133. Workers’ compensation: When a claim for workers’ compensation is accepted, all services related to that injury or illness are not covered, even if some services are denied by workers’ compensation 134. Transcranial Magnetic Stimulation (TMS) for treatment of: ◦ Obsessive-compulsive disorder (OCD) ◦ Generalized anxiety disorder (GAD) ◦ Posttraumatic stress disorder (PTSD) ◦ Smoking cessation ◦ Substance use disorder (SUD) If you have questions about whether a certain service or supply is covered, contact UMP Customer Service. If you have other medical coverage Coordination of benefits Coordination of benefits (COB) happens when you have health coverage through two or more groups (such as your employer and your spouse’s employer), and these two group health plans both pay a portion of your health care claims. The rules beginning under the “Who pays first” section determine which plan pays first (primary payer) and which pays second (secondary payer). See page 119 for a description of how the plan coordinates benefits when it pays second. The plan processes claims differently depending on if it is the primary payer or the secondary payer. The differences are described in the next several pages. TIP: If you have other health coverage, it is important that you let your providers know, including the pharmacies where you get your prescription drugs. 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. 2024 UMP Plus–PSHVN (PEBB) Certificate of Coverage 117