Glossary

UMP Classic
UMP CDHP
UMP Plus

The UMP website is moving. This website contains 2019 UMP information for PEBB members only (through the end of 2019). If you are a PEBB member and/or you will be a new School Employees Benefits Board (SEBB) member and you need 2020 UMP benefits information, visit our new UMP website.

Out-of-pocket limit

Note: This definition applies to UMP CDHP only. See the definition for UMP Classic or UMP Plus.

The out-of-pocket limit is the maximum total amount you pay to your providers for covered services and prescription drugs during a calendar year.

The limit is $4,200 for one person on an account, or $8,400 if there is more than one person on an account. However, no individual may exceed $6,850 in covered out-of-pocket expenses annually.

Once you have reached this limit, the plan pays 100 percent of the allowed amount for covered services from preferred providers for the rest of the calendar year. See Out-of-pocket limit for what does and doesn’t count toward this limit.

Note: Your deductible does apply to this limit.