Kootenai Health possible departure from UMP network
Updated 12/24/2025
New network agreement
Regence and Kootenai Health have reached an agreement. UMP members can continue to receive care from Kootenai Health at the network rate. A network disruption will not occur on January 1 and Regence will mail a follow-up letter to members indicating the agreement remains in effect.
Recently, Regence BlueShield, the administrator for Uniform Medical Plan (UMP), mailed a legally required notice to approximately 1,200 PEBB and SEBB members about an upcoming potential provider network disruption. The mailing states that Kootenai Health may no longer be in the UMP network starting January 1, 2026.
HCA understands that all parties continue to negotiate in hopes of reaching an agreement before the current contract expires. If a new agreement is reached, UMP members will receive another letter from Regence informing them of this result. HCA will update this announcement as negotiations continue.
What do I need to do if I receive the notice?
- You do not need to take any action right now.
- Any care and services you have scheduled through December 31, 2025, will still be covered at the in-network rate.
- Check this page for updates, keeping in mind that most of the time a new network agreement is ultimately reached without any provider network disruption occurring.
What if an agreement is not reached?
On or after January 1, 2026, members receiving services from Kootenai Health will pay the out-of-network rate, which is 40% of the plan’s allowed amount, plus any amount the provider bills that is above the plan’s allowed amount.
Emergency care received at any hospital emergency room would still be covered at the in-network rate. If you need immediate help, call 911 for a hospital emergency or 988 for a mental health or substance use disorder crisis.
Members currently receiving services from Kootenai Health for certain conditions may have the right to continue treatment at the network rate for a limited time under a continuity of care provision.
Eligible conditions for continuity of care include:
- Seeing the provider for a serious or complex condition, including certain chronic conditions
- Undergoing a course of institutional or inpatient care from the provider
- Being scheduled for a nonelective surgery from the provider
- Being pregnant and seeing the provider for pregnancy-related care
- Being determined to be terminally ill
Check your plan’s certificate of coverage (COC) for more information or call UMP Customer Service at one of the numbers below.
I have Medicare as my primary insurance; how will this affect me?
If Medicare covers the care that you are receiving from Kootenai Health and Kootenai Health is a Medicare-participating provider, your care with Kootenai Health will continue to be considered in-network with both Medicare and your secondary coverage under UMP. If Medicare does not cover the care you are receiving from Kootenai Health, your care from Kootenai Health on or after January 1, 2026, will be paid at the out-of-network rate by your UMP Plan.
Who can I contact for help?
- PEBB members should call UMP Customer Service at 1-888-849-3681 (TRS: 711) or visit the UMP PEBB website.
- SEBB UMP members should call UMP Customer Service at 1-800-628-3481 (TRS: 711) or visit the UMP SEBB website.