Check the plan's provider directories to see how many providers are accepting new patients and what the average wait time is for an appointment. More about IRS 1095-C. VEBA is a health reimbursement arrangement (HRA) available to some governmental employees in Washington. The amount of the individual policy will be equal to (or at the employee's option, less than) the amount of coverage as of the termination date of the policy being converted. We will also notify your medical plan of your Medicare coverage. You have five UMP medical plan options: UMP Classic When you receive care, some plans require you to pay a percentage of an allowed fee, called coinsurance. Information for employers with employees who are seeking insurance coverage in retirement. $300/person $900/family: $1,500/person. insurance. Failure to notify UW may result in loss of eligibility. Open Enrollment | ISC All medical plans cover the same basic health care services, but vary in other ways such as provider networks, premiums, your out-of-pocket costs, and prescription drug coverage. Yes. myStrength is a self-guided health and resiliency online tool for UMP members ages 13 and older available at no cost to you. Faculty with a one quarter appointment who are in a UW paid appointment of at least 50 percent or more, and whoat any time during the last 12 monthswere eligible under faculty rules at the UW or another Washington state higher education institution, are eligible for PEBB benefits on the first day of the month in which the academic quarter begins. If you do not show your plan ID card, you will have to pay the full cash price and submit a Prescription Drug Claim Form. Learn more about the prescription drug costs specific to your UMP plan. Regence BlueShield serves select counties in the state of Washington and is an Independent Licensee of the Blue Cross and Blue Shield Association. UMP CDHP - Regence Questions about PEBB or SEBB retiree benefits? If eligible dependents are enrolling, they must be covered under the same medical and dental plan as the retiree with the exceptions specified for Medicare Supplement Plan F. Retiree term life insurance (if eligible). Washington State Government offers one of the most competitive benefits packages in the nation with services including: . Are you satisfied with the quality of care and services given by the plan? The PEBB Program offers three types of medical plans (value-based plans noted in bold ). Submit the completed form along with your receipts to the address or fax number listed on the form. When you choose a UMP plan, you get an active partner in your health care. While deferring coverage, you need to be continuously enrolled in other health care coverage, such as that provided by a spouse's employer. Uniform Medical Plan (UMP) is a self-insured Preferred Provider Organization (PPO) medical plan offered through the Washington State Health Care Authority. Learn more about these plans under What are my medical plan options? To learn more, contact Washington State Rx Services, Costco, or PPS. If the exception is approved, you will pay: Youll get the UMP member discount when you buy prescription drugs through one of UMPs network retail pharmacies, network mail-order pharmacies (Costco Mail Order Pharmacy and Postal Prescription Services), or network specialty drug pharmacy (Ardon Health). A child may also include an extended dependent in your spouses or partners legal custody or guardianship. You have up to six months after the Medicare Part B enrollment date to enroll. Does the plan cover the medications you are currently taking? Premium amounts vary by medical plan. Dependent basic life and any spouse or state-registered domestic partner optional life insurance can be continued, but only if the employee continues their life insurance. The Health Care Authority (HCA) is pleased to announce the Centers for Medicare & Medicaid Services (CMS) approved a renewal for our state's Section 1115 Medicaid demonstration waiver. Some providers are network providers in one location but not another. At no cost to you, as part of your PEBB benefits package, you are automatically enrolled in: Basic Life insurance ($35,000 coverage) Basic Accidental Death & Dismemberment (AD&D) insurance ($5,000 coverage) Employer -Paid Long-Term Disability (LTD) insurance. Your prescription drug benefits are managed by Washington State Rx Services. As a PEBB member, you pay nothing for covered preventive services, including your annual physical and covered immunizations, when you see a network provider. Insurance pays the remaining percentage of the cost. The child must be incapable of self-sustaining employment and chiefly dependent upon the employee for support. The Plus plan networks are smaller, as each consists of regional providers spread throughout western Washington. Yes. (You must work at least eight hours into your seventh month to maintain eligibility). Employees retiring under plans administered by the Department of Retirement Systems must contact DRS for information about retirement eligibility.Online:www.drs.wa.govPhone:1-800-547-6657, Website feedback: Tell us how were doing, Copyright 2023 Washington Health Care Authority, I help others apply for & access Apple Health, Apple Health for Workers with Disabilities (HWD), Medically Intensive Children's Program (MICP), Behavioral health services for prenatal, children & young adults, Wraparound with Intensive Services (WISe), Behavioral health services for American Indians & Alaska Natives (AI/AN), Substance use disorder prevention & mental health promotion, Introduction overview for general eligibility, General eligibility requirements that apply to all Apple Health programs, Modified Adjusted Gross Income (MAGI) based programs manual, Long-term services & supports (LTSS) manual, Medical plans & benefits (including vision), Life, home, auto, AD&D, LTD, FSA, & DCAP benefits. Below is a summary of how PEBB eligibility rules impact various employee groups. When you choose one of our health coverage plans, you'll get affordable medical and prescription drug coverage and dependable wellness plans that meet your needs. Dont have a Regence account? You may still be eligible. The plan does not cover immunizations for travel or employment, even when recommended by the CDC or required by travel regulations. PEBB 2021 Plans UMP CDHP This page contains plan information for 2021. This is called coordination of benefits. UMP medical plans are administered by Regence BlueShield. Check with your employer for additional information. These drugs are covered only when purchased through UMPs network specialty drug pharmacy, Ardon Health. Employees and dependents may contact the PEBB Programto discuss their PEBB Continuation Coverage and PEBB retiree insurance options.Phone:1-800-200-1004(toll-free) Monday through Friday, 8 a.m. to 4:30 p.m., orSend a secure message: Employeesneed to set up an account to protect theirprivacy and sensitive health information. Excluded drugs are not covered by UMP. After you enroll, your health plan will send you an identification (ID) card to show to providers when you receive care. Some drugs need pre-authorization to determine whether they are medically necessary and meet other criteria, or the plan will not cover them. Background Indigenous people have faced negative impacts on their health and wellness since the country was colonized. The employee must submit theRetiree Enrollment form (form A) to enroll or defer. Specialty drugs may include a variety of medications from injectables to oncology therapies. The PEBB Program You do not need to enroll in Medicare Part D prescription drug coverage. We must receive the forms no later than the last day of the month before the month you or your dependent enrolls in the Medicare Advantage plan. Copayments are usually made at the doctors office, when you receive the service. Enrolling in Medicare also qualifies as a special open enrollment event, allowing you to change your medical plan. The Classic, Select, and CDHP plans share the same large network that includes providers both nationwide and worldwide. When you use a network pharmacy and show your UMP member ID card, your claims are submitted for you. Find out how much your drug costs. manage your benefits with myProvidence Welcome PEBB members! What happens to your UW Benefits after big life changes? See plans available by county. If you are enrolling in PEBB retiree insurance coverage for the first time, submit proof with your Retiree Election Form (form A). Once you have reached the out-of-pocket limit, the plan pays 100 percent of allowed charges for most covered benefits for the rest of the calendar year. Use the Pharmacy Locator Tool to find a network pharmacy near you. Once you have met your deductible for the year, you only pay your coinsurance. Website feedback: Tell us how were doing, Copyright 2023 Washington Health Care Authority, I help others apply for & access Apple Health, Engrossed Substitute House Bill 1099 (Brennen's Law), Health plans with health savings accounts (HSAs), Medical Flexible Spending Arrangement (FSA), Apple Health for Workers with Disabilities (HWD), Medically Intensive Children's Program (MICP), Behavioral health services for prenatal, children & young adults, Wraparound with Intensive Services (WISe), Behavioral health services for American Indians & Alaska Natives (AI/AN), Substance use disorder prevention & mental health promotion, Introduction overview for general eligibility, General eligibility requirements that apply to all Apple Health programs, Modified Adjusted Gross Income (MAGI) based programs manual, Long-term services & supports (LTSS) manual, Medical plans & benefits (including vision), Life, home, auto, AD&D, LTD, FSA, & DCAP benefits. You will pay the entire cost of prescription drugs until you meet your combined deductible. PEBB retirees may be eligible to purchase the following life insurance options: Employees may apply to continue their PEBB employee basic life and optional life insurance until age 100 if certain conditions are met. An employer group that ended their participation in PEBB insurance coverage on or before January 1, 2023, to enroll in PEBB medical and dental coverage by December 31, 2023. Remember, if you cover eligible dependents, everyone must enroll in the same medical and dental plans. Medicare Part A and Part B are provided to you by the federal government. Use the UMP Preferred Drug List to find out if a drug: Use the Drug Price Check tool for UMP Classic, UMP Select, UMP CDHP, and UMP Plus to estimate the cost of your drug. Other parts of Medicare are offered through private insurance companies and follow rules set by Medicare. The premium does not cover copays, coinsurance, or deductibles. Learn more about Medicare and what you have to do to keep your PEBB retiree health plan. If eligible, the subscriber and/or dependents must enroll and maintain enrollment in both Medicare Part A and Part B to qualify for PEBB retiree coverage. 206-543-4444 Specialty drugs are high-cost injectable, infused, oral, or inhaled prescription drugs or products that require special storage or handling and are subject to additional rules. Once you or your dependent enrolls in Medicare Part A and Part B, you must send us proof of the enrollment. Failure to notify UW may result in loss of eligibility. Contact us | Washington State Health Care Authority Most plans offer online resources to help you easily find information about your care to support you in making the decisions that work best for you. Online: MetLifePhone: 1-866-548-7139MetLife portability/conversion: 1-877-275-6387, The Department of Retirement Systems (DRS) You will sign up for Parts A and B on the Social Security Administration website. 3. hca.wa.gov/pebb-retirees . 2023 University of Washington | Seattle, WA, University of Washington Human Resources Home, Final candidate guide to COVID-19 vaccination requirement, HR Benefits, Analytics & Information Systems, Professional & Organizational Development, Public Employees Benefits Board (PEBB) medical, dental, and life insurance, You must submit an online UW Retirement Application, Discounts on auto, home, and renters insurance, Physician Assistants students: LTD insurance, Managing your annual contributions and IRS limits, Fund review committee for UW retirement plans, Medical FSA: Tax savings for medical costs, DCAP: Tax savings for child and elder care. Vision benefits are part of your medical plan. 2023 Regence BlueShield. Eligible UW employees are offered insurance through the Public Employees Benefits Board (PEBB) program,which is administered by the Washington State Health Care Authority (HCA). Employees who are members of a Washington higher education retirement plan (i.e., TIAA-CREF) are eligible if they immediately begin to receive a monthly retirement plan payment, meet their plans retirement eligibility criteria, or are at least age 55 with 10 years of service. Who to contact for help . The plan may not pay benefits if you see a noncontracted provider. We've got you covered. The plan does not cover over-the-counter drugs, vitamins, and supplements, except for a few that are specifically noted in the UMP Preferred Drug List. Each Medicare supplement plan is identified by a letter A through N. All plans offer the same basic benefits, and some offer extra benefits. The PEBB Program only offers Premera Blue Cross Medicare Supplement Plan G. Plan G only pays when Medicare pays for services billed under Medicare Part A and Part B. Academic staff, professional, and classified staff and librarians are eligible for PEBB insurance if they are appointed to an eligible job class that is at least an average of 80 hours per month (480 hours) UW salaried per month and the appointment is expected to continue for more than six months. Choosing a medical plan is an important decision. Most PEBB medical plans include prescription drug coverage that is as good as or better than Medicare Part D.PEBBs UnitedHealthcare PEBB Balance and PEBB Complete include Medicare Part D coverage. The subscriber is the employee or retiree enrolled in PEBB benefits. Retiree health care Attend a health care webinar Part 1: Health (Medical, Dental, Life, and Disability) Insurance Medicare Knowing you're enrolled in the right plan is reassuring when it comes to your well-being. The Statewide Health Insurance Benefits Advisors (SHIBA) provides free, unbiased, and confidential assistance with Medicare and health care choices. If you are paid directly from a non-UW entity your benefits eligibility may be affected. UMP offers five different health plans administered by Regence BlueShield and Washington State Rx Services. When you retire, you can choose to continue the Public Employees Benefits Board (PEBB) medical, dental, and life insurance you had as an employee. Compare medical plans | Washington State Health Care Authority However, there are some exceptions, as listed in the table below. Inpatient care in skilled nursing facilities. Alex, Virtual Benefits Counselor. 2023 University of Washington | Seattle, WA, University of Washington Human Resources Home, Final candidate guide to COVID-19 vaccination requirement, HR Benefits, Analytics & Information Systems, Professional & Organizational Development, step-by-step instructions for enrolling in benefits, Discounts on auto, home, and renters insurance, Physician Assistants students: LTD insurance, Managing your annual contributions and IRS limits, Fund review committee for UW retirement plans, Medical FSA: Tax savings for medical costs, DCAP: Tax savings for child and elder care. Create one now. Ends three months after the month of Medicare eligibility, or before you or your dependent's last day of the Medicare Part B initial enrollment period. Uniform Medical Plan (UMP) is a collection of high-quality, self-insured preferred provider organization (PPO) health plans offered through Washington States Public Employees Benefits Board (PEBB) Program. To submit a claim, download the Prescription Drug Claim Form, fill it out, and send it, along with your pharmacy receipts, to the address listed on the form. Of particular concern is the high rate of opioid and fentanyl-related overdose deaths, which is above the national average. Note: The PEBB and SEBB Programs do not take appointments. To learn more about your plan for 2023 visit Welcome to UMP. This insurance is only available to those who meet the PEBB Programs retiree eligibility requirements and had life insurance through the PEBB Program as an employee. Medicare Part C, also known as Medicare Advantage plans, generally includes Parts A, B, and D. Some Medicare Advantage plans include additional benefits. However, some supplies may be covered under the UMP medical benefit. You also will not receive the plan discount. Yes. As a retiree, you or your covered dependent are required to enroll in both Medicare Part A and Part B as soon as eligible to stay enrolled in a PEBB retiree health plan. Medical Insurance - Human Resource Services, Washington State University Retirement Benefits: Youre eligible for retirementbenefits administrated by DRS, Learn More. Under PEBB rules, you are required to notify the UW of the prior period of employment in a timely way in order to establish your eligibility. The WA Cares Fund is administered by the Washington State Department of Social and Health Services (DSHS). UMP Classic, UMP Select, or UMP Plus: Tier 2 cost-share, UMP CDHP: 15% coinsurance after deductible is met. Travel Assistance by The Standard. The PEBB Program determines eligibility based on when an application is received and PEBB rules. PEBB Plans UMP Classic Medicare For 2022 plan information visit the 2022 UMP Classic Medicare webpage.

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