Health Insurance Changes 

WSNA and your local unit officers held a meeting with St. Joseph’s administration today. We met to discuss the changes in health insurance benefits offered by PeaceHealth through UMR now that FCN is no longer in-network. PeaceHealth continues to assert that since FCN made the decision to drop UMR, and thus they do not consider this an issue that they are obligated to bargain over.

We are engaged in gathering information on what led to the relationship between FCN and UMR to be severed, and whether there is still any possibility of FCN rejoining UMR’s coverage network. At this point we recommend that employees pursue the insurance options presented to them for 2024 with the assumption that the current status quo will not change.

Continuity of Care

There is a provision from UMR that allows for continuation of care for 90 days after they end their in-network relationship with FCN. From PeaceHealth:

The ABHP and PPO medical plans offer out-of-network benefits coverage. The benefits plan has not changed to exclude Family Care Network as an in-network provider. If they choose to leave the network Jan. 1, 2024, our medical plans have a Continuity of Care provision:

You or Your Dependents have the option of requesting extended care from Your current health care provider or facility if the provider or facility is no longer working with Your health Plan and is no longer considered In-Network.

The In-Network benefit level may continue for up to 90 days or until You no longer meet the criteria below, whichever is earlier, despite the fact that these expenses are no longer considered In-Network due to provider or facility termination from the Network. In order to be eligible, You or Your Dependents must have been, and must continue to be, under a treatment plan by a provider or facility who was a member of the participating Network. You must also be one of the following:

• An individual undergoing a course of treatment for a serious and complex condition that is either:
• An acute Illness, meaning a condition serious enough to require specialized medical care to avoid the reasonable possibility of death or permanent harm.
• A chronic Illness or condition that is life-threatening, degenerative, potentially disabling, or congenital and requires specialized medical care over a prolonged period of time.
• An individual undergoing Inpatient or institutional care.
• An individual scheduled for non-elective surgical care, including necessary postoperative care.
• An individual who is pregnant and being treated.
• An individual who is terminally ill and receiving treatment for such Illness by a provider or facility.

To obtain a Continuity of Care form that You and Your provider will need to complete for the request to be considered, call the number on the back of Your ID card or access the benefit portal. UMR’s Plan Advisor phone number is (844) 590-5963.

If you have any issues or questions about accessing Continuity of Care from UMR or FCN, please contact Kari Johnson, System Director of Benefits (kjohnson14@peacehealth.org) with your concerns.

Questions/Comments, contact one of your WSNA Officers - you can find them listed on the St. Joseph webpage at PeaceHealth St. Joseph Medical Center – Bellingham - WSNA or WSNA Nurse Representative Grace Chesterman (gchesterman@wsna.org)