Forms & publications

Can't find what you need? Visit UMP Forms and publications for more documents.

UMP Plus UW Medicine Accountable Care Network 2017 Certificate of Coverage (COC)

This benefits book describes what is covered under UMP Plus, including medical services and prescription drugs, as well as specific services not covered by the plan. Finding network providers and how much you'll pay, including deductibles, coinsurance, and copays. It also includes how to request an appeal and submit a claim.

Publication

UMP prescription drugs: Mail-order form for PPS

This form is to order prescription drugs from the UMP network mail-order pharmacy, Postal Prescription Services (PPS).

Form

UMP Vision Claim Form

Use this form to submit claims for vision hardware, such as eyeglasses and contact lens.

Form

UMP: Preferred Drug List (2017-01)

This document lists all anticipated changes to the UMP preferred drug list (PDL) effective January 1, 2017.

Publication

UMP: Preferred Drug List (2017-03)

This document lists all anticipated changes to the UMP preferred drug list (PDL) effective March 1, 2017.

Publication

UMP: Preferred Drug List (2017-04)

This document lists all anticipated changes to the UMP preferred drug list (PDL) effective April 1, 2017.

Publication

UMP: Preferred Drug List (2017-05)

This document lists all anticipated changes to the UMP Preferred Drug List (PDL) effective May 1, 2017.

Publication

UMP: Preferred Drug List (2017-06)

This document lists all anticipated changes to the UMP preferred drug list (PDL) effective June 1, 2017.

Publication

UMP: Preferred Drug List (2017-07)

This document lists all anticipated changes to the UMP Preferred Drug List (PDL) effective July 1, 2017.

Publication

UMP: Preferred Drug List (2017-08)

This document lists all anticipated changes to the UMP Preferred Drug List (PDL) effective August 1, 2017.

Publication

Pages