Uniform Medical is a preferred provider organization (PPO) medical insurance plan administered by Regence BlueShield. Two types of Uniform Medical plans are offered to UW employees and their dependents:
Both plans feature the following:
In addition to monthly premiums which are deducted from your pay, other costs should be considered when choosing a medical plan, such as:
Also, if you have a specific medical condition, investigate costs and provider options outlined in the plan's Certificate of Coverage.
For UMP Classic, covered services are paid using a combination of deductibles, coinsurance, and copayments (explained below). Total cost for care also depends on whether you see a network or non-network provider. Not all doctors who provide services in network hospitals are necessarily in your plan's network. See hospital-based providers for more information.
Annual Medical Deductible: Before your plan pays for most services, you must pay a medical deductible every calendar year. The following services are covered before you meet your medical deductible:
Prescription Drug Deductible: Tier 1 prescription drugs (generic drugs) have no deductible. Tier 2 and Tier 3 prescription drugs (brand-name drugs) require that you pay an annual prescription drug deductible before UMP pays benefits.
Coinsurance: UMP Classic covers most medical services based on a percentage of the allowed amount providers agree to accept as payment in full. Coinsurance is the percentage of the allowed amount you must pay when the plan pays less than 100% of the allowed amount.
Uniform Medical Classic Coinsurance
For network providers:
15% of the allowed amount.
For non-network providers:
40% of the allowed amount, plus any amount billed by the provider that is above the allowed amount.
Copayment: "Copays" are a set dollar amount you pay when you receive specific services, treatments, or supplies, such as inpatient hospitalization, emergency room care, or a prescription filled through a network mail-order pharmacy.
Uniform Medical's consumer-directed health plan is a high-deductible, low-premium type of plan. The premiums are considerably lower and the annual deductible is considerably higher than the Classic plan. To enroll this plan, you must first open a Health Savings Account (HSA). The HSA is funded by pre-tax contributions from the UW. You have the option of contributing as well. Learn how a CDHP-HSA works.
Note: If you plan to enroll in a CDHP-HSA, you and your spouse will not be able to participate in an FSA in the same year. If you already have an FSA for a prior year, you will be required to use all funds by the end of the current year, i.e. there will be no grace period.
Compare the per-visit costs of some in-network benefits for PEBB's medical plans. Note: Some copays and coinsurance do not apply until after you've paid your annual deductible.
Disclaimer: The information on this page does not substitute for official plan documents. If there is a conflict between the information on this site and an official plan document, the official plan document will govern. Refer to the Benefits Forms & Publications page.
Plan availability and eligibility may change depending on your employment status and/or actions of the Washington State Health Care Authority (HCA), the agency that purchases and coordinates health insurance benefits for public employees, including employees of the University of Washington, through the Public Employees Benefits Board (PEBB) program.
Medical & Dental