Medical

Medical plan availability

Medical plans offered by the PEBB Program are available to all benefits eligible employees. To enroll in a:

• Kaiser Foundation Health Plan of the Northwest, employees must either live or work in one of the counties or ZIP codes where the plan is offered.
• Kaiser Foundation Health Plan of Washington, employees must either live or work in one of the counties where the plan is offered.
• UMP plan (except UMP plus), employees can live anywhere in the United States.
• UMP Plus plan, employees must live in one of the counties where the plan is offered.

Learn more about Medical plans available by county.

PEBB Program medical plans

Before selecting a plan or provider, employees should compare medical plans to find out what services are covered, which providers are in-network, and the costs for care.

Kaiser Foundation Health Plan of the Northwest

Kaiser Permanente NW plans are offered in Clark and Cowlitz counties in Washington and select counties and ZIP codes in Oregon.

Classic

Plan documents

• KP NW Classic Certificate of Coverage (COC)
• Summary of Benefits and Coverage (SBC)
• Urgent and emergent care while out of state

Preauthorization criteria

• Kaiser Permanente NW preauthorization requirements
  These criteria do not imply or guarantee approval. Please check with the plan to ensure coverage. Preauthorization requirements are only valid for the month published. They may have changed from previous months and may change in future months.

Find a provider

Visit Kaiser Permanente NW's online provider directory.

Contact information

Online: Kaiser Permanente NW
Phone: 1-800-813-2000
TRS: 711
Language interpretation services: 1-800-324-8010

CDHP

Plan documents

• KP NW CDHP Certificate of Coverage (COC)
• Summary of Benefits and Coverage (SBC)
• Urgent and emergent care while out of state

Learn about medical plans with health savings accounts (HSAs).

Preauthorization criteria

• Kaiser Permanente NW preauthorization requirements
  These criteria do not imply or guarantee approval. Please check with the plan to ensure coverage. Preauthorization requirements are only valid for the month published. They may have changed from previous months and may change in future months.

Find a provider

Visit Kaiser Permanente NW's online provider directory.

Contact information

Online: Kaiser Permanente NW
Phone: 1-800-813-2000
TRS: 711
Language interpretation services: 1-800-324-8010

Kaiser Foundation Health Plan of Washington

Kaiser Permanente WA plans are offered in select counties in Washington.

Classic

Plan documents

• KP WA Classic Certificate of Coverage (COC)
• Summary of Benefits and Coverage (SBC)

Preauthorization criteria

• Kaiser Permanente WA preauthorization requirements, part 1
• Kaiser Permanente WA preauthorization requirements, part 2

These criteria do not imply or guarantee approval. Please check with the plan to ensure coverage. Preauthorization requirements are only valid for the month published. They may have changed from previous months and may change in future months.

Find a provider

Visit Kaiser Permanente WA's online provider directory for the Classic, Value, and CDHP plans.

Contact information

Online: Kaiser Permanente WA
Phone: 1-866-648-1928
TTY: 1-800-833-6388
TRS: 711

Value

Plan documents

• KP WA Value Certificate of Coverage (COC)
• Summary of Benefits and Coverage (SBC)

Preauthorization criteria

• Kaiser Permanente WA preauthorization requirements, part 1
• Kaiser Permanente WA preauthorization requirements, part 2

These criteria do not imply or guarantee approval. Please check with the plan to ensure coverage. Preauthorization requirements are only valid for the month published. They may have changed from previous months and may change in future months.

Find a provider

Visit Kaiser Permanente WA's online provider directory for the Classic, Value, and CDHP plans.

Contact information

Online: Kaiser Permanente WA
Phone: 1-866-648-1928
TTY: 1-800-833-6388
TRS: 711

CDHP

Plan documents

• KP WA CDHP Certificate of Coverage (COC)
• Summary of Benefits and Coverage (SBC)

Learn about medical plans with health savings accounts (HSAs).

Preauthorization criteria

• Kaiser Permanente WA preauthorization requirements, part 1
• Kaiser Permanente WA preauthorization requirements, part 2

These criteria do not imply or guarantee approval. Please check with the plan to ensure coverage. Preauthorization requirements are only valid for the month published. They may have changed from previous months and may change in future months.

Find a provider

Visit Kaiser Permanente WA's online provider directory for the Classic, Value, and CDHP plans.

Contact information

Online: Kaiser Permanente WA
Phone: 1-866-648-1928
TTY: 1-800-833-6388
TRS: 711

SoundChoice

Plan documents

• KP WA SoundChoice Certificate of Coverage (COC)
• Summary of Benefits and Coverage (SBC)

Preauthorization criteria

• Kaiser Permanente WA preauthorization requirements, part 1
• Kaiser Permanente WA preauthorization requirements, part 2

These criteria do not imply or guarantee approval. Please check with the plan to ensure coverage. Preauthorization requirements are only valid for the month published. They may have changed from previous months and may change in future months.

Find a provider

Visit Kaiser Permanente WA's online provider directory for the SoundChoice plan.

Contact information

Online: Kaiser Permanente WA
Phone: 1-866-648-1928
TTY: 1-800-833-6388
TRS: 711

Uniform Medical Plan (UMP)

UMP plans are offered nationwide and UMP Plus plans are offered in select counties in Washington.
UMP is administered by Regence BlueShield and Washington State Rx Services.

Classic

Plan documents

• UMP Classic Certificate of Coverage (COC)
• Summary of Benefits and Coverage (SBC)
• UMP nondiscrimination and language access notice

Preauthorization criteria

• Regence preauthorization requirements (for UMP plans)
  • Document 1: Guidelines, inpatient admissions, radiology, sleep, physical medicine, lab, maternity medicine, and genetic testing
  • Document 2: Substance use disorder, mental health, DME, surgery and transplants
  • Medications covered under medical
• Washington State Rx Services preauthorization requirements (for pharmacy)
  • Part 1
  • Part 2

These criteria do not imply or guarantee approval. Please check with the plan to ensure coverage. Preauthorization requirements are only valid for the month published. They may have changed from previous months and may change in future months.

Find a provider

Visit Regence's online provider directory for the Classic plan.
UMP plans are administered by Regence BlueShield.

Contact information

Online: Uniform Medical Plan
Phone: 1-888-849-3681
TRS: 711

UMP Prescription Drug Benefits (Washington Rx Services)
Phone: 1-888-402-4237
TRS: 711
Mail order pharmacy: 1-800-552-6694 (toll-free)

Select

Plan documents

• UMP Select Certificate of Coverage (COC)
• Summary of Benefits and Coverage (SBC)
• UMP nondiscrimination and language access notice

Preauthorization criteria

• Regence preauthorization requirements (for UMP plans)
  • Document 1: Guidelines, inpatient admissions, radiology, sleep, physical medicine, lab, maternity medicine, and genetic testing
  • Document 2: Substance use disorder, mental health, DME, surgery and transplants
  • Medications covered under medical
• Washington State Rx Services preauthorization requirements (for pharmacy)
  • Part 1
  • Part 2

These criteria do not imply or guarantee approval. Please check with the plan to ensure coverage. Preauthorization requirements are only valid for the month published. They may have changed from previous months and may change in future months.

Find a provider

Visit Regence's online provider directory for the Select plan.
UMP plans are administered by Regence BlueShield

Contact information

Online: Uniform Medical Plan
Phone: 1-888-849-3681
TRS: 711

UMP Prescription Drug Benefits (Washington Rx Services)
Phone: 1-888-402-4237
TRS: 711
Mail order pharmacy: 1-800-552-6694 (toll-free)

CDHP

Plan documents

• UMP CDHP Certificate of Coverage (COC)
• Summary of Benefits and Coverage (SBC)
• UMP nondiscrimination and language access notice

Learn about medical plans with health savings accounts (HSAs).

Preauthorization criteria

• Regence preauthorization requirements (for UMP plans)
  • Document 1: Guidelines, inpatient admissions, radiology, sleep, physical medicine, lab, maternity medicine, and genetic testing
  • Document 2: Substance use disorder, mental health, DME, surgery and transplants
  • Medications covered under medical
• Washington State Rx Services preauthorization requirements (for pharmacy)
  • Part 1
  • Part 2

These criteria do not imply or guarantee approval. Please check with the plan to ensure coverage. Preauthorization requirements are only valid for the month published. They may have changed from previous months and may change in future months.

Find a provider

Visit Regence's online provider directory for the CDHP.
UMP plans are administered by Regence BlueShield

Contact information

Online: Uniform Medical Plan
Phone: 1-888-849-3681
TRS: 711

UMP Prescription Drug Benefits (Washington Rx Services)
Phone: 1-888-402-4237
TRS: 711
Mail order pharmacy: 1-800-552-6694 (toll-free)

UMP Plus PSHVN

Plan documents

• UMP Plus PSHVN Certificate of Coverage (COC)
• Summary of Benefits and Coverage (SBC)
• UMP nondiscrimination and language access notice

Preauthorization criteria

• Regence preauthorization requirements (for UMP plans)
  • Document 1: Guidelines, inpatient admissions, radiology, sleep, physical medicine, lab, maternity medicine, and genetic testing
  • Document 2: Substance use disorder, mental health, DME, surgery and transplants
  • Medications covered under medical
• Washington State Rx Services preauthorization requirements (for pharmacy)
  • Part 1
  • Part 2

These criteria do not imply or guarantee approval. Please check with the plan to ensure coverage. Preauthorization requirements are only valid for the month published. They may have changed from previous months and may change in future months.

Find a provider

Visit Regence's online provider directory for the UMP Plus-PSHVN plan.
UMP plans are administered by Regence BlueShield

Contact information

Online: UMP Plus–Puget Sound High Value Network
Phone: 1-855-776-9503
TRS: 711

UMP Prescription Drug Benefits (Washington Rx Services)
Phone: 1-888-402-4237
TRS: 711
Mail order pharmacy: 1-800-552-6694 (toll-free)

UMP Plus-UW Medicine ACN

Plan documents

• UMP Plus UW ACN Certificate of Coverage (COC)
• Summary of Benefits and Coverage (SBC)
• UMP nondiscrimination and language access notice

Preauthorization criteria

• Regence preauthorization requirements (for UMP plans)
  • Document 1: Guidelines, inpatient admissions, radiology, sleep, physical medicine, lab, maternity medicine, and genetic testing
  • Document 2: Substance use disorder, mental health, DME, surgery and transplants
  • Medications covered under medical
• Washington State Rx Services preauthorization requirements (for pharmacy)
  • Part 1
  • Part 2

These criteria do not imply or guarantee approval. Please check with the plan to ensure coverage. Preauthorization requirements are only valid for the month published. They may have changed from previous months and may change in future months.

Find a provider

Visit Regence's online provider directory for the UMP Plus-UW ACN plan.
UMP plans are administered by Regence BlueShield

Contact information

Online: UW Medicine Accountable Care Network
Phone: 1-855-520-9500
TRS: 711

UMP Prescription Drug Benefits (Washington Rx Services)
Phone: 1-888-402-4237
TRS: 711
Mail order pharmacy: 1-800-552-6694 (toll-free)

Member ID cards

Once an employee is enrolled, a welcome packet or letter is mailed to the employee by the plan. The plan will also mail a member ID card for each individual covered under the plan.

Direct employees to contact their medical plan for questions about member ID cards.