Surprise Balance Billing—We’re Here for You

  • General News
    Published February 17, 2020

    The message below is intended only for self-funded and OptiFlex groups. These groups must opt-in to participate. For fully insured groups, this benefit is included automatically and no opt-in is required. Does not apply to members with BlueCard or FEP.

    Premera Blue Cross recently shared with you the surprise balance billing law that took effect on January 1, 2020. The intention of this law is to protect patients from getting surprise or balance bills when they receive:

    • Emergency care at an out-of-network hospital
    • Treatment at an in-network facility but are seen by certain out-of-network providers covered under the Act

    Action required to participate can be complicated, but Premera can help!

    If you're a self-insured or OptiFlex group that wants to participate, the Washington State Office of the Insurance Commissioner (OIC) requires official notification. To make sure that notification to the OIC is submitted accurately, we suggest you let us do all the work. If you're interested, reach out to your Premera representative to get the process started.

    Important things to note:

    • The request to participate must come directly to Premera from you; unfortunately, we cannot accept requests from your producer.
    • We'll email you a digital authorization that you must send back to us that will allow us to submit your notification to the OIC.
    • The deadline for submission is 45 days prior to your plan renewal. You have only 45 days to submit your notification—don’t wait until the last second or you may leave your employees without surprise billing coverage until January 1, 2021.
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