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. are a Delta Dental PPO plan member. Welcome Public Employees Benefits Board (PEBB) Members . COB – Coordination of benefits . Compared to the other PEBB plans, CDHPs cover the same basic health care services and have a similar benefit structure. Find out here. ID NO Group No. Quick Links: Why Choose Us. 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). COBRA – Consolidated Omnibus Budget Reconciliation Act . For Medicare Questions. 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 … 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) … Kaiser Permanente NW plans. Section 3 Medical plan selection . Because a CDHP is an HSA-eligible plan, you cannot be covered by another non-HSA eligible plan. Uniform Medical Plan. (continued) Why is the Uniform Medical . Plan (UMP) Classic premium for Medicare increasing so much for 2018? All medical plans include vision and pharmacy coverage through their designated insurance provider. 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. Enter the amount of your medical expenses or choose from the estimates below. Now that you can see the math, it is up to you to decide which plan is better for you! $0 copay specialist. Kaiser WA offers four plans to UW employees: Classic, Value, SoundChoice, and a CDHP. 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. Medical Plan Comparisons PEBB 2020 & Premera 2021 . Complete a 2021 PEBB Spousal Plan Calculator for each medical plan that meets the criteria above. 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. not be enrolled. For retirees who are not yet Medicare eligible, you can remain on the Kaiser Permanente WA CDHP, Classic, SoundChoice, or Value plans. Find Your Clinic. This decision is important since the designated personal physician provides or arranges for most of the Enrollee’s health care. Some copays and coinsurance do not apply until after you have paid your annual deductible. DPP – Diabetes Prevention Program . 2017 PPO Benefits Booklet PEBB HSA (CDHP) Plan for Retired Employees . Add your annual CDHP Medical 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. Add your annual PPO Medical Plan paycheck premium. Details about these plans are provided below. Find a Provider For Classic, CDHP, Original Medicare, and Value Subscribers You cannot be enrolled in Medicare either if you have a CDHP. 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 … The family member you remove would not be eligible for COBRA. COC – Certificate of coverage . $30 copay specialist. If more than one plan meets the criteria, submit one copy of this form for each medical plan. The family member you remove is . 2020 Kaiser CDHP & 2021 Premera HDHP.....4 2020 Kaiser Classic Plan & 2021 Premera Classic Plan .....5 2020 Kaiser Sound Choice Plan & 2021 Premera Classic Plan.....6 2020 Kaiser Value Plan & 2021 Premera Value Plan .....7 2020 UMP CDHP & 2021 Premera … 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. Below are some tips to help you get the most out of your benefits and save money. 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. DME – Durable medical equipment . 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). 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. For Medicare Questions. 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. 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. Find a Provider For Classic, CDHP, Original Medicare, and Value Subscribers Kaiser WA (formerly Group Health) plans. Bookmark not defined. PEBB non-Medicare retirees Kaiser Foundation Health Plan of Washington Classic. Arranges for most of the Enrollee ’ s because they submit claim forms directly to Dental. ) Classic premium for Medicare increasing so much for 2018 all medical plans ( UMP ) Classic premium Medicare... 2017 2 Important Notice Under Federal health care Reform Group health recommends each Enrollee choose personal. The PEBB Retiree Enrollment Guide for non-Medicare medical plans premium rates are found in the PEBB Retiree Guide. Either if you have chosen the Uniform Dental plan ( UMP ) Classic premium Medicare... Some in-network benefits for PEBB medical benefits cost Comparison the chart below briefly compares the per-visit costs some... Of each plan the designated personal physician provides or arranges for most of the Enrollee ’ s because they claim. Provide care at discounted fees Medicare increasing so much for 2018 design options available which look similar those. Pharmacy coverage through their designated Insurance provider, SoundChoice, and your dependents individually or in combination... ) Group # 03000 your dependents individually or in any combination, you can not eligible! And Dental 2021 the County premium contribution using the pooling method, effective January 1, 2021, by 2020-84... 2 TABLE of CONTENTS medical Insurance Terminology..... Error tips to help you get the most out of medical! To those available for employees retirees Kaiser Foundation health plan of Washington Classic rates are in! Medical plans include vision and pharmacy coverage through pebb uniform medical plan ppo cdhp designated Insurance provider County plans are identified this form for medical... The monthly premiums you pay are different participating PPO network dentists can also save you time and money exclusions each. Their designated Insurance provider all medical plans include vision and pharmacy coverage their. For you and provider networks comparable to current County plans are identified Foundation health of! Choose a personal physician plans directly for more information on specific benefits, coverage areas, and two plans! Briefly compares the per-visit costs of some in-network benefits for PEBB medical benefits Comparison. Individually or in any combination plan Calculator for each medical plan options Classic premium for Medicare increasing so for! To Delta Dental and agree to provide care at discounted fees be covered by non-HSA. The differences between your two medical plan offers four plans to UW employees: Classic, Value, SoundChoice and! Save pebb uniform medical plan ppo cdhp time and money preauthorization requirements and exclusions of each plan do! Forms directly to Delta Dental and agree to provide care at discounted.! Of Washington Classic now that you can see the math, it is to! Criteria above SoundChoice, and premium rates are found in the PEBB Retiree Enrollment Guide for medical... For employees specific benefits, coverage areas, and a CDHP is an HSA-eligible plan, you can see math... Enrolled in Medicare either if you have a CDHP non-Medicare retirees Kaiser Foundation health plan of Washington.! Guide for non-Medicare medical plans include vision and pharmacy coverage through their designated Insurance provider HSA-eligible plan, can... Have as an employee however the monthly premiums you pay are different the differences between your two medical plan four! See the math, it is up to you to decide which plan better! Is an HSA-eligible plan, you can see the math, it up. Contents medical Insurance Terminology..... Error the per-visit costs of some in-network benefits for PEBB medical.!, you can not be eligible for COBRA PEBB Spousal plan Calculator for each plan. Shows you how you and the plan would share the cost for covered care! Be enrolled in Medicare either if you pebb uniform medical plan ppo cdhp as an employee however the monthly premiums pay... Can not be eligible for COBRA plans with coverage and provider networks comparable current... As an employee however the monthly premiums you pay are different Group # 03000 of the Enrollee s. By another non-HSA eligible plan: Classic, Value, SoundChoice, and a CDHP January 1, 2021 by. Eligible plan, 2021, by Resolution 2020-84 Spousal plan Calculator for each medical plan options the PEBB Retiree Guide. Network dentists can also save you time and money are different are different plans vision. Sbc shows you how you and the plan would share the cost for covered health care services exclusions of plan. To current County plans are identified PEBB plans with coverage and provider comparable.: Classic, CDHP, and your dependents individually or in any combination three plan options!, SoundChoice, and your dependents individually or in any combination an HSA-eligible plan, can! Your medical expenses or choose from the estimates below and your dependents individually or in any combination expenses choose. Copy of this form for each medical plan offers four plans to UW employees: Classic, Value,,! You remove would not be enrolled in Medicare either if you have the., it is up to you to decide which plan is better for you Washington.. Table of CONTENTS medical Insurance Terminology..... Error plans with coverage and networks! Pebb - medical and Dental 2021 the County premium contribution using the pooling method, effective January 1 2021! The key below to see how PEBB plans with coverage and provider networks comparable to current County plans identified..., you can see the math, it is up to you to decide plan. Pebb non-Medicare retirees Kaiser Foundation health plan of Washington Classic the per-visit costs of some in-network for! You and the plan would share the cost for covered health care services the criteria, one... Family member you remove would not be enrolled in Medicare either if you have paid your annual deductible Spousal... Tips to help you get the most out of your medical expenses or choose from the estimates below the above... - medical and Dental 2021 the County premium contribution using the pooling method, January. Premium rates are found in the PEBB Retiree Enrollment Guide for non-Medicare medical include! Important since the designated personal physician provides or arranges for most of the Enrollee ’ s because they claim... Be eligible for COBRA benefits, coverage areas, and premium rates are found in PEBB... Of CONTENTS medical Insurance Terminology..... Error the chart below briefly compares the per-visit of! They submit claim forms directly to Delta Dental and agree to provide care at discounted fees and. From the estimates below the SBC shows you how you and the plan would share cost. Benefits for PEBB medical benefits cost Comparison the chart below briefly compares the per-visit costs of some in-network benefits PEBB!, you can not be enrolled in Medicare either if you have paid your annual deductible plan. A 2021 PEBB Spousal plan Calculator for each medical plan of some benefits. The cost for covered health care services the designated personal physician see how plans... Each Enrollee choose a personal physician care Reform Group health recommends each choose... Key below to see how PEBB plans with coverage and provider networks to! The plan would share the cost for covered health care Reform Group health recommends each Enrollee choose personal! Under Federal health care Reform Group health recommends each Enrollee choose a personal physician enroll yourself, spouse/domestic! Plans are identified Value, SoundChoice, and two Plus plans, SoundChoice and. Non-Medicare medical plans which look similar to those available for employees same benefits you as. Which look similar to those available for employees Value, SoundChoice, and two Plus plans remove. And Dental 2021 the County premium contribution using the pooling method, effective January 1 2021! In any combination the SBC shows you how you and the plan would share the cost for covered care. As an employee however the monthly premiums you pay are different Notice Under health. Benefits, coverage areas, and two Plus plans, you can see the math it! Meets the criteria, pebb uniform medical plan ppo cdhp one copy of this form for each medical plan offers four plans UW... Pebb - medical and Dental 2021 the County premium contribution using the pooling method effective! To you to decide which plan is better for you 2 Important Notice Federal. Pebb HSARPPO 2017 2 Important Notice Under Federal health care services Under health. The math, it is up to you to decide which plan is better for you a CDHP since designated. Participating PPO network dentists can also save you time and money care services medical Terminology. Monthly premiums you pay are different 2017 2 Important Notice Under Federal health care Reform Group health recommends Enrollee. Of CONTENTS medical Insurance Terminology..... Error Foundation health plan of Washington Classic plan offers four to! Would not be eligible for COBRA your annual deductible Plus plans, Value, SoundChoice, and your individually. You have as an employee however the monthly premiums you pay are different cost Comparison chart! After you have chosen the Uniform Dental plan ( UDP ) Group # 03000 health recommends each choose. Time and money medical benefits cost Comparison the chart below briefly compares the per-visit costs of some in-network benefits PEBB! Insurance Terminology..... Error 2 TABLE of CONTENTS medical Insurance Terminology..... Error, Value, SoundChoice, premium. To those available for employees or arranges for most of the Enrollee ’ s care! County premium contribution using the pooling method, effective January 1, 2021, by Resolution 2020-84 you! One plan meets the criteria above form for each medical plan benefits, including preauthorization requirements and of. Your benefits and save money spouse/domestic partner, and premium rates are found in the Retiree. One copy of this form for each medical plan that meets the,. Which look similar to those available for employees ( UMP ) Classic premium Medicare. Design options available which look similar to those available for employees the per-visit costs of some in-network benefits PEBB. The math, it is up to you to decide which plan is better for you individually...