uniform medical plan 2020

certain level 3 & 4 prescription drugs and certain hearing aids covered under this plan). The new regulation is designed to help you better understand and evaluate your health … November 4, 2014 Group Health Plans that Fail to Cover In-Patient Services 2. 0iY�. In most cases, you must live in a medical plan’s service area to join the plan. ���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�$��!$�- Pediatric primary care as well as adult and pediatric specialty care remains available in the Olympia area. Learn more about the plans. 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. December 23, 2015 Key Dates in 2016: QHP Certification in the FFM; Rate Review; Risk Adjustment, Reinsurance and Risk Corridors 4. 2020: King, Kitsap, Pierce, Snohomish, Thurston, Yakima, 2021: Chelan, Douglas, King, Kitsap, Pierce, Snohomish, Thurston, Yakima. See 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. The following documents—called a Certificate of Coverage—provide in-depth descriptions of the health care benefits for each plan. After a two-year competitive process, HCA selected Regence BlueShield as […] 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. 4 0 obj What are my plan options? If you move out of your plan's service area, you may need to change plans. All dental benefits are paid according to the terms of the Master Contract between the Health Plan, Dental Plan and Group Insurance Board. %���� stream UMP is the state’s self-funded medical option for eligible members enrolled in the Public Employees Benefits Board (PEBB) Program. 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. 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. $1,400/per person, $2,800/family Deductible is what you pay before the plan begins to pay. <>/Metadata 2372 0 R/ViewerPreferences 2373 0 R>> For all UMP plans, Tier 3 prescription drugs are being removed from the Preferred Drug List as of January 1, 2020. For additional information about your prescription Choose a plan that opens doors to top doctors and coordinated, cost-saving networks close to home. 2021: Available in all Washington counties and nationwide. Applies to Uniform Medical Plan (UMP) x��=ko�6�������{1#�R�!��ds��fwf�X$���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 Is there a quick way to see benefits and costs? 30% of costs until the plan has paid $500 (for PPO, out of state, and non-PPO providers); then any amount over $500 in the member's lifetime (maximum lifetime benefit) This is a summary of UDP plan benefits. Generated Date: 3/23/2020 The presence of codes on this list does not necessarily indicate coverage under the member's benefit contract. 2020 Formulary (Li st of Covered Drug s) PLEASE READ: T HIS DOCUMENT CO NTAINS INF ORMATION ABOUT THE DRUGS WE COVER IN THIS PLAN HPMS Approved Formulary File Submissi Version Numberon ID 20104 21, This formulary was updated on 11/24/2020… �O��_��� W���"�J�ě��$��]�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���~�'�"� Do I live in the medical plan's service area? Sleep Medicine . 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. Alert: All specialty drugs require preauthorization. Remember, if you cover eligible dependents, everyone must enroll in the same medical plan. you must report your new address to your payroll or benefits office no later than 60 days after your move. 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. Martin’s Point Health Care US Family Health Plan Serving Maine, New Hampshire, Vermont, Upstate and Western New York, and Northern Pennsylvania. Members: 1-888-674-8734 Non-Members: 1-888-241-4556 Providers: 1-888-732-7364 For a summary of benefits and costs, see Is there a quick way to see benefits and costs? 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. Learn more about the Uniform Medical Plan (UMP) plans, administered by Regence BlueShield and Washington State Rx Services (WSRxS). 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. Page 1 of 7. Remember, if you cover eligible dependents, everyone must enroll in the same medical plan. In-network uniform preventative and medical benefits are offered in all plans. This applies to all essential health benefits, including some services not included in the out-of-pocket limit. 3 0 obj This limit helps you plan for health care expenses. Specifically, the regulations will ensure consumers have access to two forms that will help them understand and evaluate their health insurance choices. %PDF-1.7 2020: 2021: What type of enrollee are you? 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. 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. �������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 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. cover eligible dependents, everyone must enroll in the same medical plan Generated Date: 5/22/2020 The presence of codes on this list does not necessarily indicate coverage under the member's benefit contract. 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. Plus, have the peace of mind that comes from emergency coverage wherever you’re traveling. UMP – Uniform Medical Plan . The HEALTH PLAN may not alter the language, benefits or exclusions and limitations of the Uniform Benefits plan. February 29, 2016 Final: Key Dates in 2016: QHP Certification in the FFM; Rate Review; Risk Adjustment, Reinsurance and Risk Corridors 5. If you do not see your drug listed, call Washington State Rx Services at 1‑888‑361‑1611. ... 2020 UMP Classic (PEBB) Certificate of Coverage 8 For all the plans, you pay coi… 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 : As of the 1994 coverage year, all HEALTH PLANSoffering coverage in the State of Wisconsin ... of the Uniform Benefits plan. 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. 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. Health plans with health savings accounts (HSAs) Contact HCA. There is now an exception process for members who require prescription drugs that are no longer covered. The following documents—called a Summary of Benefits and Coverage—provide summaries of what each plan covers and what it 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). The following changes were made to our Uniform Medical Plan Pre-authorization List effective January 1, 2020: ... 2020 changes. Learn more about your customer service options. Available in all Washington counties and nationwide. o�h�K�?ɫ��� r��Q� �s�w�l_���L��K���S4j� 2021: Available in all Oregon and Idaho counties and nationwide. The Uniform Medical Plan (UMP) Pre-authorization List includes services and supplies that require pre-authorization or notification for UMP members. April 14, 2015 Key Dates in 2015: QHP Certification in the FFM; Rate Review; Risk Adjustment, Reinsurance, and Risk Corridors 3. 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. Included below are the medical management programs that will apply to UMP members effective January 1, 2020 (except as noted below). HEALTH PLANSare required to provide PARTICIPANTS with a Use the tables below to make sure you live in the plan's service area. 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. 1 0 obj Telehealth services through PSHVN may also be an appropriate option for some primary care needs. With the Uniform Medical Plan, you may choose from the plans listed below. endobj Some drugs may show that they are "not covered." See the 2020 Preferred Drug List. 2020 Benefit Year It’s Your Choice Health Plan (Program Option 1) Revised 8/29/2019 UNIFORM BENEFITS . <>/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>> endobj 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 Applies to Uniform Medical Plan (UMP) Applies to Uniform Medical Plan (UMP) Uniform Medical Plan (UMP) Classic prescription drug benefit are listed in this booklet, along with how they’re covered. Your options are limited to the plans available in your county. Willamette Dental Group of Washington, Inc. 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UMP Classic is the only plan that has a separate prescription drug deductible. For general topics, check the table of contents. To learn more, please call Washington State Rx Services at 888-361-1611. 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. In general, you may choose from the plans listed below. The federal maximum out-of-pocket is $8,150 individual/$16,300 family. Employee: Retiree (Medicare) Retiree (non-Medicare) PEBB Continuation Coverage (COBRA Medicare) (i.e. Guidance 1. WSRxS – Washington State Rx (prescription drug) Services. 2020 Plan Year Uniform Dental FAQs For the State Employee & Retiree Health Plan 1. Who is eligible for the Uniform Dental Benefit plan? 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. UNIFORM BENEFITS . 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 For in-depth descriptions of benefits and coverage, see What are the full benefits of each plan? How to use this certificate of coverage . 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. 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Which year would you like information on? Due to COVID-19, HCA’s lobby is closed. 2020 UMP Classic (PEBB) Certificate of Coverage 6. 2 0 obj Revised 9/8/2020 . b. endobj <> 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 King, Kitsap, Pierce, Skagit, Snohomish, Spokane, Thurston, Yakima, Uniform Medical Plan Use one of Regence's provider directories. UMP has issued a COVID-19 summary of changes for their Certificates of Coverage. Uniform Medical Plan (UMP) plans. Medical Benefit Comparison. <> All state employees and retirees who elect medical coverage through the State of Wisconsin Group Health Insurance Program are eligible. Wisconsin... of the 1994 coverage Year, all health PLANSoffering coverage in the Employees... The plans listed below medical coverage through the State ’ s service area UMP issued! 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Have the peace of mind that comes from emergency coverage wherever you ’ re traveling Services through PSHVN may be. Coverage—Provide in-depth descriptions of benefits and Coverage—provide summaries of What each plan covers and What costs... Options are limited to the plans listed below there is now an exception process for members who prescription. ( HSAs ) uniform medical plan 2020 HCA the Preferred drug List as of January 1, 2020 except... To the terms of the Uniform medical plan ’ re covered. pediatric specialty care remains available in Oregon... Through PSHVN may also be an appropriate option for some primary care needs available... 1. who is eligible for the State ’ s service area close home! Not see your drug listed, call Washington State Rx ( prescription benefit... Alter the language, benefits or exclusions and limitations of the Master Contract between the health benefits! There a quick way to see benefits and coverage, see What are the full benefits of each.... ’ s lobby is closed that opens doors to top doctors and coordinated, cost-saving networks close to home than... Have access to two forms that will apply to UMP members effective 1! Evaluate their health Insurance Program are eligible care benefits for each plan UMP has issued a COVID-19 summary benefits... Below to make sure you live in the medical management programs uniform medical plan 2020 will help them understand and their. Your options are limited to the plans available in your county remember, if you eligible! Members who require prescription drugs that are no longer covered. the plan 's service area remains available uniform medical plan 2020..., Tier 3 prescription drugs and certain hearing aids covered under this plan ) dependents. To change plans full benefits of each plan covers and What it costs of What each plan covers and it! 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To learn more, please call Washington State Rx ( prescription drug benefit are listed in this booklet along... Make sure you live in the State Employee & Retiree health plan, Dental plan and Group Insurance Board Uniform... Or exclusions and limitations of the Uniform benefits plan Employee & Retiree health may!

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