Providence, Swedish, and Pacific Medical Centers possible departure from the UMP network
Recently, Regence BlueShield (the administrator for UMP) mailed a legally required notice to approximately 57,000 PEBB and SEBB members about an upcoming potential provider network disruption. The mailing states that Providence, Swedish, and Pacific Medical Centers (PacMed) may no longer be in the UMP network in King, Pierce, Snohomish, Spokane, and Thurston counties starting April 1, 2025.
HCA understands that all parties continue to negotiate in hopes of reaching an agreement before the current contract expires. If a new network agreement is reached, UMP members will receive another letter from Regence informing them of this result. HCA will update this announcement as negotiations continue.
What do I need to do if I received the notice?
- You do not need to take any action right now.
- Any care and services you have scheduled through March 31, 2025 will still be covered at the in-network rate.
- Check back on this page for updates, keeping in mind that most of the time a new network agreement is ultimately reached without any provider network disruption occurring.
Related article: Get the inside scoop on how provider network negotiations work.
What will happen if an agreement is not reached?
On or after April 1, 2025, members receiving services from Providence, Swedish, and PacMed in the affected counties will pay the out-of-network rate, which is 40 percent of the allowed amount after deductible (50 percent for UMP Plus members). However, emergency care received at any hospital emergency room would still be covered at the in-network rate.
Members currently receiving services from Providence, Swedish, and PacMed for certain conditions may have the right to continue treatment at the network rate for a limited time under a continuity of care provision.
Eligible conditions for continuity of care include:
- Seeing the provider for a serious or complex condition, including certain chronic conditions
- Undergoing a course of institutional or inpatient care from the provider
- Being scheduled for a nonelective surgery from the provider
- Being pregnant and seeing the provider for pregnancy-related care
- Being determined to be terminally ill
Members may check their plan’s certificate of coverage (COC) for more information or call UMP Customer Service at one of the numbers below.
Who can I contact with questions?
- Public Employees Benefits Board (PEBB) members should call UMP Customer Service at 1-888-849-3681 (TRS: 711) or visit the UMP PEBB website.
- School Employees Benefits Board (SEBB) members should call UMP Customer Service at 1-800-628-3481 (TRS: 711) or visit the UMP SEBB website.