Medical

Medical plan availability

Medical plans offered by the SEBB Program are available to benefits-eligible employees based on their county of residence. Some employees may have more plan options if they work in a district that crosses county lines.

Learn more about medical plans available by county and school districts.

SEBB 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

Plan 1

Plan documents

• 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 for Plans 1, 2, and 3.

Contact information

Online: Kaiser Permanente NW
Phone: 1-800-813-2000
TRS: 711

Plan 2

Plan documents

• 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 for Plans 1, 2, and 3.

Contact information

Online: Kaiser Permanente NW
Phone: 1-800-813-2000
TRS: 711

Plan 3

Plan documents

• 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 for Plans 1, 2, and 3.

Contact information

Online: Kaiser Permanente NW
Phone: 1-800-813-2000
TRS: 711

Kaiser Foundation Health Plan of Washington

Core 1

Plan documents

• 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 Core 1, 2, and 3 plans.

Contact information

Online: Kaiser Permanente WA
Phone: 1-888-901-4636
TTY: 1-800-833-6388
TRS: 711

Core 2

Plan documents

• 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 Core 1, 2, and 3 plans.

Contact information

Online: Kaiser Permanente WA
Phone: 1-888-901-4636
TTY: 1-800-833-6388
TRS: 711

Core 3

Plan documents

• 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 Core 1, 2, and 3 plans.

Contact information

Online: Kaiser Permanente WA
Phone: 1-888-901-4636
TTY: 1-800-833-6388
TRS: 711

SoundChoice

Plan documents

• 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: 1-888-901-4636
TTY: 1-800-833-6388
TRS: 711

Kaiser Foundation Health Plan of Washington Options, Inc.

Summit PPO 1

Plan documents

• Certificate of Coverage (COC)
• Summary of Benefits and Coverage (SBC)

Preauthorization criteria

• Kaiser Permanente WA Options preauthorization requirements, Part 1
• Kaiser Permanente WA Options 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 one of Kaiser Permanente WA Options' online provider directories for the Summit PPO 1, 2, and 3 plans.

• Tier 1, preferred in-network: Summit PPO network or Washington Permanente Medical Group Provider
• Tier 2, in-network: First Choice Health network or First Health network

Contact information

Online: Kaiser Permanente WA Options, Inc.
Phone: 1-888-901-4636
TTY: 1-800-833-6388
TRS: 711

Summit PPO 2

Plan documents

• Certificate of Coverage (COC)
• Summary of Benefits and Coverage (SBC)

Preauthorization criteria

• Kaiser Permanente WA Options preauthorization requirements, Part 1
• Kaiser Permanente WA Options 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 one of Kaiser Permanente WA Options' online provider directories for the Summit PPO 1, 2, and 3 plans.

• Tier 1, preferred in-network: Summit PPO network or Washington Permanente Medical Group Provider
• Tier 2, in-network: First Choice Health network or First Health network

Contact information

Online: Kaiser Permanente WA Options, Inc.
Phone: 1-888-901-4636
TTY: 1-800-833-6388
TRS: 711

Summit PPO 3

Plan documents

• Certificate of Coverage (COC)
• Summary of Benefits and Coverage (SBC)

Preauthorization criteria

• Kaiser Permanente WA Options preauthorization requirements, Part 1
• Kaiser Permanente WA Options 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 one of Kaiser Permanente WA Options' online provider directories for the Summit PPO 1, 2, and 3 plans.

• Tier 1, preferred in-network: Summit PPO network or Washington Permanente Medical Group Provider
• Tier 2, in-network: First Choice Health network or First Health network

Contact information

Online: Kaiser Permanente WA Options, Inc.
Phone: 1-888-901-4636
TTY: 1-800-833-6388
TRS: 711

Premera Blue Cross

High PPO

Plan documents

• Certificate of Coverage (COC)
• Summary of Benefits and Coverage (SBC)

Preauthorization criteria

• Premera 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 Premera's online provider directory for the High PPO and Standard PPO plans (Heritage Prime).

Contact information

Online: Premera Blue Cross for school employees
Phone: 1-800-807-7310
TTY: 1-800-842-5357
TRS: 711

Premera HMO

Plan documents

• Certificate of Coverage (COC)
• Summary of Benefits and Coverage (SBC)

Preauthorization criteria

• Premera 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 Premera's online provider directory for the HMO plan (Tahoma network).

Contact information

Online: Premera Blue Cross for school employees
Phone: 1-800-807-7310
TTY: 1-800-842-5357
TRS: 711

Standard PPO

Plan documents

• Certificate of Coverage (COC)
• Summary of Benefits and Coverage (SBC)

Preauthorization criteria

• Premera 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 Premera's online provider directory for the High PPO and Standard PPO plans (Heritage Prime).

Contact information

Online: Premera Blue Cross for school employees
Phone: 1-800-807-7310
TTY: 1-800-842-5357
TRS: 711

Uniform Medical Plan (UMP)

UMP is administered by Regence BlueShield and Washington State Rx Services.

Achieve 1

Plan documents

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

Preauthorization criteria

• Regence preauthorization requirements (for UMP medical benefits)
  • 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 UMP pharmacy benefits)
  • 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 Achieve 1 plan.
UMP plans are administered by Regence BlueShield.

Contact information

Online: Uniform Medical Plan
Phone: 1-800-628-3481
TRS: 711

UMP Prescription Drug Benefits (Washington Rx Services)
Online: Prescription drug information
Phone: 1-888-361-1611
TRS: 711

Achieve 2

Plan documents

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

Preauthorization criteria

• Regence preauthorization requirements (for UMP medical benefits)
  • 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 UMP pharmacy benefits)
  • 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 Achieve 2 plan.
UMP plans are administered by Regence BlueShield.

Contact information

Online: Uniform Medical Plan
Phone: 1-800-628-3481
TRS: 711

UMP Prescription Drug Benefits (Washington Rx Services)
Online: Prescription drug information
Phone: 1-888-361-1611
TRS: 711

High Deductible

Plan documents

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

Preauthorization criteria

• Regence preauthorization requirements (for UMP medical benefits)
  • 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 UMP pharmacy benefits)
  • 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 High Deductible plan.
UMP plans are administered by Regence BlueShield.

Contact information

Online: Uniform Medical Plan
Phone: 1-800-628-3481
TRS: 711

UMP Prescription Drug Benefits (Washington Rx Services)
Online: Prescription drug information
Phone: 1-888-361-1611
TRS: 711

UMP Plus-PSHVN

Plan documents

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

Preauthorization criteria

• Regence preauthorization requirements (for UMP medical benefits)
  • 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 UMP pharmacy benefits)
  • 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: Uniform Medical Plan
Phone: 1-800-628-3481
TRS: 711
Online: UMP Plus–Puget Sound High Value Network
Phone: 1-877-345-8760

UMP Prescription Drug Benefits (Washington Rx Services)
Online: Prescription drug information
Phone: 1-888-361-1611
TRS: 711

UMP Plus-UW Medicine ACN

Plan documents

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

Preauthorization criteria

• Regence preauthorization requirements (for UMP medical benefits)
  • 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 UMP pharmacy benefits)
  • 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

Contact information

Online: Uniform Medical Plan
Phone: 1-800-628-3481
TRS: 711
Online: UMP Plus–UW Medicine Accountable Care Network
Phone: 1-888-402-4238
TRS: 711

UMP Prescription Drug Benefits (Washington Rx Services)
Online: Prescription drug information
Phone: 1-888-361-1611
TRS: 711

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.