UMP (PEBB) Open Enrollment

Keeping PEBB members’ health and safety a top priority during the COVID-19 pandemic, and following the state guidelines for large gatherings, PEBB will offer limited in-person benefits fairs this year. You can find out more about all of UMP’s plans online with PEBB’s virtual benefits fair.

A virtual benefits fair is a way to learn about your benefit options through an online, interactive, and personalized experience. It will be available anytime, day or night, starting September 30.

Use your computer, tablet, or smartphone to visit UMP’s virtual benefits booth. Once there, you can view UMP’s short videos to get an overview of all UMP plans or select a specific plan to see more detailed information.

UMP is hosting several webinars during open enrollment.

To learn more about UMP's plans and benefit options, view the recorded UMP (PEBB) Open Enrollment online webinar.

For general plan information, visit the UMP Plus–Puget Sound High Value Network and UMP Plus–UW Medicine Accountable Care Network plan detail pages or register to attend a UMP Plus webinar.

• Puget Sound High Value Network (PSHVN): Thursday, October 27, noon to 1 p.m. (Pacific)
  • Register for the webinar on the Zoom webinar webpage.

  • The recorded session will be available within three business days on PSHVN’s website.

• UW Medicine Accountable Care Network (ACN): Friday, October 28, noon to 1 p.m. (Pacific)
  • Register for the webinar on the Zoom webinar webpage.
  • The recorded session will be available within three business days on UW Medicine ACN’s website.

Communication Access Real-time Transcription (CART) services, or live closed captioning, are available for this event, on demand. Scheduling CART services requires a two-to-three-week lead-time. To request this accommodation, please submit a request to Janice Knutz at janice.knutz@hca.wa.gov as soon as possible. If you make your request less than a week in advance of the event, our language access manager cannot guarantee that a CART writer will be available.

For a summary of the most important information about open enrollment and 2023 coverage, read the UMP open enrollment newsletter.

UMP Open Enrollment Newsletter 2023 (non-Medicare edition)
UMP Open Enrollment Newsletter 2023 (Medicare edition)

To compare 2022 and 2023 premiums for UMP members, read the UMP 2023 premiums flyer.

For the complete list of 2023 premiums, visit the PEBB website (employees, retirees, PEBB Continuation Coverage) or read the PEBB Program’s October For Your Benefit newsletter, which will be mailed or emailed (depending on the delivery method you chose) starting on October 21, 2022.

Note: Non-represented ESD employees and employees who work for an educational service district, city, tribal government, county, port, water district, hospital, etc., must contact their payroll or benefits office to get their monthly premiums.

• For UMP Classic, UMP Select, UMP Plus–PSHVN, and UMP Plus–UW Medicine ACN members, there are no changes to the:
  • 2022 medical deductible;
  • 2022 prescription drug deductible;
  • 2022 out-of-pocket maximum; and
  • 2022 SmartHealth wellness incentive ($125 deductible credit to those who qualify)

• The UMP Consumer-Directed Health Plan (CDHP) deductible is increasing
  The deductible for UMP CDHP members is increasing to $1,500 for a single subscriber and $3,000 for a family. This is an increase from $1,400 for a single subscriber and $2,800 for a family. This deductible increase is required to maintain compliance with IRS rules, so that a subscriber can make eligible health savings account (HSA) contributions in 2023.

• Updates to member ID cards for 2023
  Members will be receiving new ID cards for 2023. The back of the new ID cards has a new look but the same important information. You use the same ID card for both medical and prescription drug services. You do not use your UMP ID card for dental services.

• Medical and pharmacy cost-share accumulators
  There’s good news for subscribers who change jobs and move from a Public Employees Benefits Board (PEBB) UMP plan to a School Employees Benefits Board (SEBB) UMP plan. Starting January 1, 2023, UMP will transfer certain medical and prescription drug accumulators, such as deductibles and out-of-pocket limits, for the existing plan year when subscribers and their enrolled dependents change between the PEBB Program and the SEBB Program during a special open enrollment and stay with UMP. This applies only to subscribers who remain the subscriber, and to enrolled dependents who change plans with the subscriber.

• Virtual behavioral health support offered by myStrength
  myStrength is a self-guided health and resiliency online tool clinically proven to improve emotional health. This secure resource is available 24 hours a day, 7 days a week to members ages 13 and over at no cost to you. myStrength’s interactive and activity-based tools are personalized to you and address conditions such as depression, anxiety, stress, substance use disorders, and chronic pain. Visit the myStrength website to sign up and learn more.

• Changes to coverage for dialysis services
  Starting January 1, 2023, you pay the standard rate for covered dialysis services. The plan pays based on the allowed amount and the network status of the provider. Other professional providers may bill separately from the facility. Amounts paid to out-of-network facilities for dialysis services (including balance-billed amounts) will not apply to your medical out-of-pocket limit.

• Reminder: Purchase continuous glucose monitors (CGMs) through a network pharmacy
  Continuous glucose monitors (CGMs) are only covered under the prescription drug benefit except for members who have Medicare as their primary coverage. UMP no longer covers CGMs under the medical benefit. This change happened on January 1, 2022. Durable Medical Equipment (DME) providers are not part of the prescription drug benefit.

• More mail-order pharmacy options
  Starting in January 2023, Costco Mail Order Pharmacy will be available as a second mail-order pharmacy option, in addition to Postal Prescription Services (PPS). You do not need to be a Costco member to use their mail-order service. Costco Mail Order Pharmacy and PPS are the mail-order pharmacies available to UMP members.

• $35 insulin cap
  Starting in January 2023, what you pay for covered insulins will be changing. Covered insulins for UMP members will not exceed $35 per 30-day supply.

• Drugs covered before you meet the deductible for UMP CDHP members
  For subscribers enrolled in UMP CDHP, certain prescription drugs used to treat specific conditions, for example, high blood pressure, depression, asthma, osteoporosis, heart disease, and diabetes, will be covered before you meet your deductible. A 15 percent coinsurance will apply for most prescription drugs. For a list of drugs covered as preventive, refer to the UMP Preferred Drug List.

• Prescription drug costs
  For information about 2023 prescription drug costs, please visit the 2023 plan webpage you are interested in (UMP Classic, UMP Select, UMP CDHP, UMP Plus–PSHVN, UMP Plus–UW Medicine ACN).
  

• See changes to the UMP Preferred Drug List
  Starting in November, see a list of anticipated changes to the UMP Preferred Drug List (PDL). The list is updated throughout the year and does not contain every anticipated change to the UMP PDL. It only contains changes that may negatively impact members, such as increasing a drug’s cost or limiting the amount of drug available per refill.

UMP Plus–Puget Sound High Value Network (PSHVN)

• UMP Plus–PSHVN does not have any service area changes for 2023. The plan will continue to serve Chelan, Douglas, King, Kitsap, Pierce, Snohomish, and Yakima counties. Learn more about the plan by visiting the UMP Plus–PSHVN webpage.

UMP Plus–UW Medicine Accountable Care Network (UW Medicine ACN)

• UMP Plus–UW Medicine ACN does not have any service area changes for 2023. The plan will continue to serve King, Kitsap, Pierce, Skagit, Snohomish, Spokane, and Thurston counties. Learn more about the plan by visiting the UMP Plus–UW Medicine ACN webpage.

UMP is updating the UMP Notice of Privacy Practices (effective November 1, 2022). It will be posted on the UMP notice of privacy practices webpage. Read it to learn how UMP and the Health Care Authority are protecting your personal information.

Your 2023 certificate of coverage is your best resource for benefit information. It describes what is covered and how much you will pay for different services.

• UMP Classic
• UMP Select
• UMP Consumer-Directed Health Plan (CDHP)
• UMP Plus–Puget Sound High Value Network (PSHVN)
• UMP Plus–UW Medicine Accountable Care Network (ACN)

UMP offers UMP Classic, UMP Select, UMP CDHP, and UMP Plus. UMP Plus has two network options: Puget Sound High Value Network (PSHVN) and UW Medicine Accountable Care Network (ACN). To quickly compare 2023 plan information:

• Review benefits comparisons (UMP Classic, UMP Select, UMP Plus, and UMP CDHP or UMP Classic Medicare).
• Use PEBB’s medical benefits comparison tool and choose up to three UMP plans to compare.
• Review Summaries of Benefits and Coverage.
• Read this summary of your prescription drug benefit.

If you qualify for services, the UMP Centers of Excellence (COE) Program covers single knee and single hip replacement surgery, and spine care evaluation and/or surgery for low to no cost.

This program is available for all UMP members except those enrolled in UMP Plus and UMP members enrolled in Medicare as their primary coverage.* To learn more, watch the COE video or visit Premera’s COE program website.

*Medicare and UMP Plus members have access to covered services related to joint replacement and spine care outside of this program.

Explore the virtual benefits fair or call:

• UMP Customer Service at 1 (888) 849-3681 (TRS: 711) for questions about medical benefits
• Washington State Rx Services at 1 (888) 361-1611 (TRS: 711) for questions about prescription drugs

WSRxS, Postal Prescription Services, Costco Mail Order Pharmacy, and Centers of Excellence do not provide BlueCross Blue Shield services and are separate companies solely responsible for their products/services.