PEBB retirees: Join us for a UMP Classic Medicare town hall

Making UMP Classic Medicare more affordable

HCA hosted several retiree listening sessions in 2023 to ask for feedback about retiree plans and benefits. PEBB retirees expressed the importance of preserving UMP Classic Medicare as a plan option for PEBB Medicare retirees. They also shared concerns that the premium is becoming too costly.

In response, HCA has explored ways to make the plan more affordable while maintaining high-quality benefits and coverage.

An option to help reduce 2025 premiums is being discussed with the PEB Board with a decision needed by the PEB Board in April; if the Board does not act by April, UMP Classic Medicare enrollees are likely to experience premium increases similar to those occurring in the past two years. The purpose of the February town hall meetings is to hear from members about their thoughts on transitioning UMP Classic Medicare’s current creditable drug prescription-drug coverage to a Part D plan, as described in the video presentation.

What is the status?

Options for improving affordability are being discussed with the PEB Board in early 2024. PEB Board meetings are open to the public. View the PEB Board meeting dates.

Has a decision been made?

UMP Classic Medicare will remain an option for any PEBB Medicare retiree. The PEB Board is evaluating an option for 2025 to lower premiums and maintain high quality benefits and coverage for UMP Classic Medicare, by transitioning from current creditable drug coverage to a Part D plan.

Join the conversation

We invite you to participate and share feedback about the option. There are two steps: 

Step 1: Watch a presentation

Watch a presentation about a proposal for keeping UMP Classic Medicare affordable before registering for a town hall.

Step 2: Register for a town hall

After watching the recording register for a town hall. At the town halls, HCA will listen to member feedback and respond to questions as best as we can at this time. The feedback received will be summarized and shared with the PEB Board as they consider options for improving UMP Classic Medicare affordability. 

Location Date and time Registration details
Town Hall - Zoom Tuesday, February 27, 2024
2 to 3:30 p.m. (Pacific)
Register for February 27
Max capacity 90

Town Hall - In-person

Health Care Authority
Cherry Street Plaza
Sue Crystal Rooms A and B
626 8th Avenue SE
Olympia, WA 98501

Thursday, February 29, 2024
10 to 11:30 a.m. (Pacific)
Registration for February 29 (in-person)
Max capacity 50

Can't attend a town hall? 

  • Send a letter to
    Health Care Authority
    PEBB UMP Medicare Feedback
    PO Box 42684
    Olympia, WA 98504

  • Send an email to the PEB Board

HCA will provide letters and emails directly to the PEB Board for their review and consideration. HCA will not respond individually to letters and emails on this issue, but will review them to guide future communications. To ensure timely review for the next PEB Board meeting, please mail your letter by March 8, 2024.

Quick facts

Below is additional information about the Part D option. View the printable PDF of the fact sheet.

Pharmacy transition to Part D plan

Advantages

  • Offers greatest premium savings for members
  • Takes advantage of federal subsidies and drug discounts
  • Provides pharmacy coverage very similar to the UMP’s current coverage
  • Part D is regulated by Medicare
  • Moda would continue to be plan administrator
  • Plan would be embedded in the single UMP Classic Medicare offering
  • Medical coverage would not change
  • Member experience would be virtually the same

Cost-share structure comparison

  • Part D deductible is the same as current UMP deductible ($100)
  • Part D out-of-pocket maximum ($2,000) is the same as current UMP
  • Vast majority of prescriptions filled through Part D would have the same or lower cost share compared to UMP
  • Over 90% of total prescriptions for UMP Medicare retirees were generics. Most of these would be covered at $0 under the Part D plan, representing the elimination of a cost Medicare retirees currently pay when filling a generic prescription.
  • Members would save on preferred brand medications under the Part D plan
  • Members who use high-cost specialty medication (~1-2% of total UMP Medicare retiree prescriptions) may have a $15/month higher cost share
  • Many non-preferred drugs that are not covered by UMP today would be covered by the Part D plan (~1% of total UMP Medicare retiree prescriptions)

Specific frequently prescribed drug coverage questions

Based on an analysis completed in October 2023, 98.2% of prescriptions filled by UMP retirees would have been covered if the plan coverage had been a Part D formulary. Remember, formularies can change at any time including for the current UMP Classic Medicare.

  • All the following frequently prescribed drugs for UMP retirees would continue to be covered and the current cost share a retiree pays when filling the prescription would be reduced to $0:
    • Levothyroxine, Lisinopril, Amlodipine, Losartan, Metoprolol, Gabapentin, Hydrochlorothiazide, Tamsulosin, Metformin, Furosemide, Trazodone, Carvedilol, Latanoprost, Allopurinol, Alendronate, and Escitalopram
  • The following frequently prescribed drugs for UMP retirees would continue to be covered and there would be no copay just like a retiree experiences today:
    • Atorvastatin, Rosuvastatin, Simvastatin, and Pravastatin
  • Examples of preferred brand (non-specialty) drugs, which many UMP Classic Medicare retirees take today, that would continue to be covered and would drop by up to $40 for 30 days:
    • Eliquis, Ozempic, Jardiance, Xarelto, Farxiga, Entresto, Trelegy Ellipta, and Tradjenta

The are few differences under a Part D formulary among the most frequently prescribed drugs for UMP Medicare retirees. The biggest difference, with the largest impact identified by HCA would be a required switch from Basaglar (insulin glargine) to Lantus (insulin glargine) for insulin coverage. These drugs have the same active ingredient, delivery method and dosage, and many members who use insulin have used both at some point in their lives, so the impact of this switch could be minimal.

Who can I contact with questions? 

Send questions to UMP Questions.