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  • Welcome Premera Washington Producers

  • What's new

    Clarified rules for "group of one"

    As a result of federal provisions for employer eligibility to purchase coverage in the small-group market, the Washington State Office of Insurance Commissioner notified us of the need to amend our 2016 small group plans. To be eligible to purchase coverage in the small-group market, an employer must have at least one common-law employee. This means that what has been considered a "group of one" but consisting of only a sole proprietor without an employee, or a self-employed individual, is no longer eligible as a new or renewing group in 2016. If you have a client that is impacted and you need assistance enrolling them on an individual plan, contact your Individual Sales Executive:

    IRS 1095 reporting deadline extension

    On December 28, 2015, the IRS issued a delay in the due dates for the 2015 Form 1095-B and 1095-C reporting requirements. The extension applies to insurers, employers and certain other providers of minimum essential coverage.

    New Deadlines:
    • 1095 B & C Statements for individuals extended from 2/1/2016 to 3/31/2016
    • 1094 C to IRS + Copies of 1095 C (paper filing) extended from 2/29/2016 to 3/31/2016
    • 1094 C to IRS + Copies of 1095 C, (electronic filing) extended from 3/31/2016 to 6/30/2016

    Note that Premera will issue our Form 1095-Bs to individuals on fully insured plans by end of January or February, unless they have chosen to receive it electronically. Members on Exchange plans will receive Form 1095-A directly from the Exchange.

    Teledoc for cold and flu care

    When employers have virtual care, sick employees can consult with a Teladoc® physician in as little as 10 minutes- by phone or video chat. They'll be back on their feet and back to work as quickly as possible.

    Talk to your sales representative about how Virtual Care can benefit your clients.

     

  •   An important notice about pathology/laboratory services  

    CellNetix is a provider of pathology services that is no longer in Premera’s network. We have asked the healthcare providers in our network to send our members’ pathology work to an alternative pathology provider. Having your pathology tests performed by CellNetix could result in higher out-of-pocket costs. If you visit one of the following healthcare providers, they may send your pathology work to CellNetix: Swedish Hospitals and Swedish Medical Group; Northwest Hospital and Medical Center; Providence Regional Medical Center Everett and Providence Medical Groups; Minor & James Medical; Highline Medical Center; and The Everett Clinic.