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Forms & publications
Can't find what you need? Visit UMP Forms and publications for more documents.
2017-2018 comparison of UMP monthly premiums
This document lists the 2017 and 2018 monthly premiums for UMP members who are employees and retirees.
Publication2018-2019 comparison of UMP monthly premiums
This document lists the 2018 and 2019 monthly premiums for UMP members who are employees and retirees.
Publication2019-2020 comparison of UMP monthly premiums
This document lists the 2019 and 2020 monthly premiums for UMP members who are employees and retirees.
PublicationABA Services Authorization Form
This form is for requesting preauthorization of Applied Behavior Analysis (ABA) Therapy services.
FormArdon Health Specialty Drug Release Form
This is a form that members must complete and send with initial order for specialty drugs from the UMP network specialty pharmacy, Ardon Health.
FormArdon patient request for non-safety caps on prescription containers
Members can use this form when purchasing specialty drugs through Ardon Health to request that Ardon Health not use child-resistant caps ("safety caps") to package a member's medication.
Formardon-phi-disclosure-authorization-form.pdf
Ardon Health Protected health information disclosure authorization form
FormCensus data spreadsheet
Spreadsheet for employers to share demographic data
FormCOE Program brochure
This flyer gives an overview of the Centers of Excellence Program in 2019 for knee and hip replacement and spine care.
PublicationCoverage of Applied Behavior Analysis Therapy (ABA Therapy Printable Summary)
This document summarizes the information on Applied Behavior Analysis (ABA) Therapy coverage available on the UMP website.
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