Small Business Plans (1-50 Employees)

Choice plans paired with our broadest selection of in-network providers under the Heritage network. HSA-qualified plans offer tax savings for both employers and employees.

Balance plans paired with Heritage Signature, a slightly smaller network than Heritage, but providing added cost savings for employers.

A health plan for Pierce, Spokane*, and Thurston* Counties.

Our Peak Care plans offer lower costs for your bottom line and an innovative healthcare experience for your employees. See how Peak Care will benefit your business at peakcare.com/employer or download the Peak Care overview brochure.

Beginning 2020, the Tahoma network includes MultiCare Connected Care Clinically Integrated Network, Physicians of Southwest Washington, Capital Medical Center, and Vivacity Care Clinics. The network also includes contracted healthcare facilities, chiropractors, acupuncturists, naturopaths, and massage therapists. With over 4,100 providers, the breadth of providers available in the Tahoma network ensures access to a full range of services to meet the needs of your employee population in the Pierce, Thurston, and Spokane County areas.

^{*Available January 1, 2020.}

Medical plans with family dental benefits built right in – and the opportunity for employees to choose their desired network. By bundling pediatric and adult dental benefits with medical coverage, employees get well-rounded health coverage for their whole family and access to our large provider network. All the while, employers get a one-stop-shopping experience for managing your benefits.

Learn more about the benefits of offering competitive dental and health plans.

We also offer 2 separate dental plans. Employers can pair these to provide adult dental coverage with any medical plan you choose. With Adult Dental Optima, employers can offer their employees comprehensive coverage and flexibility to choose their dentist. Specifically for employers with 5 employees or more, Adult Dental Optima Voluntary provides dental coverage at little or no cost.

Add a vision plan for adults to offer a complete benefits package. Pediatric vision benefits are included in each health plan.

• 2020 Vision
• Adult Vision Plan

• 2019 Vision
• Adult Vision Plan

Premera's small group medical plans include convenient options for employees to access care or their health plan information online, with our mobile app, or by phone.

24-Hour NurseLine

Members get free, confidential health advice from a registered nurse by phone any time, day or night, with our 24-Hour NurseLine.

Virtual care

Every medical plan comes with virtual care options. Video or phone consultations with a Teladoc® physician are available any time for a low copay.

The Premera mobile app

Our redesigned mobile app enables employees to find their health plan information, or search for a doctor at any time.

Premera's qualified, high-deductible health plans with a health savings account (HSA) offer your employees great basic coverage and a chance to save money and invest it for future IRS-approved medical expenses. HSA-qualified health plans allow employers to reduce their taxable income and receive lower monthly rates due to the higher annual plan deductibles.

HSA plans help employees save in 3 major ways

• Contributions are 100% tax deductible
• Tax-free withdrawals for eligible healthcare expenses
• Tax-free growth from interest earned and any earnings from investments

Learn more about HSA accounts.

We care about your employees' health, nutrition, and fitness. That's why Premera Blue Cross offers members special perks at no extra costs.

Find a variety of discounts on products and services, including:

• Diet, nutrition, and supplements
• Fitness clubs and gyms
• Eye care services and hardware
• Hearing aids and screenings
• Newborn services and products

Learn more about our range of member discounts

Note: Offers might not be available in all locations. Please have your employees check with the company offering the discount before making their purchase.

We believe in working closely with doctors and hospitals to deliver for the customer together. That’s why our provider networks are more than just a collection of contracts—they give members access to quality care, good experiences, and services at a fair price. 

For decades, Premera has maintained the largest network of doctors and medical facilities in Washington*. As a result, we offer greater network stability and deep discounts for covered in-network services.

For employers with up to 50 employees, we offer a choice of networks so you can select the level of provider access and cost that works best for your employees and business needs.

Heritage Network

Our broadest provider network offers access to 100% of Washington hospitals and 99% of primary care doctors - more than 38,400 providers, clinics, and hospitals across Washington state.

Heritage Signature

This tailored provider network offers access to more than 37,000 doctors, clinics, and hospitals across Washington state that commit to quality care, managed costs, and a focus on the customer. 

Check out the Heritage Signature flyer to see the key benefits of this network and a partial list of current providers.

The power of choice

Whether your employees want access to the most providers in Washington state, or the highest savings, give them the ability to choose their network by offering both Heritage and Heritage Signature networks.

Get help deciding which network is right for business, or if a dual offering is the way to go with the Heritage or Heritage Signature flyer.

National and worldwide network coverage with BlueCard™

With any Premera health plan, you have access to the BlueCard Program, which provides access to networks of contracted preferred and participating Blue Cross Blue Shield providers across the country. Just like here at home, these networks provide valuable discounts on billed charges and the added advantage of direct billing.

The BlueCard Program includes the added benefit of worldwide coverage with Blue Cross Blue Shield Global Core. This program provides members access to an international network of participating doctors and hospitals for a broad range of medical care services so they can feel safe wherever they go.

Healthier employees are happier and more productive employees. That's why we include a Premera Wellness Program with every fully insured health plan for small businesses–at no additional cost to you.

Take a look at what the Premera Wellness Program offers:

• Health plans with a start date in 2020
• Health plans with a start date in 2019

Guides

• 2018 Medical and Dental Benefits Guide
• 2018 Dual Choice Matrix

Medical benefit highlights

• Choice PPO
• Choice 750 Gold
• Choice 1000 Gold
• Choice 1500 Gold
• Choice 2500 Silver
• Choice 5500 Bronze

• Choice HSA Qualified
• Choice HSA Qualified 1500 Gold
• Choice HSA Qualified 3000 Silver
• Choice HSA Qualified 6000 Bronze

• Balance PPO
• Balance 500 Gold
• Balance 1000 Gold
• Balance 1500 Gold
• Balance 2000 Silver
• Balance 3000 Silver

• Balance HSA Qualified
• Balance HSA Qualified 1500 Gold
• Balance HSA Qualified 3000 Silver
• Balance HSA Qualified 6000 Bronze

Dental benefit highlights

• Balance Medical + Family Dental
• Balance 500 Gold + Family Dental
• Balance 1000 Gold + Family Dental
• Balance 2000 Silver + Family Dental

• Choice Medical + Family Dental
• Choice 750 Gold + Family Dental
• Choice 1000 Gold + Family Dental
• Choice 2500 Silver + Family Dental
• Choice HSA Qualified 3000 Silver + Family Dental

• Adult Dental Optima
• Adult Dental Optima 1000
• Adult Dental Optima 1500
• Adult Dental Optima 2000

• Adult Dental Optima Enhanced
• Adult Dental Optima 1000 Enhanced
• Adult Dental Optima 1500 Enhanced
• Adult Dental Optima 2000 Enhanced
• Adult Dental Optima 1500 Enhanced+

• Adult Dental Optima Voluntary
• Adult Dental Optima Voluntary 1000

Vision benefit highlights

• Adult Vision Plan

Small group creditable coverage status report

2020 small group creditable coverage status report

2019-2020 small group creditable coverage status report: If your plan year straddles 2019 and 2020, reference this report. It shows 2019 small group creditable coverage tested against 2020 Medicare Part D threshold amounts.

The CMS website offers general information about Medicare Part D.

Important reminder

Premera no longer sends creditable coverage status notices to members on behalf of groups with pharmacy plans.

Employers will need to provide the notifications as required by the Medicare Modernization Act (MMA) to their Medicare-eligible employees and dependents. This act requires employers to let their Medicare-eligible employees and dependents know whether the prescription drug coverage pays on average as much as the standard Medicare prescription drug coverage.

Additional information is found at the following pages of the Centers for Medicare & Medicaid Services:

• Creditable coverage
• Model notice letters

Submission of CMS Medicare Part D Disclosure Form

Federal law requires employer groups to notify the Centers for Medicare and Medicaid Services (CMS) if their prescription drug coverage for Medicare beneficiaries is creditable. CMS requires employer groups to submit a creditable coverage disclosure form each year or upon any change that could affect whether the drug coverage offered is creditable.

Medicare secondary payer (MSP) laws are complex and can be confusing even to a seasoned healthcare administrator. Employers offering group health plans must comply with the MSP statute and regulations (the MSP laws). These laws establish Medicare as the secondary payer to group health plan coverage in certain instances of dual healthcare coverage. 

This information is purely informational, does not modify your policy or coverage in any way, and should not be construed as legal advice or opinion. Additional information is available on the Centers for Medicare & Medicaid Services (CMS) website.

You can use the MSP change form to report group size and Medicare beneficiary changes to Premera that may impact MSP rules.

Group enrollment (up to 50 employees)

• 2020 group master application up to 50
• 2020 group master application benefit selections up to 50
• 2020 group master application dental benefit selections up to 50
  
  
• 2019 group master application up to 50
• 2019 group master application benefit selections up to 50

Additional group enrollment forms

• New group enrollment checklist
• Renewal group enrollment checklist
• Group size attestation
• Late enrollment acknowledgement
• Quick reference guide for plan administrators
• Key employee verification

Member enrollment and other forms

• Member enrollment and change application
• Member enrollment and change application (Spanish version)
• Affidavit of domestic partnership group plans
• Deductible credit
• Enrollment spreadsheet (in lieu of member enrollment applications)
• HIPAA pre-existing change notice and instructions
• HIPAA pre-existing change notice and instructions (Spanish version)
• Other coverage questionnaire enrollment
• Request for certification of disabled dependent
• Waiver of coverage
• Transition of care

Personal funding accounts, UMB Bank forms

• Personal funding account setup - for metallic groups
• Electronic funding authorization (HSA)
• Personal funding accounts enrollment and change application
• UMB HSA beneficiary designation
• UMB HSA name change request
• UMB HSA account closure/withdrawal request
• UMB HSA funds transfer
• HSA expense manual claim

As part of the Affordable Care Act of 2010, all health plans must provide a summary of benefits in a standard four-page format. These summaries help you understand how a plan works and makes comparing plans easier.

View summary of benefits and coverage