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PEB Board and SEB Board
Uniform Medical Plan (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
To learn more, visit the PEBB Program and SEBB Program.
Regence BlueShield
Regence BlueShield (Regence) administers UMP medical benefits 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 provider network
- Providing medical policies to determine criteria for coverage of medically necessary services. To learn more, visit:
- Providing case management, which is clinical assistance for patients with serious or complex health issues.
- Processing appeals and complaints related to medical benefits. To learn more about this process, visit:
Regence also contracts with vendors to provide other services to UMP members. For example, Regence contracts with Omada Health 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
Washington State Rx Services administers UMP prescription drug benefits under a contract with HCA. Washington State Rx Services is a partnership of companies:
- Moda Health — Administration (including preauthorization and appeals) and customer service
- Postal Prescription Services (PPS) — Network mail-order pharmacy
- Ardon Health — Network specialty drug pharmacy
To learn more about your prescription drug benefit, visit:
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:
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) 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
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 Classic, UMP Select, UMP CDHP, UMP Achieve 1, UMP Achieve 2, 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 networks
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 providers, support providers, clinics, and hospitals. To learn more about these provider types, visit:
To find a UMP Plus provider, members search the network they are enrolled in (or considering enrolling in):
Vision Service Plan (VSP)
Vision coverage is provided for UMP (PEBB) members by UMP, in collaboration with Regence Choice Vision Plan administered by Vision Service Plan (VSP). Regence BlueShield administers benefits for the treatment of diseases and disorders of the eyes. VSP administers benefits for routine eye exams and hardware (prescription lenses, frames, or prescription contact lenses) and provides claims administration for this plan.
To find a provider in the VSP Choice Network, visit the VSP website.
When you have questions about routine eye exams and hardware, call VSP Member Services at 1-844-299-3041 or Deaf, DeafBlind, Late Deafened and Hard of Hearing members call 1-800-428-4833.
If you are a UMP (SEBB) member, Regence BlueShield administers benefits for the treatment of diseases and disorders of the eyes that are not part of a routine vision exam. UMP does not cover routine vision benefits for SEBB members. Visit Vision plans and benefits (school employees or SEBB Continuation Coverage members) for more information on options for vision coverage available to SEBB subscribers and their dependents.