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UMP is a self-insured health plan offered through the Public Employees Benefits Board (PEBB) Program and the School Employees Benefits Board (SEBB) Program. All UMP prescription drugs, services, or other benefit changes may require approval by the PEB Board and SEB Board.
The PEB and SEB Boards have authority to:
- Set eligibility requirements
- Approve premium contributions for eligible employees (these may vary for certain employer groups)
- Approve benefits of all participating health insurance plans
Regence BlueShield (Regence) administers UMP under a contract with the Washington State Health Care Authority (HCA). Regence provides UMP with services such as:
- Processing medical claims
- Providing customer service for medical benefits
- Allowing members to access online account information through their Regence accounts
- Processing preauthorization requests for medical services
- Providing a preferred provider network
- Providing medical policies to determine criteria for coverage of medically necessary services. Read Policies that affect your care to learn more:
- Providing case management, which is clinical assistance for patients with serious or complex health issues.
- Processing appeals and complaints related to medical benefits. Read Claims & appeals to learn more about this process:
Regence also contracts with vendors to provide other services to UMP members. For example, Regence contracts with Omada to provide UMP's virtual diabetes prevention program benefit. To learn more about this benefit, read your plan's certificate of coverage.
UMP prescription drug benefits are managed by a partnership of companies known as Washington State Rx Services. These companies are:
- Moda Health — Administration (including preauthorization and appeals) and customer service
- MedImpact Healthcare Systems Inc. — Pharmacy network management and prescription drug claims processing
- Postal Prescription Services (PPS) — Mail-order pharmacy
- Ardon Health — Specialty drug pharmacy
To learn more about your prescription drug benefit, visit Prescription drugs:
If you have questions about your prescription drug coverage or need help finding a network vaccination pharmacy, call Washington State Rx Services Customer Service at 1-888-361-1611 (TRS: 711).
Contact the mail-order or specialty pharmacy directly for help placing or tracking prescription orders. Visit Contact us:
Note: Regence BlueShield does not provide prescription drug benefits for UMP. Always contact Washington State Rx Services with questions about your prescription drug coverage.
HealthEquity is the trustee (manager) of the health savings account (HSA) for UMP Consumer-Directed Health Plan (CDHP) and UMP High Deductible members. HealthEquity provides a member portal, customer service, and other tools (such as a debit card) to manage the HSA. Contact HealthEquity Customer Service at 1-844-351-6853 (TRS: 711) for questions about your HSA or visit HealthEquity’s website:
Premera Blue Cross administers the Centers of Excellence (COE) Program for UMP. The COE Program offers low- to no-cost knee and hip replacement surgery and spine care to qualifying UMP Achieve 1, UMP Achieve 2, UMP Classic, UMP CDHP and UMP High Deductible members.
For more information about the COE Program, read the COE Program brochure or call Premera at 1-855-784-4563 (TRS: 711).
UMP Plus covers health care services delivered through a network of providers. UMP Plus members choose either the Puget Sound High Value Network (PSHVN) or UW Medicine Accountable Care Network (UW Medicine ACN) network when they enroll.
- Puget Sound High Value Network (PSHVN)
- UW Medicine Accountable Care Network (UW Medicine ACN):
PSHVN and UW Medicine ACN deliver health care services through primary care providers, specialty care providers, ancillary providers, clinics, and hospitals. Visit UMP Plus providers and networks to learn more about these provider types:
To find a UMP Plus provider, members search the network they are enrolled in (or considering enrolling in):