▪ Timely, proper medical care without discrimination of any kind — regardless of health status or condition, sex, ethnicity, race, marital status, color, national origin, age, disability, or religion. As a plan member, you have the responsibility to: • Comply with requests for information by the date given. • Confirm provider and facility network status before every visit. • Contact the plan as soon as possible if you do not understand what is covered, if you have any questions, or if you need information. • Enroll in Medicare Part A and Part B if you are currently retired, or are in the process of retiring, and become eligible for Medicare. You must notify the PEBB Program when you enroll in Medicare Part A and Part B. Call 1-800-200-1004 (TRS: 711) to speak with a customer service representative for the PEBB Program. • Follow your providers’ instructions about your health care. • Give your providers complete information about your health to get the best possible care. • Keep your mailing address current by reporting changes as follows: ▪ Employees: To your payroll or benefits office. ▪ Retirees, PEBB Continuation Coverage members, and retired employees of a former employer group: To the PEBB Program. Send your address changes to: Health Care Authority PEBB Program PO Box 42684 Olympia, WA 98504 • Know how to access emergency care. • Not engage in fraud or abuse in dealing with the plan or your providers. • Participate with your providers in making decisions about your health care. • Pay your copays, coinsurance, and deductibles promptly. • Refund promptly any overpayment made to you or for you. • Report to the plan any outside sources of health care coverage or payment. • Return your completed Multiple Coverage Inquiry form you receive from the plan in a timely manner to prevent delay in claims payment. • Understand how to contact the plan for more information and help with any covered service or information described in this COC. • Understand how UMP coverage coordinates with other insurance coverage you may have, including Medicare. • Understand your plan benefits, including what is covered, preauthorization and notice requirements, and other information described in this COC. Information available to you We support the goal of giving you and your family the detailed information you need to make the best possible health care decisions. See the Directory pages at the beginning of this booklet for links and contact information): You may find the following information in this COC: 134 2024 UMP CDHP (PEBB) Certificate of Coverage