Performance HMO

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Introducing the Performance HMO

The Performance HMO is a new kind of HMO plan that gives you quality and cost information about your Primary Care Physician's (PCP's) medical group. With this information, you are better prepared to choose the PCP and medical group that give you the most for your money. The Performance HMO rewards you with lower costs and better benefits when you shop wisely.

	How it Works Performance = Quality + Cost Quality: Measured by the California Office of the Patient Advocate (OPA) on how well the medical group meets national standards of care. Click here for more information. Cost: Based on what the insurance company pays for VEBA members. Based on these Performance measures, your PCP’s medical group is placed in Network 1, Network 2 or Network 3. Click here to see which medical groups are in each network. Your monthly premiums and what you pay when you use services is based on which network you choose.
What You Need to Do:
Understand the rules. Your network is based on the medical group of your PCP Choose one network for the entire year for you and your family You must submit a new enrollment form if you are a PacifiCare member Find your PCP's medical group. Look on your VEBA ID card for this information Determine your PCP's network. Review the benefit plan summaries. Look at the costs between networks If your PCP is in the network you choose, then you're ready to enroll! If your PCP is NOT in the network you choose, visit the UnitedHealthcare website at www.uhcwest.com and click on "Find A Doctor" to select a new PCP

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