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PEB Board
UMP is a self-funded health plan offered through the Public Employees Benefits Board (PEBB) Program. All UMP prescription drugs, services, or other benefit changes may require approval by the PEB Board.
The PEB Board decides on the following areas for the PEBB Program:
- Sets eligibility requirements.
- Approves premium contributions for eligible employees (these may vary for employees of K-12 school districts and certain employer groups).
- Approves benefits of all participating health insurance plans.
To learn more about the PEB Board, visit the PEBB Program webpages.
Regence BlueShield
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 account.
- Processing preauthorization requests for medical services.
- Providing a preferred provider network. (UMP Plus members see UMP Plus networks.)
- Providing medical policies to determine criteria for coverage of medically necessary services. Read Medical policies 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 Complaints and appeals procedures 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.
Washington State Rx Services
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.
When 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.
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
HealthEquity is the trustee (manager) of the health savings account (HSA) for UMP Consumer-Directed Health Plan (CDHP) 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 1-877-873-8823 (TRS: 711) for questions about your HSA.
Premera Blue Cross
Premera Blue Cross administers the Centers of Excellence (COE) Program for UMP. The COE Program offers knee and hip replacement surgery and spine care for low to no cost to qualifying UMP Classic and UMP CDHP 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 networks
UMP Plus covers health care services delivered through a network of providers. There are two UMP Plus provider networks:
PSHVN and UW Medicine ACN deliver health care services through primary care providers, specialty care providers, ancillary providers, clinics, and hospitals. Visit UMP Plus provider information to learn more about these provider types.
UMP Plus members choose one of the networks when they enroll. To find a UMP Plus provider, members search the network they are enrolled in (or considering enrolling in).
Contact
See related links for partners' contact information.