Additionally, you get covered preventive care at no cost to you when you see a network provider. Administered by Regence BlueShield) applies to all UMP plans. The UMP Plus – UW Medicine ACN includes many of the finest healthcare organizations in the region, and provides high-quality, excellent service and affordable healthcare. The Puget Sound High Value Network (PSHVN) is a network comprised of the highest quality health care organizations. 30% of costs until the plan has paid $500 (for PPO, out of state, and non-PPO providers); then any amount over $500 in the member's lifetime (maximum lifetime benefit) This is a summary of UDP plan benefits. Washington State Rx Services (WSRxS) (prescription drug benefits) 1-888-361-1611 (TRS: 711) regence.com/ ump/sebb/ benefits/ prescriptions . The 113,000 public employees (over 250,000 when including their enrolled dependents) that receive benefits under the Uniform Medical Plan (UMP) represent one of the largest contracts available in the […] Rehn & Associates . UMP High Deductible covers the same services as UMP Achieve 2, but has a lower monthly premium and a higher deductible. Plus, have the peace of mind that comes from emergency coverage wherever you’re traveling. When you choose a UMP plan, you get an active partner in your health care and a dedicated service team available to answer your questions quickly and help you make the most of your benefits. UMP is ready to meet your health care needs with several affordable plan options. Available outside these hours with limited services.Extended hours: November 4, 11, and 18 until 8 p.m. to help answer open enrollment questions. Title: UMP (SEBB) (Regence) What’s new for 2021 Author: Regence BlueShield Created Date: 9/25/2020 2:12:53 PM UMP Achieve 1 also covers the full cost of certain programs to quit smoking or manage diabetes. 1 of 9 Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: 01/01/2020 – 12/31/2020 Uniform Medical Plan (UMP) Plus—UW Medicine Accountable Care Network (ACN) (SEBB) Coverage for: Individual/Family | Plan Type: ACP The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Regence. UMP High deductible uses Regence BlueShield’s largest network of providers. UMP Plus has a lower deductible and monthly premium than UMP Achieve 2 while offering most of the same benefits. UMP Achieve 2 uses Regence BlueShield’s largest network of providers, but has a lower deductible than UMP Achieve 1 and UMP High Deductible. Visit HealthEquity or watch their recorded webinar to discover the many uses for your HSA. For more details, refer to your plan’s . <> For Uniform Medical Plan (UMP) Members: Fax to: 1 (877) 663-7526 or Mail to: PO Box 2998, Tacoma, WA 98401-2998 If this is an expedited request and meets the definition indicated below, please check the expedited request box AND fax this form to 1 (855) 240-6498. For most services, you can see the specialist you choose without a referral. For most services, you can see a specialist without a referral, and you pay $0 for covered preventive care services when you see a network provider. UMP Plus has no prescription drug deductible and has a lower medical deductible than UMP Achieve 1 and UMP Achieve 2 while offering most of the same benefits. <> 2 0 obj For more details, refer to your plan’s . UMP Achieve 1 uses Regence BlueShield’s largest network of providers. For most services, you can see a specialist without a referral, and you pay $0 for covered preventive care services when you see a network provider. For the Spanish version of the above video, watch on YouTube. Direct clinical information reviews (MCG Health) For select CPT codes, Availity's electronic authorization tool automatically routes you to MCG Health's website where you can document specific clinical criteria for your patient. The Uniform Medical Plan (UMP) Pre-authorization List includes services and supplies that require pre-authorization or notification for UMP members. Visit the UMP Plus–PSHVN website to learn more about the network. With UMP Achieve 1, you pay $0 for covered preventive care when you see a network provider. If you have a favorite dentist, it's best to double-check that yours is included in our network. Wednesday, October 28, 4 to 5 p.m. UMP Plus-UW Medicine Accountable Care Network is now an option for SEBB-eligible members living in King, Snohomish, Kitsap, Pierce, Skagit, Thurston and Spokane counties. UMP is administered by Regence BlueShield and Washington State Rx Services. 2020 Changes to Uniform Medical Plan (UMP) Prescription Drug Formulary. UMP Plus–PSHVN is a network of providers offering high quality, coordinated care at a lower cost. The table below does not include every limit or exclusion under this benefit. 5 a.m. to 8 p.m. (Pacific) Find out more about this opportunity to access great healthcare while saving money. UMP High Deductible uses Regence BlueShield’s largest network of providers and covers all the same services as UMP Achieve 1 and UMP Achieve 2, but has a lower monthly premium and a higher deductible. Each plan has a different state wide network. regence uniform medical plan uhc military west regence ump geha ppo high. December 1, 2019 Uniform Medical Plan coverage limits Updates effective 1 2 /1/2019 The benefit coverage limitslisted below apply to these UMP plans: UniformMedical Plan (UMP) For most services, you can see a specialist without a referral. Phone: 1-888-361-1611TRS: 711 UMP Achieve 2 uses Regence BlueShield’s largest network of providers, but has a lower deductible and lower coinsurance than UMP Achieve 1. #z�s2�Vg&%ul�1lwycKv�(��xOpxO�X�&��&�Iϒ]4�t�n�Q�"�_�bd�;�g�]Q�2�U�Y��au#mp9N�I�DWd��˵�8D�8�. With UMP Achieve 2, you get covered preventive care at no cost to you when you see a preferred or participating provider. Monday through Friday If you have questions or need more information, contact Washington State Rx Services at 1-888-361-1611 (TRS: 711). You will also have 24/7 access to on-demand virtual care. The table below does not include every limit or exclusion under this benefit. Once the money is in your account, it’s yours, and there is no deadline to use it. Member. Find and compare treatment options, facilities and providers. Uniform Medical Plans can be found online. We provide flexible, affordable health care for members of the School Employees Benefits Board (SEBB) and Public Employees Benefits Board (PEBB) programs.. PSHVN has a large geographic footprint with over 6,500 providers and 1,100 locations. Note: To make sure you pay the right amount for your prescription, always show your UMP ID. %���� Uniform Medical Plan Pre-authorization List The Uniform Medical Plan (UMP) Pre-authorization List includes services and supplies that Postal Prescription Services (network mail-order pharmacy) 1-800-552-6694 ppsrx.com Supported by Regence, UMP Plus — PSHVN connects eligible School Employee Benefits Board (SEBB) Program members to high-quality primary and specialty care, close to home. You pay $0 for office visits with network primary care providers, including pediatricians, and there is no prescription drug deductible. By using providers within your network, your health care costs will be significantly lower than if you use providers outside your network. Visit the UMP Plus—UW Medicine ACN website to learn more about the network. Your deductibles are fixed dollar amounts you must pay each calendar year for health care and/or prescription drug expenses before the plan starts paying for covered services. There are slight variations in the language and benefits pertaining specifically to Massage Therapy depending on your client’s specific plan. Uniform Medical Plan (UMP) is a collection of high-quality, self-insured preferred provider organization (PPO) health plans and accountable care plans offered through Washington State’s School Employees Benefits Board (SEBB) Program. (HTCC) decision or a Regence BlueShield medical policy. Most primary care office visits with primary care providers, including naturopaths from the support network, are covered at no cost to you. Certificate of Coverage. UMP Plus—UW Medicine ACN is only available in certain counties: King, Kitsap, Pierce, Skagit, Snohomish, Spokane, and Thurston. UMP Plus—UW Medicine ACN is a network of providers offering high quality, coordinated care at a lower cost. UMP Achieve 1 also covers the full cost of certain programs to quit using tobacco or manage diabetes. Uniform Medical Plan (SEBB) Web TPA. Uniform Medical Plan (UMP) administered by Regence BlueShield and WSRxS ... SEBB Continuation Coverage spousal plan questionnaire 2020. The UMP Plus network is a limited network, compared to UMP Achieve 1 and UMP Achieve 2. Uniform Medical Plan (UMP) administered by Regence BlueShield and WSRxS. Premera cards with prefix PBQ (Reading/Writing/Speech services) ** Providence Hospital/Medical Network outsourced their mental health benefits to Providence Behavioral Health, aka … For most services, you can see the specialist you choose without a referral. UMP is administered by Regence BlueShield and Washington State Rx Services. Find a doctor will also help ensure you refer patients to in-network providers to minimize their out-of-pocket expenses.. Members can use Find a doctor to get results that are personalized to their networks and benefits. Try Alex, our interactive, virtual guide. For prescription drugs, the deductible is $250 per member, $750 per family. For more details, refer to your plan’s . To enroll in this plan, you must live in Chelan, Douglas, King, Kitsap, Pierce, Snohomish, Thurston, or Yakima county. %PDF-1.7 To make sure you pay the right amount for your prescription, always show your UMP ID. With UMP Achieve 2, you pay $0 for covered preventive care when you see a network provider. Certificate of Coverage. Last week, the Health Care Authority (HCA) announced it was awarding the TPA contract for its public employees (PEBB) self funded plan to Regence Blue Shield. Medical Plans: Kaiser Foundation Health Plan of the Washington Kaiser Permanente NW 1,2,3 MY.KO.ORG/SEBB 1-800-813-2000 Kaiser Foundation Health Plan of Washington Washington State Rx Services is the pharmacy benefit manager for UMP Plus. About Uniform Medical Plan (UMP), administered by Regence BlueShield. who takes my insurance? {�}�?wz��y����n��i�����/��7��~���~o�ɏ�R�nP���Bz��J�0��c�ݙj�г��T�q@�N/8%l"焰qetJ���ɠ��J��������nҠ��m��kR��So2�o���r#����Z�Hy�L�N.��_O�U�ްį�_s����Z�5���4��O���y��%r����,/d�[�ә�g�2 '��2 '��2 ��MeN4 '� This plan uses a provider network. For most services, you can see a specialist without a referral. To help you decide on a plan, it can be helpful to know the network—or the group of doctors, hospitals and pharmacies that are part of the plan. Trusteed. Find a doctor makes it easy to: endobj Members. Willamette Dental Group of Washington, Inc. Life and accidental death and dismemberment (AD&D) insurance, For PEBB Continuation Coverage - Unpaid Leave, For PEBB Continuation Coverage - COBRA (enrolled in Medicare), For PEBB Continuation Coverage - COBRA (not enrolled in Medicare), Life and accidental death & dismemberment (AD&D) insurance, Washington Apple Health (Medicaid) providers, Enroll as a health care professional practicing under a group or facility, Existing Apple Health (Medicaid) providers, Request a Zoom license to connect with patients (during the COVID-19 pandemic), Claims and billing (guides/fee schedules), Provider billing guides and fee schedules, Program benefit packages and scope of services, Autism and Applied Behavior Analysis (ABA) therapy, Access to Care Standards (ACS) and ICD information, Service Encounter Reporting Instructions (SERI), Intensive Residential Treatment (IRT) Teams, Preadmission Screening and Resident Review (PASRR), Program of Assertive Community Treatment (PACT), Medications for opioid use disorder (MOUD), Screening, brief intervention, and referral to treatment (SBIRT), Ground emergency medical transportation (GEMT), King County Superior Court Juvenile Probation Services, Washington State Federally Recognized Tribes, Apple Health (Medicaid) drug coverage criteria, Substance use disorder (SUD) consent management guidance, Sign language interpreter contract transition, Children's Mental Health Lawsuit and Agreement, Ricky’s Law: Involuntary Treatment Act (ITA), State Youth Treatment - Implementation (SYT-I) Project, Washington Screening, Brief Interventions, and Referrals to Treatment (WASBIRT-PCI) Project, Children’s Behavioral Health Data and Quality Team, Children's Behavioral Health Executive Leadership Team (CBH ELT), Children and Youth Behavioral Health Work Group (CYBHWG), Family Youth System Partner Round Table (FYSPRT), Evidence-based and research-based practices, Analytics, Research, and Measurement (ARM), Initiative 1: transformation through ACHs, Initiative 2: long-term services & supports, Initiative 3: supportive housing & supported employment, Initiative 4: substance use disorder (SUD) IMD, Medicaid Transformation Learning Symposium, School Employees Benefits Board (SEBB) Program FAQs, Apple Health (Medicaid) quality strategy and compliance oversight, Apple Health (Medicaid) MCO and BH-ASO state contracts, Revised Indian Nation agreements and program agreements, Governor's Indian Health Advisory Council, Washington Prescription Drug Program (WPDP), Multi-payer Primary Care Transformation Model, HCA connects employee ambitions with career goals, Office of Medicaid Eligibility and Policy leads the effort in making access to Apple Health simple, Celebrating HCA’s nurses during National Nurses Week, May 6-12, Community based specialists help people with free or low-cost health care coverage, Military experiences shape personal and professional values, Artist turned graphic designer helps HCA create and maintain hundreds of print and web products, Infants at the Workplace Program provides support and flexibility for new parents, HCA goes ‘above and beyond’ for employees with disabilities, Black History Month celebration was a first at HCA, Apple Health (Medicaid) and managed care reports, Public Employees Benefits Board (PEBB) Program enrollment, School Employees Benefits Board (SEBB) Program enrollment, Washington State All Payer Claims Database (WA-APCD), Behavioral health and recovery rulemaking, Public Employees Benefits Board rulemaking, School Employees Benefits Board rulemaking, Personal injury, casualty recoveries, & special needs trusts, Employee eligibility tools and worksheets, PEBB Continuation Coverage spousal plan questionnaire 2020, Learn more about your customer service options, UMP Prescription drug benefit information, Knee or hip replacement and spine care information, UMP Plus—UW Medicine Accountable Care Network, Make the switch to UMP Plus—UW Medicine ACN, Knee or hip replacement or spine care information, Website feedback: Tell us how we’re doing, Watch the UMP Achieve 1, Achieve 2, and High Deductible, Watch the UMP Plus—Puget Sound High Value Network, Watch the UMP Plus—UW Medicine Accountable Care Network. The UMP Plus – UW Medicine Accountable Care Network is an innovative healthcare option available to PEBB-eligible employees. <>/Metadata 226 0 R/ViewerPreferences 227 0 R>> The state’s self-insured plan (Uniform Medical Plan/ UMP) is administered by Regence. Monday through Friday With UMP High Deductible, you pay $0 for covered preventive care services when you see a network provider. Tricare. Learn more about your customer service options. This allows you to set aside pretax money to pay for qualified medical expenses, including prescription drugs and more. 24 hours a day, 7 days a week . Welcome to the health plan that has been supporting school employees for nearly 60 years. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 20 0 R 28 0 R] /MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> These UMP plans are available in every county and are available to anyone living outside of Washington, including those who ... Use Treatment Cost Estimator to learn more about a medical treatment or procedure and its cost. UMP Plus has a lower deductible and monthly premium than UMP Achieve 2 while offering most of the same benefits. Use our Find a doctor tool to quickly verify the information about your practice and the networks you participate in. UMP Plus—PSHVN is only available in certain counties: King, Kitsap, Pierce, Snohomish, Thurston, and Yakima. Premera and Kaiser are the two private insurance companies offering plans through SEBB.