Certificate of Coverage. About Uniform Medical Plan (UMP), administered by Regence BlueShield. It is a network of providers offering high quality, coordinated care at a lower cost. Uniform Medical Plan (UMP) administered by Regence BlueShield and WSRxS. (HTCC) decision or a Regence BlueShield medical policy. This plan has a combined deductible for medical and prescription drug expenses, which means you pay all of these expenses before the plan starts paying for covered medical services and covered prescription drugs. 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 Achieve 2 uses Regence BlueShield’s largest network of providers, but has a lower deductible than UMP Achieve 1 and UMP High Deductible. There are slight variations in the language and benefits pertaining specifically to Massage Therapy depending on your client’s specific plan. Monday through Friday 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. A plan’s network consists of doctors, clinics, hospitals, specialists, and other health care providers. • Page 43: In the “Medical Benefits Comparison” chart: • Under “Hearing hardware” for the Kaiser Foundation Plan of the Northwest, Kaiser Foundation Plan of Washington, and Kaiser Foundation Plan of Washington Options, Inc. plans it should read, “$400 max per ear 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. Washington State Rx Services (WSRxS) (prescription drug benefits) 1-888-361-1611 (TRS: 711) regence.com/ ump/sebb/ benefits/ prescriptions . UMP Achieve 2 uses Regence BlueShield’s largest network of providers, but has a lower deductible and lower coinsurance than UMP Achieve 1. For more details, refer to your plan’s . Members. %PDF-1.7 To enroll in this plan, you must live in King, Kitsap, Pierce, Skagit, Snohomish, Spokane, or Thurston county. 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. For most services, you can see a specialist without a referral. 5 a.m. to 8 p.m. (Pacific) UMP Achieve 1 also covers the full cost of certain programs to quit using tobacco or manage diabetes. (HTCC) decision or a Regence BlueShield medical policy. 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. With UMP High Deductible, you pay $0 for covered preventive care services when you see a network provider. With UMP Achieve 2, you get covered preventive care at no cost to you when you see a preferred or participating provider. To browse each plan’s network or to find a s… ump.regence.com/sebb or call 1-800-628-3481 (TRS: 711) for a list of network providers (preferred providers). Visit HealthEquity or watch their recorded webinar to discover the many uses for your HSA. Cancel Proceed. <> You pay $0 for office visits with network primary care providers, including pediatricians, and there is no prescription drug deductible. Choose a plan that opens doors to top doctors and coordinated, cost-saving networks close to home. For prescription drugs, the deductible is $250 per member, $750 per family. Uniform Medical Plan Pre-authorization List The Uniform Medical Plan (UMP) Pre-authorization List includes services and supplies that You also get covered preventive care at no cost to you when you see a preferred or participating provider. x��=�n�H�����H �f�΅a�v��,6���{�d(��8-���ǃ����=��HIE٢K�6@$K,�\���T��(�q2,����uY&�I:_/����.�����>�'e��/��%~�K�����Jܼ��x�ƶl�KG�"��0vD��}���b������7��0�w�o$���A`Ł�o�����?} The table below does not include every limit or exclusion under this benefit. The Plus plan networks are smaller, as each consists of regional providers spread throughout western Washington. Administered by Regence BlueShield) applies to all UMP plans. Certificate of Coverage. Rehn & Associates . With UMP Achieve 2, you pay $0 for covered preventive care when you see a network provider. Find out more about this opportunity to access great healthcare while saving money. Premera cards with prefix PBQ (Reading/Writing/Speech services) ** Providence Hospital/Medical Network outsourced their mental health benefits to Providence Behavioral Health, aka … regence uniform medical plan uhc military west regence ump geha ppo high. With UMP Achieve 1, you get covered preventive care at no cost to you when you see a preferred or participating provider. You will also have 24/7 access to on-demand virtual care. Uniform Medical Plan Pre-authorization List The Uniform Medical Plan (UMP) Pre-authorization List includes services and supplies that endobj UMP is administered by Regence BlueShield and Washington State Rx Services. Postal Prescription Services (network mail-order pharmacy) 1-800-552-6694 ppsrx.com 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. All times are listed in Pacific Time. stream <> 2020 Changes to Uniform Medical Plan (UMP) Prescription Drug Formulary. Regence. endobj 2 0 obj 24 hours a day, 7 days a week . 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. You pay $0 for office visits with network primary care providers, including pediatricians, and there is no prescription drug deductible. endobj who takes my insurance? UMP Plus–PSHVN is a network of providers offering high quality, coordinated care at a lower cost. It is a network of providers providing high quality, coordinated care at a lower cost. 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 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. Visit the UMP Plus–PSHVN website to learn more about the network. Most health plans cover many … Find and compare treatment options, facilities and providers. 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 Trusteed. For most services, you can see a specialist without a referral. <>/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>> Phone: 1-888-361-1611TRS: 711 For more details, refer to your plan’s . UMP is administered by Regence BlueShield and Washington State Rx Services. Additionally, you get covered preventive care at no cost to you when you see a network provider. The Public Employees Benefit Board (PEBB) passed the following resolution at their April 24th meeting: The table below does not include every limit or exclusion under this benefit. UMP Achieve 1 uses Regence BlueShield’s largest provider network. 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 a list of network pharmacies, visit the Prescription drugs webpage at ump.regence.com/sebb/benefits/presc riptions or call 1 -888 361 1611 (TRS: 711). ASC First MI DME Supplier NPI Phone Number Confidential Voice MailFax Number YesNo To make sure you pay the right amount for your prescription, always show your UMP ID. Tricare. Most primary care office visits with primary care providers, including naturopaths from the support network, are covered at no cost to you. UMP Plus has a lower deductible and monthly premium than UMP Achieve 2 while offering most of the same benefits. 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The UMP Plus – PSHVN participating organizations include: CHI Franciscan and independent providers as part of … If you have questions or need more information, contact Washington State Rx Services at 1-888-361-1611 (TRS: 711). The Puget Sound High Value Network (PSHVN) is a network comprised of the highest quality health care organizations. UMP is ready to meet your health care needs with several affordable plan options. UMP Achieve 2 also covers the full cost of certain programs to quit using tobacco or manage diabetes. The UMP Select medical deductible is $750 per member and $2,250 per family. 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) You will also have 24/7 access to on-demand virtual care. When you enroll in UMP High Deductible, you are automatically enrolled in a health savings account (HSA) through our HSA partner HealthEquity who manages the account. 3 0 obj Uniform Medical Plan Contact us with any questions . 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. Certificate of Coverage. 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. 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. Try Alex, our interactive, virtual guide. UMP Plus—UW Medicine ACN is only available in certain counties: King, Kitsap, Pierce, Skagit, Snohomish, Spokane, and Thurston. The UMP Plus—UW Medicine ACN network is a limited network compared to UMP Achieve 1,UMP Achieve 2, and UMP High Deductible. Premera and Kaiser are the two private insurance companies offering plans through SEBB. 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. By using providers within your network, your health care costs will be significantly lower than if you use providers outside your network. UMP High deductible uses Regence BlueShield’s largest network of providers. ���C�i :b!#����_JA�=VO�����wRTxa���˱���d�A/#�{q�}�wï��1��Xbtו�_Ҥ��ȳ3R�}��{��#�w�H�}i��1�}��@��v�q,��~O�*N�5cKyO�����d��>gh!��Ҹd�(��Vؕ��s��*þX�USQ,���$w�z �5U�^�w �n�ag�!2;�j��9�F]�)aI�Y�\��a��J���+Zp���;�w2\�}���-0"Q[. Each plan has a different state wide network. For most services, you can see a specialist without a referral. 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. For more details, refer to your plan’s . Saturday 8 a.m. to 4:30 p.m. (Pacific). Uniform Medical Plans can be found online. The state’s self-insured plan (Uniform Medical Plan/ UMP) is administered by Regence. UMP Achieve 1 also covers the full cost of certain programs to quit smoking or manage diabetes. Visit Pharmacy to learn more about prescription drug coverage and cost, find a network pharmacy, learn about prescription drug policies, and log in to your pharmacy account.. 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. 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. Due to COVID-19, HCA’s lobby is closed. 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. Uniform Medical Plan (SEBB) Web TPA. %���� The Uniform Medical Plan (UMP) was built to provide top-quality, affordable healthcare to eligible Washington state public employees (active and retired), Leave Without Pay members, non-Medicare retirees or COBRA members. Members. All plans pay for covered preventive services like annual checkups, and certain screenings and vaccines at no cost to you when you see a network provider. Once the money is in your account, it’s yours, and there is no deadline to use it. Monday through Friday Available outside these hours with limited services.Extended hours: November 4, 11, and 18 until 8 p.m. to help answer open enrollment questions. With UMP Achieve 1, you pay $0 for covered preventive care when you see a network provider. UMP Achieve 2 also covers the full cost of certain programs to quit smoking or manage diabetes. Visit the UMP Plus—UW Medicine ACN website to learn more about the network. Use our Find a doctor tool to quickly verify the information about your practice and the networks you participate in. Title: UMP (SEBB) (Regence) What’s new for 2021 Author: Regence BlueShield Created Date: 9/25/2020 2:12:53 PM You are about to leave regence.com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association. For the Spanish version of the above video, watch on YouTube. If you have a favorite dentist, it's best to double-check that yours is included in our network. Uniform Medical Plan Pre-authorization List The Uniform Medical Plan (UMP) Pre-authorization List includes services and supplies that 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. ��)��S�>��훯=�������o������x��V\�p��e>k��C��� ߮I��(v7�p#�g2l��|��1���(�u��Jd��? The Classic and CDHP plans share the same large network that includes providers both nationwide and worldwide. UMP High Deductible covers the same services as UMP Achieve 2, but has a lower monthly premium and a higher deductible. These UMP plans are available in every county and are available to anyone living outside of Washington, including those who <>/Metadata 226 0 R/ViewerPreferences 227 0 R>> The UMP Plus–PSHVN network is a limited network compared to UMP Achieve 1, UMP Achieve 2, and UMP High Deductible. The plan offers a lower monthly premium than UMP Achieve 2 and UMP Plus, but has a higher coinsurance (the amount you pay your provider) than other UMP plans. You will also have 24/7 access to on-demand virtual care. UMP High Deductible automatically enrolls the subscriber in a health savings account (HSA), which allows you to set aside pre-tax money to pay for qualified medical expenses. 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