decorative photograph
Payment of benefits
You may not assign, transfer, or in any way convey your benefits under the Plan or any cause of action related to your benefits under the Plan to a provider or to any other third party. Nothing in this Plan shall be construed to make the Plan, plan sponsor, or UnitedHealthcare or its affiliates liable for payments to a provider or to a third party to whom you may be liable for payments for benefits.
The Plan will not recognize claims for benefits brought by a third party. Also, any such third party shall not have standing to bring any such claim independently, as a covered person or beneficiary, or derivatively, as an assignee of a covered person or beneficiary.
References to "third parties" include references to providers as well as any collection agencies or third parties that have purchased accounts receivable from providers or to whom accounts receivables have been assigned.
As a matter of convenience to a covered person, and where practicable for UnitedHealthcare (as determined in its sole discretion), UHC may make payment of benefits directly to a provider.
Any such payment to a provider:
  • is NOT an assignment of your benefits under the Plan or of any legal or equitable right to institute any proceeding relating to your benefits; and
  • is NOT a waiver of the prohibition on assignment of benefits under the Plan; and
  • shall NOT estop the Plan, plan sponsor, or UnitedHealthcare from asserting that any purported assignment of benefits under the Plan is invalid and prohibited.
If this direct payment for your convenience is made, the Plan's obligation to you with respect to such benefits is extinguished by such payment. If any payment of your benefits is made to a provider as a convenience to you, UnitedHealthcare will treat you, rather than the provider, as the beneficiary of your claim for benefits, and the Plan reserves the right to offset any benefits to be paid to a provider by any amounts that the provider owes the Plan (including amounts owed as a result of the assignment of other plans' overpayment recovery rights to the Plan), as described under Coordination of Benefits.
Eligible expenses to an out-of-network provider for covered services that are subject to the No Surprises Act of the Consolidated Appropriations Act (P.L. 116-260) are paid directly to the provider.