Contact UMP and WSRxS If you or your dependents have other insurance, you must let UMP and WSRxS know so claims are processed correctly. To do this, you must complete and submit a separate form for medical services and prescription drugs. Each person claiming payment for benefits under the plan is required to give Regence and WSRxS any facts needed to apply these COB rules. If your coverage under other plans changes, you must let UMP and WSRxS know so claims are processed correctly. See the Directory pages at the beginning of this booklet for contact information and ways to get and submit COB forms. Who pays first Note: If you cannot determine which plan pays first, contact UMP Customer Service. Alert: Medicare will be the primary payer for covered benefits provided to Medicare-eligible members who are enrolled in UMP as a dependent of a currently employed state-registered domestic partner. Medicare will remain the secondary payer for benefits payable under UMP for (1) individuals age 65 or over who have UMP as a result of their own current employee status, or (2) individuals age 65 or over who have UMP as a result of the current employment status of a spouse of any age. When UMP coordinates benefits with other plans, the following rules determine which plan pays first. These rules apply in order, so the first rule below that applies to your situation will determine which plan is your primary coverage, and subsequent rules will not apply. The following plan pays first: • Any group plan that does not coordinate benefits. • The plan that covers the member as a subscriber, not a dependent. Exception: When the subscriber is a Medicare beneficiary, the plan covering the person as the retiree is secondary to the plan covering the person as a dependent. • The plan that covers the member (or their spouse or state-registered domestic partner) as an active employee pays before a plan that covers the member as a retired employee. • A plan covering the member as an employee, subscriber, retiree, or the dependent of such an employee, subscriber, or retiree will pay before a COBRA or a state right of continuation plan. • If the other plan is Medicare, UMP pays first if the member is age 65 or over who have UMP as a result of their own active employee status or the active employee status of a spouse of any age. Note: Medicare benefits are primary to UMP for members who are enrolled in UMP as a dependent of a currently employed state-registered domestic partner. • The plan that has covered the member (or their spouse or state-registered domestic partner) as a subscriber the longest, if there are two plans and the first five bullets do not determine which plan pays first. • If none of the preceding rules determines the order of benefits, the allowable expenses must be shared equally between the plans. 2024 UMP CDHP (PEBB) Certificate of Coverage 117