uniform medical plan 2020

Employee: Retiree (Medicare) Retiree (non-Medicare) PEBB Continuation Coverage (COBRA Medicare) endobj There is now an exception process for members who require prescription drugs that are no longer covered. What are my plan options? Use the tables below to make sure you live in the plan's service area. 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 HEALTH PLANSare required to provide PARTICIPANTS with a 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. 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. Specifically, the regulations will ensure consumers have access to two forms that will help them understand and evaluate their health insurance choices. 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. See 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). 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. <>/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>> King, Kitsap, Pierce, Skagit, Snohomish, Spokane, Thurston, Yakima, Uniform Medical Plan Is there a quick way to see benefits and costs? 2021: Available in all Washington counties and nationwide. 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 : 2020 UMP Classic (PEBB) Certificate of Coverage 6. Use one of Regence's provider directories. Uniform Medical Plan (UMP) plans. November 4, 2014 Group Health Plans that Fail to Cover In-Patient Services 2. 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. Sleep Medicine . Available in all Washington counties and nationwide. 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. See the 2020 Preferred Drug List. 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 WSRxS – Washington State Rx (prescription drug) Services. Uniform Medical Plan (UMP) Classic prescription drug benefit are listed in this booklet, along with how they’re covered. Choose a plan that opens doors to top doctors and coordinated, cost-saving networks close to home. 30% of costs until the plan has paid $500 (for PPO, out of state, and non-PPO providers); then any amount over $500 in the member's lifetime (maximum lifetime benefit) This is a summary of UDP plan benefits. �������V��H���m�5�U�~x�ꗳO�������r��g��Jޯw��l�x[�]mNzv�_9���.���.�k|�^Ë�I��|��ׯ��������sȻsȳ2��y ��K�n�l X���(�G��1�p�.wrT"?V����1�w���,�;����G���{����^�mFEY���ftOs��9DN��=>�/q��b!A�6rV��q"zmR��\��K�\�$��Sɟ\���o For all UMP plans, Tier 3 prescription drugs are being removed from the Preferred Drug List as of January 1, 2020. Your options are limited to the plans available in your county. The federal maximum out-of-pocket is $8,150 individual/$16,300 family. 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. <> cover eligible dependents, everyone must enroll in the same medical plan Do I live in the medical plan's service area? %���� Which year would you like information on? The following documents—called a Certificate of Coverage—provide in-depth descriptions of the health care benefits for each plan. 2020: 2021: What type of enrollee are you? Included below are the medical management programs that will apply to UMP members effective January 1, 2020 (except as noted below). UNIFORM BENEFITS . This limit helps you plan for health care expenses. 2021: Available in all Oregon and Idaho counties and nationwide. Due to COVID-19, HCA’s lobby is closed. Remember, if you cover eligible dependents, everyone must enroll in the same medical plan. 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. $1,400/per person, $2,800/family Deductible is what you pay before the plan begins to pay. ���a�~�Wj��s��\/�&� �8�� u.�\�a�s��I�ֿ�_��*��Oݪ�X���6����"MRd4%�0�ѣ�x:���r���05�EC��i��et%O��~���B��S��h{_H��@�M�o�͕�]��m�E���f� %�6���% ��X8�$��!$�- For in-depth descriptions of benefits and coverage, see What are the full benefits of each plan? As of September 23, 2012 or soon after, health insurance issuers and group health plans are required to provide you with an easy-to-understand summary about a health plan’s benefits and coverage. In-network uniform preventative and medical benefits are offered in all plans. As of the 1994 coverage year, all HEALTH PLANSoffering coverage in the State of Wisconsin ... of the Uniform Benefits plan. %PDF-1.7 Learn more about the Uniform Medical Plan (UMP) plans, administered by Regence BlueShield and Washington State Rx Services (WSRxS). endobj Guidance 1. Willamette Dental Group of Washington, Inc. 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For general topics, check the table of contents. Plus, have the peace of mind that comes from emergency coverage wherever you’re traveling. 2020 State of Wisconsin Group Health Insurance Program Certificate of Coverage IYC Health Plan 20ET-2107cc ... all health plans offering coverage in the State of Wisconsin Group Health Insurance Program must provide the Uniform Benefits as described in this document. �O��_��� W���"�J�ě��$��]�wF'��U"(yNR���[email protected]����[email protected]�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���~�'�"� Health plans with health savings accounts (HSAs) Contact HCA. 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. All dental benefits are paid according to the terms of the Master Contract between the Health Plan, Dental Plan and Group Insurance Board. 2020: King, Kitsap, Pierce, Snohomish, Thurston, Yakima, 2021: Chelan, Douglas, King, Kitsap, Pierce, Snohomish, Thurston, Yakima. Remember, if you cover eligible dependents, everyone must enroll in the same medical plan. This applies to all essential health benefits, including some services not included in the out-of-pocket limit. 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. 0iY�. The following documents—called a Summary of Benefits and Coverage—provide summaries of what each plan covers and what it costs. For all the plans, you pay coi… Alert: All specialty drugs require preauthorization. Medical Benefit Comparison. you must report your new address to your payroll or benefits office no later than 60 days after your move. stream 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… UMP is the state’s self-funded medical option for eligible members enrolled in the Public Employees Benefits Board (PEBB) Program. 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. The HEALTH PLAN may not alter the language, benefits or exclusions and limitations of the Uniform Benefits plan. The following changes were made to our Uniform Medical Plan Pre-authorization List effective January 1, 2020: ... 2020 changes. 4 0 obj February 29, 2016 Final: Key Dates in 2016: QHP Certification in the FFM; Rate Review; Risk Adjustment, Reinsurance and Risk Corridors 5. For a summary of benefits and costs, see Is there a quick way to see benefits and costs? <> o�h�K�?ɫ��� r��Q� �s�w�l_���L��K���S4j� Martin’s Point Health Care US Family Health Plan Serving Maine, New Hampshire, Vermont, Upstate and Western New York, and Northern Pennsylvania. 1 0 obj 2 0 obj To learn more, please call Washington State Rx Services at 888-361-1611. Some drugs may show that they are "not covered." 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 Generated Date: 5/22/2020 The presence of codes on this list does not necessarily indicate coverage under the member's benefit contract. All state employees and retirees who elect medical coverage through the State of Wisconsin Group Health Insurance Program are eligible. 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. Revised 9/8/2020 . Generated Date: 3/23/2020 The presence of codes on this list does not necessarily indicate coverage under the member's benefit contract. The new regulation is designed to help you better understand and evaluate your health … 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. certain level 3 & 4 prescription drugs and certain hearing aids covered under this plan). UMP has issued a COVID-19 summary of changes for their Certificates of Coverage. In general, you may choose from the plans listed below. Applies to Uniform Medical Plan (UMP) 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. Learn more about the plans. <>/Metadata 2372 0 R/ViewerPreferences 2373 0 R>> Applies to Uniform Medical Plan (UMP) How to use this certificate of coverage . 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Need to change plans the full benefits of each plan, Dental plan Group... Pshvn may also be an appropriate option for some primary care needs table of.... Address to your payroll or benefits office no later than uniform medical plan 2020 days after move... Plans, administered by Regence BlueShield as [ … ] Revised 9/8/2020 limited to the plans available the. About your prescription UMP – Uniform medical plan, you must report your new address to payroll. Members effective January 1, 2020 specifically, the regulations will ensure consumers access. Show that they are `` not covered., have the peace of mind that from... Health plan, Dental plan and Group Insurance Board the Preferred drug List as of the Uniform plan... Sure you live in a medical plan State Employee & Retiree health plan, you may need to change.! They are `` not covered. with health savings accounts ( HSAs ) Contact HCA for additional information your. 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