Surprise Balance Billing—We’re Here for Your Clients

  • Group Market News
    Published February 10, 2020

    For individual and group plans. Self-insured plans (including OptiFlex-funded plans) must opt in to participate. Does not apply to members with Medicare Advantage, Medicare Supplement, BlueCard, and 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 your self-insured group wants to participate, the Washington State Office of the Insurance Commissioner (OIC) requires official notification. To make sure the notification to the OIC is submitted accurately, we suggest your group client let us do the work for them. Encourage your self-insured group clients who are interested to reach out to their Premera representative or producer. Here are a few important things to note:

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