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

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  • Welcome Producers

  • Anthem cyberattack and impact to Premera members

    For ongoing updates, we encourage you and your employer clients to visit our employer website. Members can be directed to premeranews.com/anthem as a resource for their questions. Updates to these resources will occur regularly as the situation evolves.

    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.

    To find out more about Virtual Care, contact your Premera sales representative.

    And the networks grow!

    Premera has expanded both the Heritage Signature and Heritage Prime networks for this fall and January 1. Look at our hospital list to see which facilities are in these networks for January.

    New individual 2015 plans posted

    In 2015, your clients will have a wide range of plan options - and an expanded provider network- from Premera Blue Cross. Check out our individual and family plans on our health plan page.

    New individual accident, critical care and life plans

    Premera Blue Cross is pleased to offer Individual accident, critical illness, and life coverage through our new relationship with Washington National Insurance Company. Your clients will receive supplemental protection against accidental injuries with Accident Assure. Critical illness coverage for cancer, heart, stroke, and kidney conditions is available with Critical Solutions. Washington National also offers straightforward, assured life insurance with Life Assure. Contact your sales executive for more information.

    Special enrollment and qualifying events

    The special enrollment period for Individual ACA - compliant metallic plans runs from April 1 through December 31, 2014. Individual consumers may apply for coverage from Premera Blue Cross during special enrollment periods when qualifying events occur until the next open enrollment period in the fall. For more information, we created a Frequently Asked Questions (FAQ) document for you.

    Use the Declaration of Domestic Partnership form for your clients who want to add a domestic partner to their coverage during the special enrollment period.

    Cost and Quality Transparency Tools to help our members

    We want to help and support our members to become empowered consumers, as they take on more responsibility for decision-making and how their money is spent.

    That's why we are offering our members online transparency tools that allow them to easily compare costs and quality to make informed decisions about their healthcare, removing the guesswork.

    We provide members with tools to:

    • Compare physician and hospital quality data
    • Get an estimate for out-of-pocket costs
    • Read member reviews of doctors
    • Track healthcare spending activity

    Check out this flyer for more information on these online tools. 

    New admin guide

    Individual Admin Guide 

    Small group wellness programs with built-in rewards

    Use our new wellness program to:

    • Save 7.5% on premiums for each employee who completes the wellness activities
    • Reward employee healthy behaviors with a $100 Visa® debit card (earned upon completion of wellness activities)

    Check out this flyer for more information on these online tools.

    Preventive Services lists

    For non-grandfathered members, many preventive services received in network are covered in full as part of healthcare reform.

    Preventive Care Services - non-grandfathered plans
    Preventive Care Services - grandfathered plans

    Juice: iPhone app to kick start healthy habits

    Juice, an iPhone app, is the first in a series of consumer mHealth apps. The app helps you assess energy zappers and provides all kinds of tips – including mood, stress and life balance! Check out the Juice video for a quick introduction. Then give it a try and let us know what you think!