• Jim Grazko
    President, Blue Cross Blue Shield of Alaska

    The summer issue of Premera For Your Health is here!

    Premera For Your Health includes timely articles, such as how to receive care while traveling and summer cost-savings available through Premera member discounts. We designed these newsletters to engage consumers, so they get the most out of their coverage.

    Group summer edition

    Employers are receiving the new summer edition of the group member newsletter now. We recently sent this email to employers who have an email on file with us. We provided them with an Outlook template so that they can easily share the newsletter with their employees. 

    Individual summer edition

    Your clients enrolled in Individual plans are also receiving the new summer edition of the member newsletter now. We sent digital copies recently to our members who have an email on file with us. We’ll send print copies to members who do not have an email on record with us later this month.

    If you have questions about his publication, contact your Premera Account Manager or Individual Producer Support at 877-205-9725, Option 3.

    New member dashboard and mobile app

    Check out the new member dashboard on the website

    Snazzy new layout makes it easier to find and use website tools, such as:

    • Order prescriptions
    • Connect with preventive services such as health risk assessments, weight and activity tracking, and care guides for common conditions
    • Use the secure inbox (to communicate private information)
    • Use the online EOB
    • New tools help members:
    • Track dental as well as medical deductibles
    • Estimate treatment costs
    • Make payments (members on individual plans only)

    The mobile app has some new tricks and improved experience

    Use new features for the mobile app to:

    • Track where you stand on your deductible
    • Check coverage for a referral instantly
    • Check the status of claims
    • The improved design makes it even handier to:
    • Find a doctor or hospital
    • Email your proof of coverage to the doctor
    • Connect with the 24-Hour NurseLine
    • Discover and use Extra! discounts

    You can find out about the many mobile apps available to Premera members by visiting premera.com. Please recommend these improved electronic tools to your clients so they can start enjoying the upgraded member experience today.

    Meet our team

    Jason Mahoney, Account Specialist


    Jason joined Premera Blue Cross in 2008. Prior to his current role as an Account Specialist, he was an Account Service Representative in the Washington Large Group market. His current responsibilities include daily account management and maintenance for large self-funded clients. He is also a liaison for other functional areas and assists with escalated service issues.

    Jason was born and raised in Washington State and has enjoyed traveling throughout Alaska over the last few years, experiencing everything the state has to offer. He enjoys traveling, reading and spending time with family and friends.

    Before joining Premera, Jason attended the University of Washington where he received a BS degree in Psychology.

  • John Mychalishyn
    Director, Individual Market Segment

    Premera + Washington National

    Offering your clients more choices in financial protection

    Imagine a runner, or a hiker. Pretty common sports in our active part of the world right? What’s also easy to envision are potential falls resulting from these activities. In fact, falls are the number one cause of accidental injuries in the U.S.1 Can you picture a client getting a cancer diagnosis? It’s not something anyone wants to think about, but beyond the realities of treating the illness, even with a health plan in hand, nearly 61% of all cancer costs will be nonmedical.2

    These are just two examples of why we recently entered a relationship with highly regarded Washington National Insurance Company. It was so we could offer our members additional financial protection when they need it most through supplemental health and life insurance products.

    Since 1911, Washington National has helped Americans protect themselves and their families from the financial hardship that often comes with critical illness, accidents or loss of life. Washington National insures nearly 1 million policyholders and 25,000 employer groups offering important benefits at a competitive price. You and your clients can count on Washington National for dependable, high-quality service and support.

    Specific product information

    Accident, critical care and life insurance are the three offerings you will see through us from Washington National. There is no specific open enrollment period for these products so anytime is a good time to discuss them with your clients.

    • Washington National Accident Assure® – supplemental protection against accidental injuries
    • Washington National Critical Solutions® – critical illness coverage that’s simple to understand and use
    • Washington National Life AssureSM – straightforward, assured life insurance that keeps pace with your clients’ lives

    More detailed information is available on premera.com.

    Washington National is an independent provider of accident, critical care and life insurance products that does not provide Blue Cross Blue Shield products or services. Washington National is solely responsible for its products and services. Premera Blue Cross is an independent licensee of the Blue Cross Blue Shield Association.

    Get appointed today

    It’s important to get appointed today so we can send you e-leads that come directly to us for these products. You can request a producer appointment using Washington National’s ezAppoint:

    1. Open a browser and paste in “washingtonnational.com/ezappoint”.
    2. Click “instruction manual”, which walks you through the appointment process.
    3. Create a Premera logon and password.
    4. Enter a package code. If you are:
      1. An agency principal (paid agent) enter “CFX5301”
      2. An affiliated producer within your agency (licensed-only agent) enter “CFX5302”
      3. An independently contracted producer enter “CFX5301”

    We’re here to help

    If you have further questions about our relationship with Washington National or these products contact Nancy Valdez at 907-677-2406 or Producer Support at 877-205-9725, Option 3.

    1 National Safety Council, Injury Facts, 2010 Edition
    2 American Cancer Society, Cancer Facts & Figures 2010, p1

    One month left for Individual dental open enrollment!

    Summertime is dental time for your Individual clients. That's because our dental open enrollment period continues until the end of July. Your clients can enroll in one of the new Premera Preferred Adult Dental Plans through July 31, 2014!

    The new Individual dental products are available to your clients age 19 years and older, who are enrolled on one of our Individual medical plans - including metallic plans on and off the exchange, grandfathered and extended non-grandfathered plans. Enrollment is easy! Existing consumers enrolled on a Premera medical plan use this application.

    Your clients will have coverage for more than 200 dental procedures with our Preferred Adult Dental Plans, including common preventive, diagnostic, basic and major dental services. The plans also offer two deductible choices:

    • $50 for individuals; $150 for families
    • $75 for individuals; $225 for families

    For details and rates on the dental plans, view our sales brochure.

    To view more information about the new Individual Preferred Adult Dental Plans, as well as information on Washington National, check out a recording of our recent webinar.

    If you have questions about our Preferred Adult Dental Plans, contact Nancy Valdez at 907-677-2406 or Producer Support at 877-205-9725, Option 3.

    New reinstatement policy

    With the launch of the new Individual metallic plans, some of you have asked us if Premera Blue Cross Blue Shield of Alaska will allow reinstatements, if your clients’ plans are terminated due to late payment. Here’s how we’re approaching requests for reinstatement for plans purchased directly from Premera

    For Individual metallic plans direct from Premera

    If your client’s Individual metallic plan is cancelled due to non-payment of premium, reinstatement is not available. In this situation, your client’s next opportunity to enroll in an Individual metallic plan is the upcoming open enrollment period, which will be November 15, 2014 – February 15, 2015.

    For Individual non-metallic plans

    Your clients enrolled on Individual non-metallic plans have continued access to reinstatement once every 12 months if their plan is terminated for lack of payment. These are the Individual grandfathered plans and the Individual non-grandfathered plans that were extended.

    If your client with an Individual non-metallic plan receives a notification from us saying their plan has been terminated they must pay the full amount due by the stated date in the letter. They will be granted only one reinstatement every 12 months.

    On the exchange

    Your clients who obtain a policy on the exchange and not direct from us will need to contact the exchange to see if reinstatement is possible.

    For more information

    Should you need to request an exception on behalf of your client please email it to producer.support@premera.com. If you have further questions, please contact Producer Support at 877-205-9725, Option 3.

    Medical Loss Ratio rebates to Individual members

    Last month, Premera announced it would issue rebates to Individual customers as a result of the Affordable Care Act, which requires health plans to meet a minimum medical loss ratio (MLR) of 80% for Individual and Family policies. Premera began releasing MLR rebates last week. All rebates are pro-rated for the number of months the individual was active during the 2013 calendar year, and are issued as follows:

    • Active Individual members whose plan was effective during 2013 will receive a premium credit on their August invoice.
    • Refund checks are mailed no later than August 1, 2014 to Individual members whose coverage cancelled in 2013.

    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 after rebates are issued to your Individual clients as follows:

    • In the July statement as a single-line manual adjustment, followed up with a detailed explanation mailed separately.

    In addition, Individual customers will receive a notice of the rebate that includes information regarding resources for information on this topic. You can also find additional information regarding MLR regulations here.

    Questions? Please contact the Individual Producer Support team at producer.support@premera.com or at 877-205-9725, Option 3.

  • Lynn Rust Henderson
    Vice President of Sales

    Extended groups – it’s never too early to think about renewing!

    At the height of summer—when you’re enjoying long days and warmer weather, when school is out and everyone seems to be outside, too—you’re probably not thinking about clients whose plans renew in the middle of winter. But there’s no time like the present to talk to your extended groups about their 2015 renewals.

    We are now offering extended groups with a January 2015 renewal date the chance to renew in December 2014 instead. By moving their renewal date out of the busiest month, they’ll receive their renewal sooner. And when your clients choose this option, it means you’ll be done with the work before the holidays are in full swing.

    Please let your account manager know if you have groups who are ready to make the move.

    Act now to help members take healthy steps

    We’re committed to starting members on a journey to wellness that leads to better health – and real rewards!

    When members of metallic Small Group plans complete their wellness activities within 90 days of their plan effective date or plan renewal date, they receive a $150 gift card. And for each employee that completes the wellness steps within this timeframe, the group wins, too – they save 7.5% on their premium back to their effective date for the plan year!

    The wellness program is built into every Premera small group metallic health plan. Please contact your AK Wellness or your Premera account manager for more information on how the wellness program benefits your small group clients.

  • Lynn Rust Henderson
    Vice President of Sales

    Final Mental Health Parity Rules – Effective July 1

    With so much attention focused on the Affordable Care Act, it’s easy to lose sight of other important changes, including final regulations issued under the Mental Health Parity and Addiction Equity Act of 2008. We’ve had interim rules in place since 2010, and now final rules provide guidance and rules on how parity requirements relate to the ACA, and other issues that were not addressed in the interim rule.

    These new rules go in to effect for Large Groups (fully insured and self-funded) with 51 or more employees that are new or renewing on and after July 1, 2014. Medical necessity criteria must still be met when applicable:

    • Contract exclusion for residential treatment and quantitative (e.g., number of hours) limits on neurodevelopmental testing no longer apply
    • Detoxification now covered in any medically necessary setting when coverage requirements are met
    • Physical, occupational and speech therapies for mental conditions, including autism, are now covered under the mental health care benefit (not under the rehabilitation, neurodevelopmental, or habilitative care benefits), and automatic visit limits no longer apply.

    Your group’s contract will be updated when issued in 2015, and Premera will issue a contract endorsement upon renewal in 2014.

    If you have any question, please contact your sales team.