• Jim Grazko, President
    Blue Cross Blue Shield of Alaska

    Jeff Davis Retiring

    After 19 years of service to Premera Blue Cross Blue Shield of Alaska and Alaska’s insurance community, Jeff Davis has announced his retirement on June 30. Under Jeff’s leadership, the Anchorage office grew from a staff of three with ancient phones and computers that didn’t talk to each other to a savvy staff of 35 who are knowledgeable about the complexities and characteristics that make Alaska such a unique place to do business. Jeff played an integral role in shaping the brand and success of Premera Blue Cross Blue Shield of Alaska over the years and will be missed.

    Premera has never been more optimistic about our position in Alaska and the time is right for us to expand our business here. Under the new leadership of Senior Vice President Jim Grazko—who has worked with producers and employers in this market for more than 15 years—you will continue to be served by the same exceptional team, focusing on Premera’s main advantages in Alaska:

    • Cost advantage relative to other carriers that is improving over time
    • Ease of doing business with a company that understands, and works tirelessly toward fulfilling, our market’s needs
    • Top-flight products and unparalleled service
    • A robust built-in wellness program that helps companies manage costs and encourage healthy behavior among their employees

    We thank Jeff for his years of service to the Alaska market and the strong foundation he established that Premera Blue Cross Blue Shield of Alaska will build on into the future. We wish Jeff all the best.

    Alaska Wellness Academy Kickoff

    This month, we’re kicking off the newest component of Premera’s Alaska Wellness program: the Alaska Wellness Academy. The quarterly training helps employers motivate employees to practice healthy habits and love doing so.


    The Academy’s eight modules provide a deep understanding of wellness topics including:

    • The state of our health
    • Changing habits
    • Personal motivation
    • Self-efficacy
    • Self-motivation
    • Social efficacy
    • Reward science
    • Environmental efficacy

    Hands-on experience and networking with other employers concerned about wellness are additional opportunities you and your clients will enjoy.


    All groups (regardless of size or funding structure) will enjoy the benefits they'll reap from participating in the Academy and creating their own vibrant worksite wellness program:

    • Happier, healthier employees
    • Increased productivity
    • Increased employee retention
    • Fewer days lost to sick leave
    • Highest employer premium rate discounts for fully engaged groups


    Join us for the first quarterly in-person training:

    Date: Friday, June 13, 2014
    Time: 9 a.m. – Noon AKDT
    Location: Dena'ina Civic and Convention Center, Anchorage
    Topic: The state of our health
    Host: Andrew Sykes, CEO, Health at Work Wellness Actuaries
    Register now! 

    CEOs and CFOs are highly encouraged to attend. HR, benefits, wellness, engagement or occupational health positions may also attend. Producers are welcome to join their clients for this exciting opportunity. There is no participation fee.

    Next week employers will receive a reminder to register for the first Academy training.


    Questions? Email Maureen Gali, Client Manager, or call 907-677-2407.

    COBRA clients get one-time special OEP

    Limited time to enroll in an Individual metallic plan on the exchange

    Now is the time to act if you have clients enrolled on COBRA coverage who you think could be better off on an Individual metallic plan on the Alaska Federal Exchange.

    The federal government is offering a one-time special open enrollment period for people on COBRA. They have between now and July 1, 2014, to enroll on an Individual metallic plan on the exchange.

    Your clients enrolled on COBRA coverage could be paying higher premiums than they would for an Individual metallic plan on the exchange. This is especially true if they qualify for a subsidy to help cover the cost of their premium.

    If you have questions about this special open enrollment period, contact the Producer Support team at 877-205-9725, Option 3.

    Why prompt premium payment is important

    Enduring a policy cancellation is just about the last thing a group wants to go through. Please share the following information with clients who regularly make monthly premium payments after the first of the month –especially those who make a habit of paying very late – and encourage them to pay in a timely manner.

    1. Premera Blue Cross Blue Shield of Alaska is a pre-paid health plan. That is, June’s payment is due on June 1 and covers June 1 to June 30.
    2. A group that pays very close to the end of the grace period is flirting with cancellation.  By paying on the last possible day, the group has no wiggle room for illness, bad weather, or forgetfulness.
    3. While the group may not realize it, member claims are not paid until that month’s payment is received.  This means Premera’s payments to members’ providers aren’t paid on-time. 
    4. Over time, this practice may affect providers’ services that are available to members.

    Correcting the issue

    It may be a hardship for late-paying groups to get back on-track with timely payments, as they will likely have to pay the current month’s and the upcoming month’s premium payments close together. You may suggest that groups in this situation begin to wean away from late payments by paying a week earlier each month until the situation is corrected.

    Utilization Management digital magazine update

    Our Medical Services and Quality staff develops and adopts medical policies that support safe, quality medical care and treatments for our members. These policies also help reduce waste and harm of unnecessary treatments. Take a look at our new easy-to-view quarterly Utilization Management Digital Magazine.

    Highlighted in this edition:

    • UM Performance Reports
      • ESA Policy
      • Home Sleep Study Policy
    • Lumbar Spine Decompression

    Feel free to share this newsletter with your group administrators and ask your account manager if you have any questions.

    The summer issue of Premera for Your Health is almost here!

    The summer issue will be packed with information for your groups’ employees about how to avoid health problems while out enjoying the summer, plus how to get care no matter where adventures take you.

    In keeping with our first issue, the summer edition is a quick read with details where they count. It's another way to reach out and teach members about:

    • How their health plan works
    • How to save on out-of-pocket costs
    • The proactive health support their plan offers

    Dates and details

    Starting on June 19 we will be sending employer groups the summer issue of Premera For Your Health. Expect to see a link to the digital summer newsletter in the July bulletin.

    Meet our team

    Terri Good, Sales Support Manager, Alaska Managment and Sales


    Terri Good has been in the healthcare industry for 23 years. Her responsibilities include oversight of daily sales service and operations, program implementations, and liaison for other functional areas. She is LEAN certified and works to leverage LEAN capabilities into the team’s daily activities.

    After living throughout Washington State and traveling extensively while she was on active duty in the United States Navy, Terri and her husband moved to Alaska in 2003. She says the only regret they have is that they didn’t move here much sooner.

    Terri is active in veterans' organizations. She is both an Adjutant for the Department of AMVETS and a post officer, and she serves on two national committees. Additionally, she is a representative of the Veterans Administration Volunteer Services. She enjoys travel, cooking, fishing, and reading.

  • John Mychalishyn, Director, Individual Market Segment
    Premera Blue Cross Blue Shield of Alaska

    New Individual adult dental plans launch

    Preferred Adult Dental Plans use the same network available on Group plans

    Premera Blue Cross Blue Shield of Alaska is unveiling new Individual adult dental plans with a first effective date of July 1, 2014. They’re called the Preferred Adult Dental Plans, and they’re available to your clients age 19 and older enrolled on one of our Individual medical plans – including metallic plans on and off the exchange, grandfathered and extended non-grandfathered plans.

    Our Preferred Adult Dental Plans provide coverage for more than 200 dental procedures, including common preventive, diagnostic, basic, and major dental services.

    The plans offer two deductible choices of $50 and $75 for individuals and $150 and $225 for families. More plan details including rates are available in our sales brochure.

    Your clients who enroll on the plan are able to choose from a large network of dental providers in Alaska and a broad nationwide network. It’s the same network available to Premera’s Group customers.

    The first open enrollment period is June 1 – July 31, 2014. After that time, we’ll have two open enrollment periods a year. Please note: Existing Individual medical customers use this application while new Individual dental applicants use this application.

    Existing Individual members will receive either an email or a post card starting this week, if they are not already enrolled on the Dental, Vision, and Hearing Plan, which the Alaska Division of Insurance requires us to offer.

    For more information, contact Nancy Valdez at 907-677-2406 or Producer Support at 877-205-9725, Option 3.

    The dentist is coming! The dentist is coming!

    Special dental open enrollment June 1 – July 31, 2014

    Did you know Paul Revere was a dentist?1 He’d likely be amazed that, according to the American Dental Association, 100 million Americans fail to see a dentist each year.2  

    You can help change that. Now is the time to talk to your Premera clients about enrolling in the Preferred Adult Dental Plan during a special open enrollment period of June 1 – July 31, 2014, for effective dates of July 1 or August 1. The Preferred Adult Dental Plan is available to Premera Individual members age 19 or older on metallic, grandfathered and extended non-grandfathered plans. Members on existing plans use this application while new applicants use a different application.

    With Premera dental plans your clients get:

    • Choice of deductible – choose either a $50 or $75 annual deductible plan (Individual)
    • Predictability of costs – clients pay a set coinsurance amount for each of the over 200 covered services
    • Wide range of coverage – clients are covered for the most commonly used preventive, minor and major dental services
    • Choice of providers – the same dental providers available on our Group dental plans

    With the strong connection between dental health and overall wellness, this is a good opportunity to encourage your clients to consider a Premera Blue Cross Blue Shield of Alaska dental plan to round out their medical plan. Just remember, common enrollment is required.

    For more information about Premera’s dental plans, please contact your sales executive or Producer Support at 877-205-9725, Option 3.

    1 Dental Buzz
     2American Dental Association  

    New Individual accident, critical illness and life coverage available

    Premera is pleased to offer Individual accident, critical illness and life coverage through our new relationship with Washington National Insurance Company. The first effective date for coverage on these plans was June 1, 2014.

    We selected Washington National to help you provide your clients with the additional financial protection they need.


    Supplemental protection against accidental injuries with Accident Assure®. 

    Critical care 

    Critical illness coverage for cancer, heart, stroke and kidney conditions withCritical Solutions®. 


    Straightforward, assured life insurance with Life AssureSM 

    For more information

    Product webinars will be posted online as a resource for you next week.  If you want information about Washington National coverage, please contact your sales executive.

    Individual special enrollment FAQ updated

    Revision clarifies qualifying events when Group coverage is cancelled

    Producers have asked us many questions about Individual special enrollment periods during the past two months. We created a Frequently Asked Questions (FAQ) document and posted it on our producer web pages as a resource for you last March.

    Since that time, we’ve updated it twice to reflect new information we’ve learned. Some of you have asked us more questions about qualifying events. For example, is it a qualifying event for the employee and employer when the employer voluntarily cancels Group coverage?

    This latest version of the FAQ provides the answer.  (See Nos. 15 and 16 in the FAQ.)

    Contact your sales executive or Producer Support at  877-205-9725, Option 3 if you have additional questions.

    Medical Loss Ratio Rebates for Individual and Family subscribers coming soon

    Per the Affordable Care Act, which requires health plans to meet a minimum medical loss ratio (MLR) of 80% for Individual and Family policies, Premera will issue a rebate to Individual customers in 2014. In 2013, Premera members used fewer medical services than projected. This means Premera paid less than 80% Individual plan premium revenues in medical claims during the 2013 calendar year.

    Your Individual clients whose plans were effective during 2013 will receive a rebate in the form of a premium credit or rebate check. MLR calculations must be complete by May 31, 2014, and rebates

    issued no later than August 1, 2014. We are currently on schedule to finalize our calculations and issue rebates within this timeframe.

    Since producer commissions are considered administrative expenses by HHS, producers representing active and cancelled plans will have commissions proportionately reversed based on the MLR calculation. Commission checks will reflect the adjustment following your Individual client’s rebates.

    We’ll provide an update in the next monthly producer bulletin with more information.

    New summer hours for Individual Producer Support team

    Plus a big thanks to this hard-working crew

    There’s a team of dynamos working behind the scenes to help you get the information you need and fast. It’s the Individual Producer Support team, and they are here to get many of your questions addressed, so you can keep your business running smoothly.

    In the summer, call volumes are much higher earlier in the day, with few calls after 4:30 p.m. So through August, we’re going to shorten the lunch hour and close at 4:30 p.m. We’ll resume regular hours in September.

    New summer Producer Support hours
    June 2 – August 29

    Monday through Friday

    Open at 7 a.m. – 11:30 p.m. AKDT

    Close for lunch - 11:30 – Noon AKDT

    Reopen at Noon – 3:30 p.m. AKDT

    The Producer Support team covers a wide range of issues for you:

    • Client application status
    • Eligibility information
    • Web-selling assistance
    • Supply requests
    • Product questions
    • Book of business report requests
    • Navigating the website

    You can reach the team at producer.support@premera.com or at 877-205-9725, Option 3.

  • Lynn Rust Henderson, Vice President
    Alaska Group Sales and Service

    Extension of non-grandfathered Small Group plans

    Last November, based on an announcement by President Obama, Premera Blue Cross Blue Shield of Alaska allowed non-grandfathered small groups of 2 – 50 employees to extend their health plans through December 31, 2014. This gave groups an additional year to move to a new metallic plan as required by the Affordable Care Act. Now, these extended groups can choose to retain their current plans for another year, thanks to a second presidential announcement.

    In order to avoid the huge volume of groups with January renewal dates Premera is offering extended NGF plans the choice to renew either on December 1, 2014 or January 1, 2015 and their plans will run through December 31, 2015. New rates will be a part of this renewal process.

    Premera account managers will be available to meet with producers well in advance of the renewal dates to discuss plan strategies for your clients. We will be able to provide you with some information which may be used to help determine which extended groups may wish to continue with their current plan and which may prefer switching to a metallic plan.

    Please contact your account manager with any questions.

    Important RapidRateTM reminder

    RapidRate, Premera’s online rate quoting tool, is available to generate quotes for groups of 1 – 50 employees only. It cannot be used to quote groups of 51-99 employees; RapidRate quotes will not be honored for 51 – 99 groups. This means that any group with 51 or more on payroll must send a rate request into the Premera office.

    Please also note that the tool is known to run more slowly and time out if a large number of benefit designs are proposed at once.

    Remember, RapidRate is the place to go for:

    • Accurate quotes. In fact, it is now the main place to get quotes for plans offered by PBCBS of Alaska. Additionally, new group quotes will only be accepted through RapidRate.
    • Easy-to-read premiums. New metallic medical plans rates are now displayed in one Monthly Premium Total.
    • Latest ACA requirements. Our Underwriting Assumptions have been updated with the most recent ACA regulations.

    Ready. Set. Quote!

    Ready to get a quote? Login to RapidRate now.

    For information on how to use RapidRate, check out our RapidRate Tips Sheet.

    For questions, please contact Sydney Saitta, Sales Coordinator.

    Metallic Small Group discontinuation notices to be sent

    Changes to our 2015 metallic small group portfolio will trigger a discontinuation of certain plans, primarily HRA and HSA plans with employer contributions. We’ll be streamlining our offerings, going from 86 plans to 58 plans. Our new portfolio will showcased after the filings are approved.

    At the end of June, we will begin notifying affected groups whose plans are slated to be discontinued in 2015. The Department of Insurance requires that groups be contacted six months prior to their renewal date regarding a discontinuation. Groups will be directed to their account manager or producer for help choosing a similar plan. Members will be informed of the discontinuation after the groups are notified.

    For more information, please contact your Premera sales executive or account manager.

  • Lynn Rust Henderson, Vice President
    Alaska Group Sales and Service

    Check out the Express Scripts Drug Trend Report

    Annually we share the Express Scripts Drug Trend Report with our employer groups. We like to promote the newly released results, discuss some of the trends and explain what Premera is doing to stay ahead of them. The 2013 annual report was recently released and it includes a few areas where Premera is either ahead of the trend, or where we have active work underway to address these areas of opportunity. 

    Here are some quick links to the Express Scripts information:

    2013 Drug Trend Report – for the complete 90 pages of charts and analysis

    2013 Drug Trend Report Highlights – for a summary of the key findings

    Check out the message that our Account Managers will be sharing with employer groups in early June.