• Live Smart

    Medicare Supplement plan options for your client's budgets and coverage needs.

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  • Company Closure Notice
    The Premera offices will be closed on Friday, July 3. During this time, all of our online tools will be available. We expect higher-than-normal call volumes on Monday, July 6, so we encourage you to continue using our online tools to avoid long wait times.

  •   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 pathology tests performed by CellNetix could result in higher out-of-pocket costs. If members visit one of the following healthcare providers, they should be aware their pathology work may be sent to CellNetix unless they request otherwise: Swedish Hospitals and Swedish Medical Group, The Polyclinic; Northwest Hospital and Medical Center; Providence Regional Medical Center Everett and Providence Medical Groups; Minor & James Medical; Highline Medical Center; and The Everett Clinic.

  • Welcome Producers

  • What's New

    PCORI fee deadline approaching

    If you have self-funded employer group clients with a calendar year plan, they need to know the PCORI fee deadline is July 31st. More information is available on the IRS website.

    Helpful new webinars available

    New 'pop' webinars - webinars in five minutes or less - are available in the resource section. These new pop webinars (geared to the individual market) highlight features or provide a brief overview on a specific topic.

    Find a Doctor tool enhancements

    Our newly improved Find a Doctor tool (provider search engine) now offers members better cost information, smarter features, and deeper quality reviews once logged in. Check out these new features by logging in or talking to your sales representative today.

    Removing member prior authorization penalty with contracted providers

    As business renews, beginning January 1, 2015, members will no longer be financially liable if contracted providers fail to obtain a required prior authorization. This affects Individual and Small Group Metallic plans and Large Group fully-insured plans.

    Individual and small groups 

    • Contracted providers- If the provider fails to obtain prior authorization, the member is not penalized.
    • Non-contracted providers- If the provider fails to obtain prior authorization, the claim is administratively denied and the provider may bill the member for the full amount

    Midsized and large groups 

    • Contracted providers- If the provider fails to obtain prior authorization, the member is not penalized.
    • Non-contracted providers- If the provider fails to obtain prior authorization, the claim is paid to the allowed amount- less 50% to a maximum of $1,500- and the provider may bill the member

    This change is designed to improve compliance with the prior authorization program and make coverage more predictable for members.

    Premera now covers virtual care

    Virtual care gives members immediate and convenient access to care whenever and wherever they need it (except in Idaho).

    Members who are covered (as plans enroll or renew beginning January 1, 2015) receive care virtually from their own doctor or from a doctor at our national provider service, Teladoc®. Covered members can get care via phone call, online video, or other online media at least as easily as they walk into an office and get care face to face. See our virtual care flyer!

    Our new virtual care solution is getting a lot of media coverage. Check out an article in the Seattle Times, Herald Business Journal, or State of Reform.