Summary of Benefits and Coverage 2019 UMP Plus UW Medicine Accountable Care Network

This is a summary of popular benefits covered under UMP Plus UW Medicine Accountable Care Network. It tells you how much you'll pay for these services, as well as specific related limits and exclusions.

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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)

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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).

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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).

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UMP (PEBB) (Regence) New website

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

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

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

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UMP (PEBB) (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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UMP (PEBB) (Regence) What’s new for 2020

Overview of new Uniform Medical Plan (UMP) benefits for plan year 2020. UMP medical benefits are administered by Regence.

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UMP (PEBB) (WSRxS) list of prescription drugs subject to emergency fill

This is a partial list of prescription drugs for which UMP (PEBB) members may request an emergency fill during the preauthorization process, and a description of how the process works. Washington State Rx Services (WSRxS)

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UMP (PEBB) (WSRxS) Preferred Drug List (PDL)

This document is the PEBB version of the Preferred Drug List (PDL) for the Uniform Medical Plan (UMP). It lists prescription drugs covered by UMP (PEBB), administered by Washington State Rx Services (WSRxS).

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