Legal
UnitedHealthOne is the brand name used for products underwritten and administered by the UnitedHealthcare family of companies offering personal health insurance, including Golden Rule Insurance Company and American Medical Security Life Insurance Company. For costs, benefits, exclusions, limitations, eligibility and renewal terms, call 888-276-8057 or visit www.goldenrule.com/TV. When you call or visit, we will identify the particular underwriter and/or administrator of products in your state. Product and network availability, and benefits, vary by state. Medical service discounts vary by provider, geographic area and service provided. Insurance is subject to health underwriting. Neither Golden Rule nor American Medical Security is licensed in New York. Coverage may be provided through multiple policies or certificates. Policy Forms: C-006.3 or -006.4; GRI-PA-20.1-06 or -21.1-06; GRI-N21M-07 or -N21S-07; GRI-PA-22.1-10 or -23.1-10; GRI-N21M-15 or -N21S-15; GRI-N22M-16 or -N22S-16; GRI-N21M-27, -N21M-27-HSA, -N22S-27, or -N22S-27-HSA; GRI-N21M-30 or -N21S-30; GRI-N21M-40 or -N21S-40; GRI-N22M-49 or-N22S-49; GRI-H-5.7-06, -5.7-06, -5.7-07, -5.7-10, -5.7-15, -5.7-28, -5.7-30, -5.7-39, -5.7-40, -5.7-49; MGR03928; MGR03927; TNI1000; TNI5000; GRI-DEN1 or state variations.
Important Notice on Payment of Out-of-Network Benefits

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UnitedHealthOne is the brand name of the UnitedHealthcare family of companies that offer
personal health insurance products, including Golden Rule Insurance Company and
United HealthCare Insurance Company, the underwriter or administrator of these plans.
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