regence uniform medical plan sebb

��)��S�>��훯=�������o������x��V\�p��e>k��C��� ߮I��(v7�p#�g2l��|��1���(�u��Jd��? The Puget Sound High Value Network (PSHVN) is a network comprised of the highest quality health care organizations. 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. 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. The UMP Select medical deductible is $750 per member and $2,250 per family. 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. 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. 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. These UMP plans are available in every county and are available to anyone living outside of Washington, including those who 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. A plan’s network consists of doctors, clinics, hospitals, specialists, and other health care providers. regence uniform medical plan uhc military west regence ump geha ppo high. Visit the UMP Plus—UW Medicine ACN website to learn more about the network. The UMP Plus – PSHVN participating organizations include: CHI Franciscan and independent providers as part of … Title: UMP (SEBB) (Regence) What’s new for 2021 Author: Regence BlueShield Created Date: 9/25/2020 2:12:53 PM UMP Achieve 1 uses Regence BlueShield’s largest network of providers. This allows you to set aside pretax money to pay for qualified medical expenses, including prescription drugs and more. 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. 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. 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. UMP Plus has a lower deductible and monthly premium than UMP Achieve 2 while offering most of the same benefits. endobj The UMP Plus network is a limited network, compared to UMP Achieve 1 and UMP Achieve 2. 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To browse each plan’s network or to find a s… Welcome to the health plan that has been supporting school employees for nearly 60 years. Visit HealthEquity or watch their recorded webinar to discover the many uses for your HSA. All times are listed in Pacific Time. The table below does not include every limit or exclusion under this benefit. %���� <>/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>> 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. • 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, “$400 max per ear Administered by Regence BlueShield) applies to all UMP plans. All plans pay for covered preventive services like annual checkups, and certain screenings and vaccines at no cost to you when you see a network provider. Plus, have the peace of mind that comes from emergency coverage wherever you’re traveling. You will also have 24/7 access to on-demand virtual care. With UMP Achieve 2, you get covered preventive care at no cost to you when you see a preferred or participating provider. With UMP Achieve 1, you get covered preventive care at no cost to you when you see a preferred or participating provider. Available outside these hours with limited services.Extended hours: November 4, 11, and 18 until 8 p.m. to help answer open enrollment questions. UMP is administered by Regence BlueShield and Washington State Rx Services. Uniform Medical Plan Pre-authorization List The Uniform Medical Plan (UMP) Pre-authorization List includes services and supplies that 2020 Changes to Uniform Medical Plan (UMP) Prescription Drug Formulary. <> The table below does not include every limit or exclusion under this benefit. By using providers within your network, your health care costs will be significantly lower than if you use providers outside your network. Certificate of Coverage. If you have questions or need more information, contact Washington State Rx Services at 1-888-361-1611 (TRS: 711). To enroll in this plan, you must live in Chelan, Douglas, King, Kitsap, Pierce, Snohomish, Thurston, or Yakima county. You will also have 24/7 access to on-demand virtual care. Note: To make sure you pay the right amount for your prescription, always show your UMP ID. x��=�n�H�����H �f�΅a�v��,6���{�d(��8-���ǃ����=��HIE٢K�6@$K,�\���T��(�q2,����uY&�I:_/����.�����>�'e��/��%~�K�����Jܼ��x�ƶl�KG�"��0vD��}���b������7��0�w�o$���A`Ł�o�����?} Member. You also get covered preventive care at no cost to you when you see a preferred or participating provider. UMP Achieve 1 also covers the full cost of certain programs to quit using tobacco or manage diabetes. The Public Employees Benefit Board (PEBB) passed the following resolution at their April 24th meeting: Cancel Proceed. The UMP Plus–PSHVN network is a limited network compared to UMP Achieve 1, UMP Achieve 2, and UMP High Deductible. UMP is administered by Regence BlueShield and Washington State Rx Services. Members. Designed with K-12 employees in mind, our School Employees Benefits Board (SEBB) health plans offer robust benefits and include the same great service you have come to expect from Premera. The table below does not include every limit or exclusion under this benefit. Use our Find a doctor tool to quickly verify the information about your practice and the networks you participate in. ASC First MI DME Supplier NPI Phone Number Confidential Voice MailFax Number YesNo 3 0 obj Find out more about this opportunity to access great healthcare while saving money. %PDF-1.7 ump.regence.com/sebb or call 1-800-628-3481 (TRS: 711) for a list of network providers (preferred providers). UMP Plus—UW Medicine ACN is only available in certain counties: King, Kitsap, Pierce, Skagit, Snohomish, Spokane, and Thurston. The state’s self-insured plan (Uniform Medical Plan/ UMP) is administered by Regence. You will also have 24/7 access to on-demand virtual care. 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. Saturday 8 a.m. to 4:30 p.m. (Pacific). Once the money is in your account, it’s yours, and there is no deadline to use it. Additionally, you get covered preventive care at no cost to you when you see a network provider. 5 a.m. to 8 p.m. (Pacific) For most services, you can see a specialist without a referral. (HTCC) decision or a Regence BlueShield medical policy. 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. Find a doctor makes it easy to: UMP Plus has a lower deductible and monthly premium than UMP Achieve 2 while offering most of the same benefits. 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 […] #z�s2�Vg&%ul�1lwycKv�(��xOpxO�X�&��&�Iϒ]4�t�n�Q�"�_�bd�;�g�]Q�2�U�Y��au#mp9N�I�DWd��˵�8D�8�. 4 0 obj (HTCC) decision or a Regence BlueShield medical policy. It is a network of providers offering high quality, coordinated care at a lower cost. Rehn & Associates . 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. The UMP Plus – UW Medicine Accountable Care Network is an innovative healthcare option available to PEBB-eligible employees. The Plus plan networks are smaller, as each consists of regional providers spread throughout western Washington. About Uniform Medical Plan (UMP), administered by Regence BlueShield. This plan uses a provider network. Members. For most services, you can see the specialist you choose without a referral. With UMP High Deductible, you pay $0 for covered preventive care services when you see a network provider. Most primary care office visits with primary care providers, including naturopaths from the support network, are covered at no cost to you. Uniform Medical Plan Pre-authorization List The Uniform Medical Plan (UMP) Pre-authorization List includes services and supplies that Additionally, you get covered preventive care 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. <>/Metadata 226 0 R/ViewerPreferences 227 0 R>> Find and compare treatment options, facilities and providers. Washington State Rx Services (WSRxS) (prescription drug benefits) 1-888-361-1611 (TRS: 711) regence.com/ ump/sebb/ benefits/ prescriptions . Regence. stream Due to COVID-19, HCA’s lobby is closed. 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). The Classic and CDHP plans share the same large network that includes providers both nationwide and worldwide. For most services, you can see the specialist you choose without a referral. Uniform Medical Plan Pre-authorization List The Uniform Medical Plan (UMP) Pre-authorization List includes services and supplies that Learn more about your customer service options. 2 0 obj Washington State Rx Services is the pharmacy benefit manager for UMP Plus. It is a network of providers providing high quality, coordinated care at a lower cost. 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. Try Alex, our interactive, virtual guide. UMP Plus—PSHVN is only available in certain counties: King, Kitsap, Pierce, Snohomish, Thurston, and Yakima. Uniform Medical Plan (UMP) administered by Regence BlueShield and WSRxS ... SEBB Continuation Coverage spousal plan questionnaire 2020. UMP High deductible uses Regence BlueShield’s largest network of providers. Most read as follows: Massage Therapy The plan pays the standard rate for up to 16 massage therapy visits per {�}�?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 '� Monday through Friday <> With UMP Achieve 2, you pay $0 for covered preventive care when you see a network provider. Certificate of Coverage. 7:30 a.m. to 5:30 p.m. (Pacific) Premera and Kaiser are the two private insurance companies offering plans through SEBB. 1 0 obj UMP Achieve 2 also covers the full cost of certain programs to quit using tobacco or manage diabetes. UMP is ready to meet your health care needs with several affordable plan options. 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. To enroll in this plan, you must live in King, Kitsap, Pierce, Skagit, Snohomish, Spokane, or Thurston county. The UMP Plus—UW Medicine ACN network is a limited network compared to UMP Achieve 1,UMP Achieve 2, and UMP High Deductible. Premera cards with prefix PBQ (Reading/Writing/Speech services) ** Providence Hospital/Medical Network outsourced their mental health benefits to Providence Behavioral Health, aka … 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) Postal Prescription Services (network mail-order pharmacy) 1-800-552-6694 ppsrx.com There are slight variations in the language and benefits pertaining specifically to Massage Therapy depending on your client’s specific plan. UMP Plus—UW Medicine ACN is a network of providers offering high quality, coordinated care at a lower cost. 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. Visit the UMP Plus–PSHVN website to learn more about the network. 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. Trusteed. Uniform Medical Plan Contact us with any questions . If you choose DeltaCare, you must choose a primary care dentist from within the DeltaCare network when you enroll for coverage. Phone: 1-888-361-1611TRS: 711 SEBB Continuation Coverage:​Submit your form, Phone: 1-800-628-3481TRS: 711 Tricare. Each plan has a different state wide network. 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. The Uniform Medical Plan (UMP) Pre-authorization List includes services and supplies that require pre-authorization or notification for UMP members. 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. endobj endobj For more details, refer to your plan’s . UMP Achieve 1 uses Regence BlueShield’s largest provider network. UMP Plus–PSHVN is a network of providers offering high quality, coordinated care at a lower cost. 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. To make sure you pay the right amount for your prescription, always show your UMP ID. For more details, refer to your plan’s . ���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[. who takes my insurance? 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. UMP Achieve 1 also covers the full cost of certain programs to quit smoking or manage diabetes. You pay $0 for office visits with network primary care providers, including pediatricians, and there is no prescription drug deductible. For prescription drugs, the deductible is $250 per member, $750 per family. Most primary care office visits with primary care providers, including naturopaths from the support network, are covered at no cost to you. 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. The State of Washington contributes annually to the account on an individual or family basis. UMP Achieve 2 uses Regence BlueShield’s largest network of providers, but has a lower deductible and lower coinsurance than UMP Achieve 1. UMP High Deductible covers the same services as UMP Achieve 2, but has a lower monthly premium and a higher deductible. 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. Most health plans cover many … You pay $0 for office visits with network primary care providers, including pediatricians, and there is no prescription drug deductible. Monday through Friday 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. Choose a plan that opens doors to top doctors and coordinated, cost-saving networks close to home. ... Use Treatment Cost Estimator to learn more about a medical treatment or procedure and its cost. 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 UMP Achieve 2 also covers the full cost of certain programs to quit smoking or manage diabetes. Uniform Medical Plan (UMP) administered by Regence BlueShield and WSRxS. For more details, refer to your plan’s . Willamette Dental Group of Washington, Inc. 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With UMP Achieve 1, you pay $0 for covered preventive care when you see a network provider. 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. 24 hours a day, 7 days a week . For the Spanish version of the above video, watch on YouTube. 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. Uniform Medical Plans can be found online. (HTCC) decision or a Regence BlueShield medical policy. If you have a favorite dentist, it's best to double-check that yours is included in our network. Uniform Medical Plan (SEBB) Web TPA. by Carol Dotlich, RPEC Executive Board Member. 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.. 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Outside your network, are covered at no cost to you when you see a network providers! Sure you pay $ 0 for covered preventive care at a lower cost meet your health care.., but has a lower cost counties: King, Kitsap, Pierce,,. Medical plans can be found online Puget Sound High Value network ( PSHVN ) is by! Quality health care providers, including naturopaths from the support network, are covered at no cost to you you. Contributes annually to the account on an individual or family basis will be significantly lower than you... 711 ) for a list of network providers ( preferred regence uniform medical plan sebb ) will also have access... Largest provider network UMP Plus—PSHVN is only available in certain counties: King, Kitsap, Pierce,,... To on-demand virtual care UMP Plus network is a network of providers offering High quality, coordinated at. Washington State Rx services at 1-888-361-1611 ( TRS: 711 ), have the peace of mind that from! Programs to quit smoking or manage diabetes plan questionnaire 2020 2 also covers the same benefits list services. Services ( network mail-order pharmacy ) 1-800-552-6694 ppsrx.com Uniform Medical plan ( UMP ) administered by Regence when! ] Q�2�U�Y��au # mp9N�I�DWd��˵�8D�8� pay the right amount for your HSA a day 7! Blueshield ’ s largest provider network be significantly lower than if you choose DeltaCare, you see! Included in our network find out more about this opportunity to access great healthcare while money! For the Spanish version of the same large network that includes providers nationwide... Only available in certain counties: King, Kitsap, Pierce, Snohomish, Thurston and.
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