Anthem cyberattack and impact to Premera members
For ongoing updates, we encourage you and your employer clients to visit our employer website. Members can be directed to premeranews.com/anthem as a resource for their questions. Updates to these resources will occur regularly as the situation evolves.
Removing member prior authorization pentalty with contracted providers
As business renews, beginning January 1, 2015, members will no longer be financially liable if contracted providers fail to obtain a required prior authorization. This affects Individual and Small Group Metallic plans and Large Group fully-insured non-grandfathered plans.
- Contracted providers- If the provider fails to obtain prior authorization, the member is not penalized.
- Non-contracted providers- If the provider fails to obtain prior authorization, the claim is paid to the allowed amount, less 50% to a maximum of $1,500 and the provider may bill the member.
This change is designed to improve compliance with the prior authorization program and make coverage more predictible for members.
Premera now covers virtual care
Virtual care gives members immediate and convenient access to care whenever and wherever they need it (except in Idaho).
Members who are covered (as plans enroll or renew beginning January 1, 2015) receive care virtually from their own doctor or from a doctor at our national provider service, Teladoc®.
Covered members can get care via phone call, online video, or other online media at least as easily as they walk into an office and get care face to face.
To find out more about Virtual Care, contact your Premera sales representative.
New Requirements for the Federal Exchange
Producer registration is now open on the Federally Facilitated Marketplace (FFM). If you're selling Premera Individual or Small Group health plans on the FFM, you're now required to have a current producer license, pass the agent and broker course for FFM certification, and provide copies of your curriculum certificate to us. Learn what you need to do to comply in this letter to producers.