UMP (Regence) Medical Claim Form

This medical claim form to send in a claim for medical services for all Uniform Medical Plans (UMP) (Regence).

Form

UMP (Regence) Medical incident report

This form is to report to Regence if an injury or illness may be covered under a third party. You may need to use this form even if the incident is not subject to third party coverage.

Form

UMP (Regence) medical multiple coverage inquiry form (coordination of benefits (COB))

This form is to notify Regence that you have additional coverage under another medical plan.

Form

UMP (Regence) Medical Preferred Drug List

This document is the Medical Preferred Drug List (PDL) for the Uniform Medical Plan (UMP). It lists prescription drugs covered by UMP under the medical benefit administered by Regence. This list applies to both PEBB and SEBB.

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UMP (Regence) provider fee schedule January 2020

This is the Regence BlueShield fee schedule for providers.

Fee schedule

UMP (Regence) Vision Claim Form

Use this Uniform Medical Plan (UMP) form to submit claims for vision hardware, such as eyeglasses and contact lens, to Regence.

Form

UMP (SEBB) (Regence) Important information for 2020

This document provides information to help School Employees Benefits Board (SEBB) members decide if UMP is right for them. Some examples of topics covered include explaining your choices if you and your spouse or state-registered domestic partner are enrolling in a UMP plan, what happens if you have an active preauthorization for medical care, and what happens if you are covered by two health insurance plans.

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UMP (SEBB) (Regence) New website

Overview of Uniform Medical Plan's (UMP) new website, administered by Regence.

Publication

UMP (SEBB) (Regence) Postcard to request certificate of coverage (COC)

Complete and mail in this postcard to request a copy of a Uniform Medical Plan (UMP) certificate of coverage (COC), mailed by Regence.

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UMP (SEBB) (Regence) Programs to keep you healthy 2020

This two-page document lists wellness programs offered by the Uniform Medical Plan (UMP) (Regence).

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