Network Network is the preferred and participating facilities, providers, and suppliers your health plan contracts with to provide health care services. Network pharmacy A network pharmacy contracts with WSRxS to provide prescription drug coverage to UMP members at the contracted rate (allowed amount). See the “Where to buy your prescription drugs” section for details about the advantages of using network pharmacies. Network provider A network provider is a preferred or participating provider. See the “Participating provider” definition and the “Preferred provider” definition for specific details. Network rate The network rate means the plan pays 85 percent of the allowed amount for preferred providers after you meet your medical deductible. Network status Network status refers to whether a provider is preferred, participating, or out-of-network with the plan. You may find out the network status of your provider by visiting the UMP Provider search or by contacting UMP Customer Service (see Directory for link and contact information). Network vaccination pharmacy A network vaccination pharmacy is a pharmacy that contracts with WSRxS to give covered immunizations to plan members at the preventive rate. You may find out which pharmacies are contracted on the UMP Prescription drug coverage webpage or by contacting WSRxS Customer Service (see Directory for link and contact information). Noncovered prescription drugs Noncovered prescription drugs refer to any drug that is only covered if the member receives an exception from the plan. Some drugs may be medically necessary, yet still are not covered. See the "Prescription drugs and products UMP does not cover" section. Noncovered services Noncovered services refers to any medical service that is not covered by the plan. Some services may be medically necessary, yet still are not covered. See the “What the plan does not cover” section. When the HTCC determines that a service is not covered, then the service is not covered by the plan. Nonduplication of benefits Nonduplication of benefits is how UMP coordinates benefits when UMP is your secondary coverage. When another plan is primary (pays first), that plan pays their normal benefit. UMP then pays up to the amount we would have paid if UMP had been the primary plan. If the primary plan pays as much or more than the normal UMP benefit, UMP pays nothing. UMP does not pay the rest of the allowed amount. See examples on page 119. 182 2024 UMP CDHP (PEBB) Certificate of Coverage