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 UMP Plus–PSHVN or Regence to provide healthcare services to these members. These providers have agreed to seeing members under certain rules including billing and contracted rates. The network for UMP Plus members in 2024 consists of core and support network providers. UMP Plus members will access the Regence BlueShield, including the new BlueCard Program, provider network when traveling outside the service area. 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, and their eligible dependents. The PEB Board designs benefits and eligibility and is administered by HCA as part of a comprehensive benefits package. Public Employees Benefits Board (PEBB) Program The Public Employees Benefits Board (PEBB) Program is the HCA program that administers PEBB benefit eligibility and enrollment. Quantity limit A quantity limit is a limit on how much of a prescription drug you may get for a specific time period (days’ supply). Reconstructive surgery Reconstructive surgery is surgery and follow-up treatment needed to correct or improve a part of the body because of birth defects, accidents, injuries, or medical conditions. Regence BlueShield service area The Regence BlueShield service area means the Washington counties of Clallam, Columbia, Cowlitz, Grays Harbor, Jefferson, King, Kitsap, Klickitat, Lewis, Mason, Pacific, Pierce, San Juan, Skagit, Skamania, 2024 UMP Plus–PSHVN (PEBB) Certificate of Coverage 187