Preventive rate Covered preventive services are not subject to your medical deductible. The plan’s preventive rate depends on the provider’s status: • Preferred providers: You pay $0. The plan pays 100 percent of the allowed amount. • Participating providers: You pay $0. The plan pays 100 percent of the allowed amount. • Out-of-network providers: You pay 40 percent of the allowed amount. You pay all charges billed to you above the allowed amount (known as balance billing). The plan pays 60 percent of the allowed amount. Primary care provider (PCP) A primary care provider (PCP) is a physician (see the “Physician services” definition), nurse practitioner, or physician assistant who provides, coordinates, or helps a member access a range of health care services. See page 18 for a list of specialties that may be a primary care provider. Primary payer The primary payer is the insurance plan that processes the claim first when a member has more than one group insurance plan covering the services and the plans must coordinate benefits. Professional services Professional services are non-facility medical services performed by professional providers, including, but not limited to, medical doctors, doctors of osteopathy, naturopathic physicians, and advanced registered nurse practitioners. Provider A provider is an individual medical professional (such as a doctor or nurse), hospital, skilled nursing facility, pharmacy, program, equipment and supply vendor, or other facility, organization, or entity that provides care or bills for health care services or products. Provider network A provider network is a group of providers who negotiate a contract with Regence BlueShield to provide health care services to plan members. These providers have agreed to see members under certain rules, including billing at contracted rates (see the “Allowed amount, medical services” definition). The Regence BlueShield, including the BlueCard Program, provider network for UMP Select members in 2024 consist of preferred and participating providers. Public Employees Benefits Board (PEBB) The Public Employees Benefits Board (PEBB), is a group of representatives, appointed by the governor, who approves insurance benefit plans for employees and their dependents, and establishes eligibility criteria for participation in insurance benefit plans. Public Employees Benefits Board (PEBB) plan A Public Employees Benefits Board (PEBB) plan is one of several health benefit plans, including the Uniform Medical Plan (UMP Classic, UMP Select, UMP Consumer-Directed Health Plan, and UMP Plus plans: UMP Plus–Puget Sound High Value Network and UMP Plus–UW Medicine Accountable Care Network), offered through the PEBB Program to eligible public employees, former employees and dependents in Continuation Coverage, retirees, survivors, retired employees of a former employer group, 2024 UMP Select (PEBB) Certificate of Coverage 191