UMP (WSRxS) Prescription drug complaints and appeals form

This Washington State Rx Services (WSRxS) form may be included in an appeal or complaint regarding prescription drug coverage, but it is not required. It helps the member include all the necessary information for an appeal or complaint, and it includes the address and fax number where documents should be submitted.

Form

UMP (WSRxS) Value Tier Drugs

This is a list of drugs covered under the Value Tier cost-share for some UMP plans. Washington State Rx Services (WSRxS) created this list.

Publication

UMP Achieve 1 (SEBB) (Regence) Summary of Benefits and Coverage (SBC) 2021

This is a 2021 summary of popular benefits covered under UMP Achieve 1. It tells you how much you'll pay for these services, as well as specific related limits and exclusions. A Regence document.

Publication

UMP Achieve 1 (SEBB) (Regence) Summary of Benefits and Coverage (SBC) 2022

This is a 2022 summary of popular benefits covered under UMP Achieve 1. It tells you how much you'll pay for these services, as well as specific related limits and exclusions. A Regence document.

Publication

UMP Achieve 1 (SEBB) Certificate of Coverage (COC) 2020

This book describes what is covered under UMP Achieve 1, including medical services and prescription drugs. It describes how to find providers and how much you'll pay to see them (including your deductible, coinsurance, and out-of-pocket limit). Your COC also describes how to request an appeal and how to submit a claim. UMP is administered by Regence BlueShield and Washington State Rx Services (WSRxS) under contract with the Washington State Health Care Authority.

Publication

UMP Achieve 1 (SEBB) Certificate of Coverage (COC) 2021

54-0018

This book describes what is covered under UMP Achieve 1 (SEBB), including medical services and prescription drugs. It describes how to find providers and how much you'll pay to see them (including your deductible, coinsurance, and out-of-pocket limit). Your COC also describes how to request an appeal and how to submit a claim. UMP is administered by Regence BlueShield and Washington State Rx Services (WSRxS) under contract with the Washington State Health Care Authority.

Publication

UMP Achieve 1 (SEBB) Certificate of Coverage (COC) 2022

54-0018

This book describes what is covered under UMP Achieve 1 (SEBB), including medical services and prescription drugs. It describes how to find providers and how much you'll pay to see them (including your deductible, coinsurance, and out-of-pocket limit). Your COC also describes how to request an appeal and how to submit a claim. UMP is administered by Regence BlueShield and Washington State Rx Services (WSRxS) under contract with the Washington State Health Care Authority.

Publication

UMP Achieve 1 (SEBB) Quick start guide 2021

54-0010

This guide gives a brief overview of the UMP Achieve 1 medical and prescription drug benefits for 2021.

Publication

UMP Achieve 1, UMP Achieve 2, UMP High Deductible, and UMP Plus (SEBB) (Regence) Medical benefits comparison 2021

This handout compares 2021 benefits for UMP Achieve 1, UMP Achieve 2, UMP High Deductible, and UMP Plus (Regence).

Publication

UMP Achieve 1, UMP Achieve 2, UMP High Deductible, and UMP Plus (SEBB) (Regence) Medical benefits comparison 2022

This handout compares 2022 benefits for UMP Achieve 1, UMP Achieve 2, UMP High Deductible, and UMP Plus (Regence).

Publication

Pages