Regence nondiscrimination and language assistance notice

This nondiscrimination notice describes how Regence complies with applicable federal and Washington State civil rights laws. It also provides information about language assistance.

Publication

UMP (Ardon Health) Non-safety caps on prescription containers request form

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. Ardon Health is a member of Washington State Rx Services (WSRxS)

Form

UMP (Ardon Health) Prescription drug protected health information (PHI) disclosure authorization form

Ardon Health Protected health information (PHI) disclosure authorization form. Ardon Health is a member of Washington State Rx Services (WSRxS).

Form

UMP (Ardon Health) Specialty prescription drug release form

This is a form that members must complete and send with initial order for specialty drugs from the Uniform Medical Plan (UMP) network specialty pharmacy, Ardon Health. Ardon Health is a member of Washington State Rx Services (WSRxS).

Form

UMP (PEBB) (Regence) What’s new for 2022

This is an overview of new Uniform Medical Plan (UMP) benefits and changes to benefits for plan year 2022 for Public Employees Benefits Board (PEBB) members. UMP medical benefits are administered by Regence BlueShield and prescription drug benefits are administered by Washington State Rx Services.

Publication

UMP (PEBB) (WSRxS) Prescription drug benefits comparison for 2022

This is a summary of how prescription drug benefits work for Uniform Medical Plan (UMP) Classic, UMP Select, UMP CDHP, and UMP Plus for benefit year 2022, including what you'll pay for drugs and a partial list of network pharmacies. UMP prescription drug benefits are administered by Washington State Rx Services (WSRxS).

Publication

UMP (PEBB) monthly premiums comparison 2021-2022

54-510

This document lists the 2021 and 2022 monthly premiums for Uniform Medical Plan (UMP) members who are employees and retirees. UMP is administered by Regence BlueShield and Washington State Rx Services under contract with the Washington State Health Care Authority.

Publication

UMP (PEBB) Vision Service Plan (VSP) reimbursement form

This is the Vision Service Plan's (VSP reimbursement form for UMP (PEBB) members. UMP (PEBB) stands for Uniform Medical Plan (Public Employees Benefits Board)

Form

UMP (PEBB) Vision Service Plan Brochure 2022

This is a summary of how vision benefits work for UMP Classic, UMP Select, UMP CDHP, and UMP Plus (PEBB) for benefit year 2022, including what you'll pay for services and supplies and how to find providers. UMP vision benefits are administered by Vision Service Plan (VSP).

Publication

UMP (PPS) Prescription drug mail-order form

This form is to order prescription drugs from the UMP network mail-order pharmacy, Postal Prescription Services (PPS), which is a member of Washington State Rx Services (WSRxS).

Form

Pages