Use our Find a doctor tool to quickly verify the information about your practice and the networks you participate in. Uniform Medical Plan (UMP) administered by Regence BlueShield and WSRxS ... SEBB Continuation Coverage spousal plan questionnaire 2020. 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 Plus, have the peace of mind that comes from emergency coverage wherever you’re traveling. 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. A plan’s network consists of doctors, clinics, hospitals, specialists, and other health care providers. Each plan has a different state wide network. Washington State Rx Services is the pharmacy benefit manager for UMP Plus. 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. Saturday 8 a.m. to 4:30 p.m. (Pacific). Members. 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. 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 High Deductible covers the same services as UMP Achieve 2, but has a lower monthly premium and a higher deductible. 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. For most services, you can see a specialist without a referral. You will also have 24/7 access to on-demand virtual care. UMP Achieve 1 uses Regence BlueShield’s largest network of providers. To browse each plan’s network or to find a s… The UMP Plus–PSHVN network is a limited network compared to UMP Achieve 1, UMP Achieve 2, and UMP High Deductible. For most services, you can see the specialist you choose without a referral. Most read as follows: Massage Therapy The plan pays the standard rate for up to 16 massage therapy visits per UMP Plus—UW Medicine ACN is only available in certain counties: King, Kitsap, Pierce, Skagit, Snohomish, Spokane, and Thurston. UMP High deductible uses Regence BlueShield’s largest network of providers. For prescription drugs, the deductible is $250 per member, $750 per family. Certificate of Coverage. Choose a plan that opens doors to top doctors and coordinated, cost-saving networks close to home. Member. UMP Achieve 1 uses Regence BlueShield’s largest provider network. ump.regence.com/sebb or call 1-800-628-3481 (TRS: 711) for a list of network providers (preferred providers). 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Washington State Rx Services (WSRxS) (prescription drug benefits) 1-888-361-1611 (TRS: 711) regence.com/ ump/sebb/ benefits/ prescriptions . Monday through Friday You pay $0 for office visits with network primary care providers, including pediatricians, and there is no prescription drug deductible. Medical Plans: Kaiser Foundation Health Plan of the Washington Kaiser Permanente NW 1,2,3 MY.KO.ORG/SEBB 1-800-813-2000 Kaiser Foundation Health Plan of Washington %���� x��=�n�H�����H �f�΅a�v��,6���{�d(��8-���ǃ����=��HIE٢K�6@$K,�\���T��(�q2,����uY&�I:_/����.�����>�'e��/��%~�K�����Jܼ��x�ƶl�KG�"��0vD��}���b������7��0�w�o$���A`Ł�o�����?} 1 0 obj ASC First MI DME Supplier NPI Phone Number Confidential Voice MailFax Number YesNo Members. 4 0 obj 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. All times are listed in Pacific Time. endobj For most services, you can see a specialist without a referral. Additionally, you get covered preventive care at no cost to you when you see a network provider. The Plus plan networks are smaller, as each consists of regional providers spread throughout western Washington. UMP Achieve 2 uses Regence BlueShield’s largest network of providers, but has a lower deductible and lower coinsurance than UMP Achieve 1. 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. 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. The table below does not include every limit or exclusion under this benefit. To make sure you pay the right amount for your prescription, always show your UMP ID. <> The Classic and CDHP plans share the same large network that includes providers both nationwide and worldwide. 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 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 UMP Plus – UW Medicine Accountable Care Network is an innovative healthcare option available to PEBB-eligible employees. 3 0 obj UMP Plus—PSHVN is only available in certain counties: King, Kitsap, Pierce, Snohomish, Thurston, and Yakima. Premera cards with prefix PBQ (Reading/Writing/Speech services) ** Providence Hospital/Medical Network outsourced their mental health benefits to Providence Behavioral Health, aka … Premera and Kaiser are the two private insurance companies offering plans through SEBB. Cancel Proceed. It is a network of providers providing high quality, coordinated care at a lower cost. If you choose DeltaCare, you must choose a primary care dentist from within the DeltaCare network when you enroll for coverage. Learn more about your customer service options. <>/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>> With UMP Achieve 2, you pay $0 for covered preventive care when you see a network provider. Phone: 1-888-361-1611TRS: 711 Uniform Medical Plan (SEBB) Web TPA. Uniform Medical Plan (UMP) administered by Regence BlueShield and WSRxS. <> UMP Achieve 2 also covers the full cost of certain programs to quit using tobacco or manage diabetes. Most primary care office visits with primary care providers, including naturopaths from the support network, are covered at no cost to you. Most primary care office visits with primary care providers, including naturopaths from the support network, are covered at no cost to you. stream 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 most services, you can see the specialist you choose without a referral. The Uniform Medical Plan (UMP) Pre-authorization List includes services and supplies that require pre-authorization or notification for UMP members. This plan uses a provider network. The State of Washington contributes annually to the account on an individual or family basis. (HTCC) decision or a Regence BlueShield medical policy. • 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. 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. UMP Plus–PSHVN is a network of providers offering high quality, coordinated care at a lower cost. Find out more about this opportunity to access great healthcare while saving money. ��)��S�>��훯=�������o������x��V\�p��e>k��C��� ߮I��(v7�p#�g2l��|��1���(�u��Jd��? ... Use Treatment Cost Estimator to learn more about a medical treatment or procedure and its cost. %PDF-1.7 7:30 a.m. to 5:30 p.m. (Pacific) There are slight variations in the language and benefits pertaining specifically to Massage Therapy depending on your client’s specific plan. For more details, refer to your plan’s . Certificate of Coverage. UMP Plus has a lower deductible and monthly premium than UMP Achieve 2 while offering most of the same benefits. endobj (HTCC) decision or a Regence BlueShield medical policy. Once the money is in your account, it’s yours, and there is no deadline to use it. Due to COVID-19, HCA’s lobby is closed. UMP Achieve 2 uses Regence BlueShield’s largest network of providers, but has a lower deductible than UMP Achieve 1 and UMP High Deductible. 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. Find and compare treatment options, facilities and providers. For more details, refer to your plan’s . UMP Achieve 2 also covers the full cost of certain programs to quit smoking or manage diabetes. With UMP Achieve 2, you get covered preventive care at no cost to you when you see a preferred or participating provider. The UMP Select medical deductible is $750 per member and $2,250 per family. The Public Employees Benefit Board (PEBB) passed the following resolution at their April 24th meeting: You pay $0 for office visits with network primary care providers, including pediatricians, and there is no prescription drug deductible. UMP is administered by Regence BlueShield and Washington State Rx Services. Uniform Medical Plans can be found online. 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