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Partners

HCA's Public Employees Benefits Board (PEBB) Program oversees the Uniform Medical Plan (UMP). PEBB's responsibilities include:

  • Purchase and coordinate insurance benefits and provide contract oversight for outside vendors.
  • Manage UMP administrative functions. (UMP is a self-insured plan that the PEBB Program oversees. It is not regulated by the Office of the Insurance Commissioner.)
  • Provide customer service to retirees and self-pay members on eligibility, enrollment, and surcharges (and related appeals and complaints).

UMP partners include:

  • Regence BlueShield
  • Washington State Rx Services
  • HealthEquity (UMP CDHP only)
  • Puget Sound High Value Network (UMP Plus only)
  • UW Medicine Accountable Care Network (UMP Plus only)

Uniform Medical Plan business partners

Regence BlueShield

Regence BlueShield is under contract with HCA to provide UMP services such as:

  • Medical claims.
  • Customer service for medical benefits (not prescription drug benefits).
  • Online account information on regence.com.
  • Preauthorization of medical services.
  • Preferred provider network (also see UMP Plus only below for UMP Plus networks).
  • Clinical/medical policies: Criteria for coverage of medically necessary services.
  • Case management: Clinical assistance for patients with serious or complex health issues.
  • Appeals and complaints related to medical benefits.

Regence BlueShield also contracts with vendors to provide other services to UMP members.

Washington State Rx Services
(contact customer service)

UMP prescription drug benefits are managed by a partnership of companies known as Washington State Rx Services, including:

  • Moda Health—Administration and customer service.
  • MedImpact Healthcare Systems Inc.—Pharmacy network management and claims processing.
  • PPS (Postal Prescription Services)—Mail-order pharmacy.
  • Ardon Health—Specialty drug pharmacy.
Health Equity
(UMP CDHP only)
HealthEquity is the trustee managing the health savings account (HSA) for UMP CDHP members. HealthEquity provides customer service, an online account, and other tools (such as a debit card) to manage the HSA.

UMP Plus only

The Health Care Authority contracts with two preferred provider organization (PPO) networks that include a choice of primary care providers, specialty care providers, clinics, and hospitals. UMP Plus members choose one of the networks when they enroll.