENCIÓN: Si habla español (Spanish), hay servicios de asistencia de idiomas, sin cargo, a su disposición. Llame al número de teléfono gratuito que aparece en su tarjeta de identificación.請注意:如果您說中文 (Chinese),我們免費為您提供語言協助服務。請撥打會員卡所列的免付費會員電話號碼。XIN LƯU Ý: Nếu quý vị nói ếng Việt (Vietnamese), quý vị sẽ được cung cấp dịch vụ trợ giúp về ngôn ngữ miễn phí. Vui lòng gọi số điện thoại miễn phí ở mặt sau thẻ hội viên của quý vị.알림: 한국어(Korean)를 사용하시는 경우 언어 지원 서비스를무료로 이용하실 수 있습니다. 귀하의 신분증 카드에 기재된 무료 회원 전화번호로 문의하십시오.PAALALA: Kung nagsasalita ka ng Tagalog (Tagalog), may makukuha kang mga libreng serbisyo ng tulong sa wika. Pakitawagan ang toll-free na numero ng telepono na nasa iyong identification card.(Russian). (Arabic)ATANSYON: Si w pale Kreyòl ayisyen (Haitian Creole), ou kapab benefisye sèvis ki gratis pou ede w nan lang pa w. Tanpri rele nimewo gratis ki sou kat idantifikasyon w.ATTENTION : Si vous parlez français (French), des services d’aide linguistique vous sont proposés gratuitement. Veuillez appeler le numéro de téléphone gratuit figurant sur votre carte d’identification.UWAGA: Jeżeli mówisz po polsku (Polish), udostępniliśmy darmowe usługi tłumacza. Prosimy zadzwonić pod bezpłatny numer telefonu podany na karcie identyfikacyjnej.ATENÇÃO: Se você fala português (Portuguese), contate o serviço de assistência de idiomas gratuito. Ligue gratuitamente para o número encontrado no seu cartão de identificação.ATTENZIONE: in caso la lingua parlata sia l’italiano (Italian), sono disponibili servizi di assistenza linguistica gratuiti. Per favore chiamate il numero di telefono verde indicato sulla vostra tessera identificativa.ACHTUNG: Falls Sie Deutsch (German) sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Bitte rufen Sie die gebührenfreie Rufnummer auf der Rückseite Ihres Mitgliedsausweises an.注意事項:日本語 (Japanese) を話される場合、無料の言語支援サービスをご利用いただけます。健康保険証に記載されているフリーダイヤルにお電話ください。(Farsi)ध्यान दें: यदि आप हिंदी (Hindi) बोलते है, आपको भाषा सहायता सेबाएं, नि:शुल्क उपलब्ध हैं। कृपया अपने पहचान पत्र पर सूचीबद्ध टोल-फ्री फोन नंबर पर कॉल करें।CEEB TOOM: Yog koj hais Lus Hmoob (Hmong), muaj kev pab txhais lus pub dawb rau koj. Thov hu rau tus xov tooj hu deb dawb uas teev muaj nyob rau ntawm koj daim yuaj cim qhia tus kheej.ΠΡΟΣΟΧΗ : Αν μιλάτε Ελληνικά (Greek), υπάρχει δωρεάν βοήθεια στη γλώσσα σας. Παρακαλείστε να καλέσετε το δωρεάν αριθμό που θα βρείτε στην κάρτα ταυτότητας μέλους.PAKDAAR: Nu saritaem ti Ilocano (Ilocano), ti serbisyo para ti baddang ti lengguahe nga awanan bayadna, ket sidadaan para kenyam. Maidawat nga awagan iti toll-free a numero ti telepono nga nakalista ayan iti identification card mo.(Navajo) OGOW: Haddii aad ku hadasho Soomaali (Somali), adeegyada taageerada luqadda, oo bilaash ah, ayaad heli kartaa. Fadlan wac lambarka telefonka khadka bilaashka ee ku yaalla kaarkaaga aqoonsiga.ગુજરાતી (Gujarati): ધ્યાન આપો: જો તમે ગુજરાતી બોલતા હો તો આપને ભાષાકીય મદદરૂપ સેવા વવના મૂલ્યે પ્રાપ્ય છે. મહેરબાની કરી તમારા આઈડી કાડડની સૂચિ પર આપેલા સભ્ય માટેના ટોલ-ફ્રી નંબર ઉપર કોલ કરો. Facebook.com/UnitedHealthcare Instagram.com/UnitedHealthcare YouTube.com/UnitedHealthcareAdministrative services provided by United HealthCare Services, Inc. and their affiliates.Twitter.com/UHC B2C 9183517.0 11/19 ©2020 United HealthCare Services, Inc. 19-12550