Quick Links: Why Choose Us. Plans (PPO) Feature Uniform Medical Plan Classic – In-Network Summary Deductible Medical: $250/Person $750/Family Rx: $100/Person $300/Family Tier 2 & 3 only Out of Pocket Maximum Medical: $2,000/Person $4,000/Family Rx: $2,000/Person Office Visits 15% Inpatient Hospital $200/day - $600 maximum/year/person + 15% professional fees Lab/X-ray 15% Health) and Uniform Medical Plan. Find Your Doctor. Medical Plan Comparison PEBB and Current Pierce County Plans The chart below briefly compares the per-visit costs of some in-network benefits for current Pierce County and PEBB medical plans. COB – Coordination of benefits . not be enrolled. Complete a 2021 PEBB Spousal Plan Calculator for each medical plan that meets the criteria above. DME – Durable medical equipment . Add your annual CDHP Medical What are the differences between your two medical plan options? You cannot be enrolled in Medicare either if you have a CDHP. > Preferred Provider Organization Plans > Managed Care Plans > Consumer Directed Health Plans (CDHP) You … The SBC shows you how you and the plan would share the cost for covered health care services. Three plan design options available which look similar to those available for employees. Like other plans, you pay coinsurance for services, your care costs less when using network providers, and you receive coverage for common services like vision and prescriptions. PEBB HSARPPO 2017 2 Important Notice Under Federal Health Care Reform Group Health recommends each Enrollee choose a personal physician. PEBB Plans. Find a Provider For Classic, CDHP, Original Medicare, and Value Subscribers Uniform Medical Plan CDHP 553.72 1,049.10 939.84 1,376.89 Effective 7/1/2014: The following surcharges will be applied to some employees Tobacco use surcharge 25.00 25.00 25.00 25.00 Spouse surcharge 50.00 50.00. This decision is important since the designated personal physician provides or arranges for most of the Enrollee’s health care. PEBB - Medical and Dental 2021 The County premium contribution using the pooling method, effective January 1, 2021, by Resolution 2020-84. UnitedHealthcare PEBB Balance (PPO) UnitedHealthcare PEBB Complete (PPO) Annual medical deductible: $0: $0: Annual out-of-pocket maximum: $2,000: $500: Office and clinic visits: $15 copay primary care. Enter the amount of your medical expenses or choose from the estimates below. $0 copay specialist. Because a CDHP is an HSA-eligible plan, you cannot be covered by another non-HSA eligible plan. $30 copay specialist. If more than one plan meets the criteria, submit one copy of this form for each medical plan. Below are some tips to help you get the most out of your benefits and save money. eligible for COBRA. Plans (PPO) Feature Uniform Medical Plan Classic – In-Network Summary Deductible Medical: $250/Person $750/Family Rx: $100/Person $300/Family Tier 2 only Out of Pocket Maximum Medical: $2,000/Person $4,000/Family Rx: $4,000/family Office Visits 15% Inpatient Hospital $200/day - $600 maximum/year/person + 15% professional fees Lab/X-ray 15% COE – Centers of Excellence Program . For Medicare Questions. Kaiser Permanente NW plans. Subscriber becomes eligible for Medicare. If at least one plan results in “You will have to pay the surcharge,” then you will be charged the premium surcharge in addition to your monthly medical premium. Provider Directories. If you are interested in a Medicare Advantage health plan and want to speak with a Kaiser Permanente Medicare specialist: 1-800-581-8252 (TTY 711) For eligibility and enrollment questions: Visit the PEBB website. Non-Medicare Retiree plans. That’s because they submit claim forms directly to Delta Dental and agree to provide care at discounted fees. Uniform Medical Plan coverage limits Updates effective 12/1/2019 The benefit coverage limits listed below apply to these UMP plans: Uniform Medical Plan (UMP) Classic (PEBB) UMP Consumer-Directed Health Plan (UMP CDHP) (PEBB) UMP Plus–Puget Sound High Value Network (UMP Plus–PSHVN) (PEBB) UMP Plus–UW Medicine Accountable Care Network (UMP Plus–UW Medicine ACN) (PEBB) … are a Delta Dental PPO plan member. Uniform Medical Plan (UMP) Consumer-Directed Health Plan (CDHP) (PEBB) Coverage for: Individual/Family | Plan Type: PPO The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Health Plan (CDHP) 2019 Quick Start Guide Health insurance can seem complicated, especially if you’re new to the plan. Find Your Clinic. 10003948 RX BIN:003585 RX PCN:38600 UDW W123456789 RX Group:10008217 M D RX V 00 SUBSCRIBER SAMPLE Y N Y MedImpact* Y SUBSCRIBER SAMPLE 1259-RE 229F IC(WA05) WA05 … Review the full benefits and exclusions of each plan. Medical Plan Comparisons PEBB 2020 & Premera 2021 . Use the key below to see how PEBB plans with coverage and provider networks comparable to current County plans are identified. You have chosen the Uniform Dental Plan (UDP) GROUP #03000. Uniform Medical Plans (Regence) 24 Hour Health Line: (800) 267-6729097 Customer Service: UMP Classic & UMP CDHP: (888) 849-3681 UMP Plus Puget Sound: … The UW Medicine Accountable Care Network (ACN) brings together leading healthcare providers in the Puget Sound region to offer an innovative coverage option to PEBB-eligible employees in King, Kitsap, Pierce, Skagit, Snohomish and Thurston counties. CDHP – Consumer-directed health plan . Uniform Medical Plan Plus (PPO) Uniform CDHP (PPO) Group Health Value Group Health SoundChoice (HMO) Kaiser CDHP (HMO) Kaiser Classic Group Health CDHP (PPO) Multiple Plan Options • Managed Care plans • Preferred Provider plans • Varying levels of deductibles • Varying networks 2017 Monthly Medical Premiums (pg. Not every medical provider may be willing to offer a payment plan, which means your network is effectively limited because of how you choose to pay. (continued) Why is the Uniform Medical . Participating PPO network dentists can also save you time and money. Uniform Medical Plan Plus (PPO) Uniform CDHP (PPO) Kaiser WA Value Kaiser WA SoundChoice (HMO) Kaiser WA CDHP (PPO) Kaiser NW Classic Kaiser NW CDHP (HMO) Multiple Plan Options • Managed Care plans • Preferred Provider plans • Varying levels of deductibles • Varying networks 2017 Monthly Medical Premiums (pg. Plan (UMP) Classic premium for Medicare increasing so much for 2018? Dental plans You are not required to enroll in a dental plan, but to enroll in a dental plan you must be enrolled in a medical plan choice (Opt Out is a medical plan choice). Preferred Provider (PPO) Medical Plans: Managed Care Medical Plans: Uniform Medical Plan (UMP) plans (administered by Regence) Kaiser Permanente WA plans: Select a plan category above to: Find providers. Uniform Medical Plan Plus (PPO) Uniform CDHP (PPO) Kaiser WA Value Kaiser WA SoundChoice (HMO) Kaiser WA CDHP (PPO) Kaiser NW Classic Kaiser NW CDHP (HMO) Multiple Plan Options • Managed Care plans • Preferred Provider plans • Varying levels of deductibles • Varying networks 20 2018 Monthly Medical Premiums (pg. CHIP – Children’s Health Insurance Program . Clinic Map. These are the same benefits you have as an employee however the monthly premiums you pay are different. Kaiser WA (formerly Group Health) plans. Kaiser Permanente of Washington (formerly Group Health) will: Introduce a prescription drug deductible and prescription drug out-of-pocket maximum to all of their plans except the consumer-directed health plan (CDHP) with a health savings account (HSA) and Original Medicare. 2014 medical plan benefits cost comparison (continued) The chart below briefly compares the per-visit costs of some in-network benefits for PEBB plans, and extended-network … Now that you can see the math, it is up to you to decide which plan is better for you! PEBB-CHANGING PLANS. Medical plan premiums are partly . Some copays and coinsurance do not apply until after you have paid your annual deductible. Kaiser NW CDHP 590.87 1170.25 1039.99 1561.04 Uniform Classic 657.86 1310.70 1147.49 1800.33 UMP CDHP 588.91 1166.83 1036.93 1556.52 UMP Plus‐PSHVN 600.56 1196.10 1047.22 1642.76 UMP Plus‐UW Med ACN 600.56 1196.10 1047.22 1642.76 * Or qualified/state‐registered domestic partner >PEBB plans offer secondary coverage to Medicare Parts A & B and provide coverage for important … 2 TABLE OF CONTENTS Medical Insurance Terminology ..... Error! If you are eligible for the employer contribution toward PEBB benefits but do not waive or enroll in PEBB Program medical coverage, you will be enrolled by default as a single subscriber in Uniform Medical Plan (UMP) Classic. The family member you remove is . PEBB non-Medicare retirees Kaiser Foundation Health Plan of Washington Classic. The family member you remove would not be eligible for COBRA. CMS – Centers for Medicare and Medicaid Services . Provider Directories. Find a Provider For Classic, CDHP, Original Medicare, and Value Subscribers • Switch the CDHP network from Access PPO to Core HMO, adding: ... a non-CDHP PEBB medical plan or remove the Medicare-eligible family member from your coverage. On-Demand Virtual Care. Uniform Medical Plan offers four plans to UW employees: Classic, CDHP, and two Plus plans. Meet Our Members. health plan (CDHP) with a health savings account (HSA) in 2018, you must change to a non-CDHP PEBB medical plan or remove the Medicare-eligible family member from your coverage. Check only one. WTWT offers a choice of the WTWT Plan A PPO plan or the WTWT Kaiser HMO plan. not. For Medicare Questions. Under state law, the Uniform Medical Plans (UMP Achieve 1, UMP Achieve 2, UMP Classic, UMP CDHP, UMP High Deductible, UMP Plus – Puget Sound High Value Network, and UMP Plus – UW Medicine ACN) must comply with decisions made by the Health Technology Clinical Committee (HTCC). 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