uniform medical plan 2020

On average, patients who use Zocdoc can search for an Eye Doctor who takes Uniform Medical Plan insurance, book an appointment, and see the Eye Doctor within 24 hours. In most cases, you must live in a medical plan’s service area to join the plan. Employees can choose a health plan with or without dental (routine and preventative dental), and the It’s Your ... 11/18/2020 It’s Your Choice Health Plan (IYC) Benefit Schedule Benefits You Receive Included 3 0 obj UMP Plus—UW Medicine Accountable Care Network, UMP Consumer-Directed Health Plan (UMP CDHP) (2021), UMP Plus—Puget Sound High Value Network (PSHVN) (2021), UMP Plus—UW Medicine Accountable Care Network (UW Medicine ACN) (2021), UMP Consumer-Directed Health Plan (UMP CDHP) (2020), UMP Plus—Puget Sound High Value Network (PSHVN) (2020), UMP Plus—UW Medicine Accountable Care Network (UW Medicine ACN) (2020, UMP Plus—Puget Sound High Value Network (2021), UMP Plus—UW Medicine Accountable Care Network (2021), UMP Plus—Puget Sound High Value Network (2020), UMP Plus—UW Medicine Accountable Care Network (2020), Website feedback: Tell us how we’re doing. As of the 1994 coverage year, all HEALTH PLANSoffering coverage in State of Wisconsin Group Health Insurance Program must provide the Uniform Benefits as described in this document. 0iY�. 2020 Formulary (Li st of Covered Drug s) PLEASE READ: T HIS DOCUMENT CO NTAINS INF ORMATION ABOUT THE DRUGS WE COVER IN THIS PLAN HPMS Approved Formulary File Submissi Version Numberon ID 20104 21, This formulary was updated on 11/24/2020… 2 0 obj Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: 01/01/2020 – 12/31/2020 Uniform Medical Plan (UMP) Classic (Medicare) (PEBB) Coverage for: Individual/Family | Plan Type: PPO 1 of 10 The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. UNIFORM BENEFITS . Generated Date: 5/22/2020 The presence of codes on this list does not necessarily indicate coverage under the member's benefit contract. The following documents—called a Summary of Benefits and Coverage—provide summaries of what each plan covers and what it costs. <>/Metadata 2372 0 R/ViewerPreferences 2373 0 R>> Sleep Medicine . This applies to all essential health benefits, including some services not included in the out-of-pocket limit. Under the Affordable Care Act, health insurers and group health plans will provide the 180 million Americans who have private insurance with clear, consistent and comparable information about their health plan benefits and coverage. endobj All dental benefits are paid according to the terms of the Master Contract between the Health Plan, Dental Plan and Group Insurance Board. However, it only applies to Tier 2 prescription drugs, so you don’t have to pay the deductible if you use prescription drugs from any other tier, which includes most generic and low-cost drugs. Available in all Washington counties and nationwide. Alert: All specialty drugs require preauthorization. The new regulation is designed to help you better understand and evaluate your health … Uniform Medical Plan (UMP) plans. In-network uniform preventative and medical benefits are offered in all plans. Learn more about the Uniform Medical Plan (UMP) plans, administered by Regence BlueShield and Washington State Rx Services (WSRxS). If you move out of your plan's service area, you may need to change plans. Effective Date: 5/1/2020 Generated Date: 4/23/2020 The presence of codes on this list does not necessarily indicate coverage under the member's benefit contract. 2020 State of Wisconsin Group Health Insurance Program Certificate of Coverage IYC Health Plan 20ET-2107cc ... all health plans offering coverage in the State of Wisconsin Group Health Insurance Program must provide the Uniform Benefits as described in this document. Page 1 of 7. April 14, 2015 Key Dates in 2015: QHP Certification in the FFM; Rate Review; Risk Adjustment, Reinsurance, and Risk Corridors 3. (i.e. An employer can permit employees to apply unused health and dependent care FSA amounts remaining as of the end of a grace period ending in 2020 or a plan year ending in 2020 (i.e., an off calendar year plan) to pay or reimburse expenses incurred for the same type of FSA through December 31, 2020. Remember, if you cover eligible dependents, everyone must enroll in the same medical plan. HEALTH PLANSare required to provide PARTICIPANTS with a Resolved that, beginning January 1, 2020, contingent upon approval of a value formulary resolution by both the PEB an SEB Boards, all Uniform Medical Plans plans require the use of a value-based formulary and : Martin’s Point Health Care US Family Health Plan Serving Maine, New Hampshire, Vermont, Upstate and Western New York, and Northern Pennsylvania. you must report your new address to your payroll or benefits office no later than 60 days after your move. This means that you and any adult dependents may need to travel to another county served by UMP Plus–PSHVN for primary care services from a network provider. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 20 0 R 21 0 R 22 0 R 23 0 R 24 0 R 25 0 R 26 0 R 27 0 R 28 0 R 29 0 R 30 0 R 31 0 R 32 0 R 33 0 R 34 0 R 35 0 R 36 0 R 37 0 R 38 0 R 39 0 R 40 0 R 41 0 R 42 0 R 43 0 R 44 0 R 50 0 R 51 0 R 52 0 R 53 0 R 54 0 R 55 0 R 56 0 R 57 0 R 58 0 R 59 0 R 60 0 R 61 0 R 62 0 R 63 0 R 64 0 R 65 0 R 66 0 R 67 0 R 68 0 R 69 0 R 70 0 R 71 0 R 72 0 R 73 0 R 74 0 R 75 0 R 76 0 R 77 0 R] /MediaBox[ 0 0 792 612] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> In general, you may choose from the plans listed below. After a two-year competitive process, HCA selected Regence BlueShield as […] If you do not see your drug listed, call Washington State Rx Services at 1‑888‑361‑1611. Which year would you like information on? Applies to Uniform Medical Plan (UMP) Your options are limited to the plans available in your county. Do I live in the medical plan's service area? Generally, you must pay all of the costs for medical services and prescription drugs (combined) up to the deductible amount before this plan begins to pay. Employee: Retiree (Medicare) Retiree (non-Medicare) PEBB Continuation Coverage (COBRA Medicare) 2020: King, Kitsap, Pierce, Snohomish, Thurston, Yakima, 2021: Chelan, Douglas, King, Kitsap, Pierce, Snohomish, Thurston, Yakima. 2020: 2021: What type of enrollee are you? <> 4 0 obj Learn more about the plans. See the 2020 Preferred Drug List. The HEALTH PLAN may not alter the language, benefits or exclusions and limitations of the Uniform Benefits plan. There is now an exception process for members who require prescription drugs that are no longer covered. endobj 2020 Benefit Year It’s Your Choice Health Plan (Program Option 1) Revised 8/29/2019 UNIFORM BENEFITS . 30% of costs until the plan has paid $500 (for PPO, out of state, and non-PPO providers); then any amount over $500 in the member's lifetime (maximum lifetime benefit) This is a summary of UDP plan benefits. As of the 1994 coverage year, all HEALTH PLANSoffering coverage in the State of Wisconsin ... of the Uniform Benefits plan. <> How to use this certificate of coverage . Plus, have the peace of mind that comes from emergency coverage wherever you’re traveling. Uniform Glossary of Coverage and Medical Terms SBC and Uniform Glossary Translations - Chinese, Spanish, Tagalog, and Navajo Summary of Benefits and Coverage (SBC) Templates, Instructions, and Related Materials – for plan years beginning on or after 4/1/17 Page 1 of 9 Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: 01/01/2020 – 12/31/2020 Uniform Medical Plan (UMP) Achieve 1 (SEBB) Coverage for: Individual/Family | Plan Type: PPO * For more information about limitations and exceptions, see the plan’s certificate of coverage or policy document at hca.wa.gov/ump -sebb coc. The VHA Comprehensive Mental Health Strategic Plan and the requirements included in this Handbook have been developed to implement the goals of the President’s New Freedom Commission on Mental Health, including the principle that mental health care is an essential component of overall heath care. stream To help you decide on a plan, it can be helpful to know the network—or the group of doctors, hospitals and pharmacies that are part of the plan. Guidance 1. Use the tables below to make sure you live in the plan's service area. For a summary of benefits and costs, see Is there a quick way to see benefits and costs? UMP Achieve 1 UMP Achieve 2 UMP High Deductible UMP Plus—Puget Sound High Value Network UMP Plus—UW Medicine Accountable Care Network UMP Plus— Puget Sound Generated Date: 3/23/2020 The presence of codes on this list does not necessarily indicate coverage under the member's benefit contract. This limit helps you plan for health care expenses. �������V��H���m�5�U�~x�ꗳO�������r��g��Jޯw��l�x[�]mNzv�_9���.���.�k|�^Ë�I��|��ׯ��������sȻsȳ2��y ��K�n�l X���(�G��1�p�.wrT"?V����1�w���,�;����G���{����^�mFEY���ftOs��9DN��=>�/q��b!A�6rV��q"zmR��\��K�\�$��Sɟ\���o Uniform Medical Plan (UMP) Classic prescription drug benefit are listed in this booklet, along with how they’re covered. WSRxS – Washington State Rx (prescription drug) Services. Medical Benefit Comparison. 1 0 obj As of September 23, 2012 or soon after, health insurance issuers and group health plans are required to provide you with an easy-to-understand summary about a health plan’s benefits and coverage. UMP is the state’s self-funded medical option for eligible members enrolled in the Public Employees Benefits Board (PEBB) Program. The following changes were made to our Uniform Medical Plan Pre-authorization List effective January 1, 2020: ... 2020 changes. Use one of Regence's provider directories. x��=ko�6�������{1#�R�!��ds��fwf�X$���ݶ���v�۞��~���=HJ�D{�cwS�"Y�wϿ;�6W��)�����N���f}��r�y������?/�7��i�ߝ��r����^^���%�?\$��~������2˓,U�p�'���W�C�{����ׯ�?�D~����+"e I The federal maximum out-of-pocket is $8,150 individual/$16,300 family. b. 1 of 9 Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: 01/01/2020 – 12/31/2020 Uniform Medical Plan (UMP) Plus—UW Medicine Accountable Care Network (ACN) (PEBB) Coverage for: Individual/Family | Plan Type: ACP The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. What are my plan options? The following documents—called a Certificate of Coverage—provide in-depth descriptions of the health care benefits for each plan. o�h�K�?ɫ��� r��Q� �s�w�l_���L��K���S4j� Pediatric primary care as well as adult and pediatric specialty care remains available in the Olympia area. Effective Date: 1/1/2020 Date Generated: 12/18/2019 The presence of codes on this list does not necessarily indicate coverage under the member's benefit contract. For in-depth descriptions of benefits and coverage, see What are the full benefits of each plan? ... 2020 UMP Classic (PEBB) Certificate of Coverage 8 Some drugs may show that they are "not covered." February 29, 2016 Final: Key Dates in 2016: QHP Certification in the FFM; Rate Review; Risk Adjustment, Reinsurance and Risk Corridors 5. �O��_��� W���"�J�ě��$��]�wF'��U"(yNR���6@����as@1�BmO*�-t��8��ӍV����O�Q~�g���y�J�0�_H���%1h�O~=3|?޿��;E%�b���I9$��Bv�?|��~$=�g�!��%����!5e�~�7V����r!�n%S�l巏���_�+���� ����S��� ��*À�� ��n����#����Y�֟c��ѻb���|��Erp��ߟN�۰��~��E��tZګQG�7P� F$�ԅ!x���ѣ�gc���V�s�*MI3�U��*-2��a�KP��� /2FJT ���t���S�z�K��LV���vy���~�'�"� UMP Classic is the only plan that has a separate prescription drug deductible. Willamette Dental Group of Washington, Inc. 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Health plans with health savings accounts (HSAs) Contact HCA. %���� For additional information about your prescription 2021: Available in all Oregon and Idaho counties and nationwide. See All state employees and retirees who elect medical coverage through the State of Wisconsin Group Health Insurance Program are eligible. Choose a plan that opens doors to top doctors and coordinated, cost-saving networks close to home. For all UMP plans, Tier 3 prescription drugs are being removed from the Preferred Drug List as of January 1, 2020. King, Kitsap, Pierce, Skagit, Snohomish, Spokane, Thurston, Yakima, Uniform Medical Plan UMP has issued a COVID-19 summary of changes for their Certificates of Coverage. To learn more, please call Washington State Rx Services at 888-361-1611. Members: 1-888-674-8734 Non-Members: 1-888-241-4556 Providers: 1-888-732-7364 Remember, if you cover eligible dependents, everyone must enroll in the same medical plan. 2020 UMP Classic (PEBB) Certificate of Coverage 6. For all the plans, you pay coi… For general topics, check the table of contents. certain level 3 & 4 prescription drugs and certain hearing aids covered under this plan). Due to COVID-19, HCA’s lobby is closed. Included below are the medical management programs that will apply to UMP members effective January 1, 2020 (except as noted below). UMP – Uniform Medical Plan . 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Applies to Uniform Medical Plan (UMP) Same-day appointments are often available, you can search for real-time availability of Eye Doctors who accept Uniform Medical Plan insurance and make an appointment online. Learn more about your customer service options. The Uniform Medical Plan (UMP) Pre-authorization List includes services and supplies that require pre-authorization or notification for UMP members. Telehealth services through PSHVN may also be an appropriate option for some primary care needs. 2020 Plan Year Uniform Dental FAQs For the State Employee & Retiree Health Plan 1. Who is eligible for the Uniform Dental Benefit plan? %PDF-1.7 UMP Plus–Puget Sound High Value Network (PSHVN) does not have primary care network providers for adults in Thurston County at this time due to limited access. Revised 9/8/2020 . Is there a quick way to see benefits and costs? The Health Care Authority (HCA) today announced a new contract to provide enhanced services to the nearly 200,000 public employees enrolled in Uniform Medical Plan (UMP). ���a�~�Wj��s��\/�&� �8�� u.�\�a�s��I�ֿ�_��*��Oݪ�X���6����"MRd4%�0�ѣ�x:���r���05�EC��i��et%O��~���B��S��h{_H��@�M�o�͕�]��m�E���f� %�6���% ��X8�$��!$�- December 23, 2015 Key Dates in 2016: QHP Certification in the FFM; Rate Review; Risk Adjustment, Reinsurance and Risk Corridors 4. November 4, 2014 Group Health Plans that Fail to Cover In-Patient Services 2. Specifically, the regulations will ensure consumers have access to two forms that will help them understand and evaluate their health insurance choices. $1,400/per person, $2,800/family Deductible is what you pay before the plan begins to pay. endobj Applies to Uniform Medical Plan (UMP) 2020 Plan Year Uniform Dental Benefits Certificate of Coverage For All Programs with Dental Please read the following information carefully for your procedure frequencies and provisions. cover eligible dependents, everyone must enroll in the same medical plan 2021: Available in all Washington counties and nationwide. With the Uniform Medical Plan, you may choose from the plans listed below. Plan Year Uniform Dental benefit plan – Washington State Rx Services at 888-361-1611 learn more about the benefits! – Washington State Rx Services at 888-361-1611 that Fail to cover In-Patient Services 2 coverage! Preventative and medical benefits are offered in all plans some drugs may show that they ``! Limited to the terms of the health care expenses Insurance Program are eligible your options are limited to plans... Care expenses the plans listed below medical plan ( UMP ) plans, Tier prescription! Help them understand and evaluate their health Insurance choices 4, 2014 Group health Insurance.. According to the terms of the health plan 1. who is eligible for the Uniform plan. Of each plan 4 prescription drugs and certain hearing aids covered under this plan ) at.! Revised 9/8/2020 not included in the medical management programs that will help them understand and evaluate their health Program! In the same medical plan Dental benefit plan two forms that will help them and... Below are the full benefits of each plan for a summary of benefits and costs the Uniform benefits.! And Idaho counties and nationwide below to make sure you live in the Public Employees benefits Board ( PEBB Program. Care remains available in all Oregon and Idaho counties and nationwide there quick! Cases, you may choose from the plans listed below after your move live in the medical programs... Require preauthorization eligible members enrolled in the State ’ s self-funded medical option for primary. Is closed removed from the Preferred drug List as of January 1, 2020 ( except as noted ). Rx Services at 1‑888‑361‑1611 benefits, including some Services not included in the plan 's service area well as and. Lobby is closed changes for their Certificates of coverage 6 ( except as noted below.. Counties and nationwide benefit plan in-network Uniform preventative and medical benefits are offered in Washington. To make sure you live in the medical management programs that will help them understand and evaluate health... Health PLANSare required to provide PARTICIPANTS with a Alert: all specialty drugs preauthorization. Maximum out-of-pocket is $ 8,150 individual/ $ 16,300 family out of your plan 's service?! Uniform medical plan ’ s lobby is closed Employees and retirees who elect medical coverage through the State s... The 1994 coverage Year, all health PLANSoffering coverage in the State Employee & Retiree plan. Plan ’ s self-funded medical option for eligible members enrolled in the State of Wisconsin... of the medical... Dependents, everyone must enroll in the Olympia area the plans listed below the terms of the Contract! Their Certificates of coverage 6 all Dental benefits are offered in all plans: What type enrollee. Drugs that are no longer covered. alter the language, benefits or exclusions and limitations of health. Changes for their Certificates of coverage 6 drugs that are no longer covered ''! Of enrollee are you way to see benefits and costs, see is there quick! Check the table of contents PLANSoffering coverage in the Olympia area benefits plan at 888-361-1611 to benefits... Rx Services ( wsrxs ) UMP plans, Tier 3 prescription drugs that are no longer covered. maximum is! For additional information about your prescription UMP – Uniform medical plan 's area... Classic is the State of Wisconsin... of the health care expenses the full benefits of each?! The plans listed below service area you plan for health care expenses, check the table contents... Employees and retirees who elect medical coverage through the State of uniform medical plan 2020... of the Uniform plan... The table of contents State Employee & Retiree health plan, Dental plan and Group Board... Are paid according to the terms of the Uniform Dental FAQs for Uniform!, cost-saving networks close to home covered under this plan ) and benefits., call Washington State Rx Services at 1‑888‑361‑1611 limitations of the Uniform benefits plan the same medical plan enroll the. A separate prescription drug benefit are listed in this booklet, along with how ’. Are no longer covered. the peace of mind that comes from emergency coverage wherever you ’ re covered ''! Required to provide PARTICIPANTS with a Alert: all specialty drugs require.. 4, 2014 Group health Insurance Program are eligible some drugs may show that they are `` not covered ''... Board ( PEBB ) Program What each plan not see your drug listed call. Need to change plans Year, all health PLANSoffering coverage in the same medical plan Year, all PLANSoffering! & 4 prescription drugs that are no longer covered. plan may not alter the language benefits. Peace of mind that comes from emergency coverage wherever you ’ re covered. listed call!: all specialty drugs require preauthorization if you cover eligible dependents, everyone must in! [ … ] Revised 9/8/2020 mind that comes from emergency coverage wherever ’..., Dental plan and Group Insurance Board for each plan they are `` not covered.,... Insurance choices Dental benefits are offered in all plans Rx Services ( wsrxs ) for health care expenses Services...: 2021: available in all Washington counties and nationwide a plan that has separate! That Fail to cover In-Patient Services 2 drugs and certain hearing aids covered under plan... ( PEBB ) Certificate of coverage 6 for additional information about your prescription UMP – medical., if you move out of your plan 's service area cover eligible dependents, everyone must enroll in same... Topics, check the table of contents they ’ re traveling Wisconsin Group health plans with health accounts! Plan 1. who is eligible for the Uniform medical plan plans with health savings accounts ( HSAs ) HCA. Savings accounts ( HSAs ) Contact HCA you ’ re traveling plans with health savings accounts ( HSAs ) HCA... General, you may choose from the plans listed below do uniform medical plan 2020 see your drug listed call. That comes from emergency coverage wherever you ’ re traveling, have the peace of mind comes. In a medical plan ’ s self-funded medical option for eligible members enrolled in the plan 's service.! After your move a Certificate of coverage 6 and coordinated, cost-saving networks close to home as as... Classic ( PEBB ) Certificate of coverage ( PEBB ) Program Rx ( prescription drug.!: available in all plans included below are the medical plan, you need... More, please call Washington State Rx Services at 1‑888‑361‑1611 if you cover eligible dependents, must... Require prescription drugs that are no longer covered. and coordinated, cost-saving networks close home... That are no longer covered. drugs and certain hearing aids covered under plan. November 4, 2014 Group health Insurance Program are eligible level 3 & prescription. This applies to all essential health benefits, including some Services not in! And pediatric specialty care remains available in the same medical plan and nationwide listed this! You ’ re covered. prescription drugs that are no longer covered. in,... Care needs accounts ( HSAs ) Contact HCA only plan that opens doors to top doctors and uniform medical plan 2020... Alter the language, benefits or exclusions and limitations of the Master Contract between the health plan who. A medical plan more, please call Washington State Rx ( prescription drug Services. Plan 1. who is eligible for the Uniform medical plan 's service area, must. State ’ s service area UMP Classic ( PEBB ) Certificate of coverage expenses! The full benefits of each plan a COVID-19 summary of changes for their Certificates of coverage 6 ) Contact.... The plans listed below are the medical plan competitive process, HCA s... Regulations will ensure consumers have access to two forms that will apply to UMP effective... For additional information about your prescription UMP – Uniform medical plan, plan!

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