Forms & publications

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

Ardon patient request for non-safety caps on prescription containers

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.

Form

COE Program brochure

This flyer gives an overview of the Centers of Excellence Program in 2019 for knee and hip replacement and spine care.

Publication

Coverage of Applied Behavior Analysis Therapy (ABA Therapy Printable Summary)

54-0004

This document summarizes the information on Applied Behavior Analysis (ABA) Therapy coverage available on the UMP website.

Publication

Criteria for Coverage of ABA Therapy Services

54-0003

Lists criteria for coverage of Applied Behavior Analysis (ABA) Therapy services.

Criteria of coverage

Hepatitis C lawsuit settlement agreement

This document explains the settlement agreement reached during a class-action lawsuit over the Health Care Authority's coverage of hepatitis C direct-acting antiviral drugs.

Publication

Important information about the UMP plans (SEBB)

This document provides information to help School Employees Benefits Board (SEBB) members decide if UMP is right for them. Some examples of topics covered include explaining your choices if you and your spouse or state-registered domestic partner are enrolling in a UMP plan, what happens if you have an active preauthorization for medical care, and what happens if you are covered by two health insurance plans.

Publication

List of prescription drugs subject to emergency fill

This is a partial list of prescription drugs for which you may request an emergency fill during the preauthorization process, and a description of how it works.

Publication

List of prescription drugs subject to emergency fill

This is a partial list of prescription drugs for which you may request an emergency fill during the preauthorization process, and a description of how it works.

Publication

Make the switch to UMP Plus–PSHVN

Find out if UMP Plus–Puget Sound High Value Network (PSHVN) might be the right plan for you. Learn about UMP Plus–PSHVN's health plan features, such as excellent customer service and lower health care costs, and find out how the plan's providers work together to improve your care.

Publication

Make the switch to UMP Plus–UW Medicine ACN

Find out if UMP Plus–UW Medicine Accountable Care Network (ACN) might be the right plan for you. Learn about UMP Plus–UW Medicine ACN's health plan features, such as excellent coverage and lower costs, and find out how the plan's providers work together to improve your care.

Publication

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