It’s easy. Your client can apply either online or by mail.
Your clients can apply using your own personal enrollment link. Applying online allows you to track your clients current status of their application.
If you do not have a personal enrollment link please call Producer Support at 877-205-9725, Option 3.
Download and complete the following forms:
2014 Individual and Family Application: One application per family.
Use the Application for the Addition of Family Members to an Individual or Group Conversion plan.
Sign and mail the application to:
Premera Blue Cross Blue Shield of Alaska2550 Denali Street, Suite 1404Anchorage, AK 99503-2753
Premera Blue Cross Blue Shield of Alaska offers both a Dental/Vision Plan and a Dental/Vision/Hearing Plan. Benefits Highlights & Rates.
To apply, complete the Alaska Dental/Vision/Hearing Plan Application.
Premera Blue Cross Blue Shield of AlaskaPO Box 91120Seattle, WA 98111-9220
If your clients qualify for premium credit assistance, cost share reduction plans or American Indian/Alaska Native plans, they will want to enroll in a plan through AlaskaFFM.
Individuals eligible to apply for a Premera plan must be:
The open enrollment period this year is October 1, 2013 – March 31, 2014. Your client can select a new plan during this period. If they do not enroll during this period, they’ll have to wait until November 15, 2014, to change their plan or purchase coverage for January 1, 2015.
Your clients currently enrolled on a Premera non-grandfathered plan will need to choose from one of the new metallic plans before January 1, 2014. If they do not select a plan, we will automatically move them to the plan that most closely matches the one they have today. Information was mailed to your clients the week of September 16.
For 2014 health plan options
Your Sales Executive and Producer Support are available to help answer any questions you might have about these plans.
Individuals are eligible to apply for coverage outside of the annual open enrollment period only when they have a qualifying event.
Application and supporting documentation must be received within 60 days of the qualifying event.
For birth of child to policyholder or enrolled spouse, submit:
For placement for adoption or adoption of the applicant for whom coverage is sought, submit:
For a child placed in foster care, as a legal ward, or for medical support orders (for Qualified Health Plans), submit one of the following:
Application and supporting documentation must be submitted within 60 days of the qualifying event:
For loss of COBRA benefits because the COBRA coverage period has ended (usually after 18 months) or the individual has exceeded the lifetime limit in the plan, and no other COBRA coverage is available, submit:
Note: Voluntary termination of COBRA is not a qualifying event. If you terminate or stop paying for your COBRA, you must wait for the next open enrollment period to apply.
If you have recently married or entered domestic partnership, submit one of the following with both names clearly listed:
Application and supporting documentation must be submitted within 60 days of the qualifying event.
For loss of coverage due to divorce, dissolution of marriage, or termination of domestic partnership, submit:
For loss of employer-sponsored coverage, submit:
For a loss in Medicaid or other public program providing health benefits, submit:
For loss in coverage due to permanent change in residence, work, or living situation, where your prior plan does not provide coverage in your new service area, submit: