About Small Group Plans

2017 plans

2017 Medical Benefits Guide

Medical Plan Options Flyer

Dual Choice Matrix

Get to know PersonalCare Plans

PersonalCare Plan Flyer

Download the PersonalCare Plan video transcript

Medical plan summaries

Balance Plans

• Balance 500 Gold
• Balance 750 Gold
• Balance 1000 Gold
• Balance 1500 Gold
• Balance 2000 Silver
• Balance 3000 Silver

Balance HSA and HSA Qualified Plans

• Balance 3000 Qualified Silver
• Balance 4000 HSA Silver
• Balance 6000 HSA Bronze

Balance Employee Only Plan

• Balance 500 Gold Employee Only

Balance + Family Plans

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

Choice Plans

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

PersonalCare Plans

• PersonalCare Gold 750
• PersonalCare Silver 2500
• PersonalCare Bronze 4500

2016 plans

2016 Medical Benefits Guide

Medical plan summaries

• Balance Gold 500
• Balance Gold 750
• Balance Gold 1000
• Balance Gold 1500

• Balance Gold PCP 500
• Balance Gold PCP 750
• Balance Gold PCP 1000
• Balance Gold PCP 1500

• Balance Gold PCP HRA 2000

• Balance Gold PCP 500 Employee Only
• Balance Gold PCP 750 Employee Only
• Balance Gold PCP 1000 Employee Only
• Balance Gold PCP 1500 Employee Only

• Balance Silver 2000

• Balance Silver PCP 2000
• Balance Silver PCP 2500
• Balance Silver PCP 3000

• Balance Silver HSA 3000
• Balance Silver HSA 5000

• Balance Bronze PCP 5500
• Balance Bronze PCP 6350

• Balance Bronze HSA 6000

• Choice Gold 500 PCP
• Choice Gold 750 PCP
• Choice Gold 1000 PCP

• PersonalCare Gold 750
• PersonalCare Silver 2500
• PersonalCare Bronze 4500

Dental Benefits Guide*

2017 DentalBlue benefit guide

An Adult Vision Plan can be pared with any small group medical plan.

• Adult Vision Plan
• Adult Vision Plan - Employee only
• Vision plan summary

Important reminder

Premera no longer sends creditable coverage notices to members on behalf of groups with pharmacy plans prior to the Medicare annual open enrollment period.

Employers will need to send the notifications 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 in their employer health plan 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

Small group creditable coverage status report

2017 small group creditable coverage status report

2016 small group creditable coverage status report

2016 small group creditable coverage tested against 2017 Medicare Part D threshold amounts (if your plan straddles 2016 and 2017 reference this list).

Individual and Medicare Supplement

We will continue to mail creditable coverage notices, as required under the MMA to individual and Medicare Supplement subscribers.

Small group personal funding accounts

Personal funding accounts offer your business a consumer-driven approach to improving the bottom line-combining quality healthcare coverage with a choice of tax-advantaged healthcare spending accounts.

Personal funding accounts:

• Give employees more choice and control over their healthcare spending
• Encourage a more health-conscious, productive and satisfied workforce
• Help employees offset out-of-pocket expenses with potential tax advantages
• Minimize costs and add an affordable healthcare program to the total compensation package
• Take advantage of potential tax savings for your business (please consult a tax advisor regarding IRS guidelines)

Already have an HSA account? Check out our how-to-guide that walks you through how to fund your employer contributions!

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.

Small Group Plan SBCs

Healthy rewards for healthy employees

We offer a variety of programs and services that are designed to keep employees healthy, lower costs, and reward people for doing the right thing.

A wellness program designed with small businesses in mind.

New wellness programs available to employer groups with 1-50 employees starting January 1, 2014 for new business and renewing groups on non-grandfathered plans.

We know that healthier employees lead to a healthier budget. That's why we have included a robust wellness program where:

• Employers will save 7.5% on premiums for each employee who completes wellness activities
• Employees who qualify may receive telephonic health coaching at no additional cost
• Employees will earn a $100 Visa® debit card (once they have completed the wellness activities)

Help your clients launch a successful wellness program with our wellness program employer toolkit.

Group Enrollment (up to 50 employees)

2017

• Group Master Application Up to 50
• Group Master Application Up to 50 – Dental
• Group Master Application Benefit Selections Up to 50
• Group Master Application Dental Benefit Selections Up to 50
• Groups of One Attestation
• Small Group - Group Size Certification
• Personal Funding Account Setup - For Metallic Groups

2016 & 2017

• New Group Enrollment Checklist
• Renewal Group Enrollment Checklist
• Electronic Funding Authorization (HRA and HSA)
• ERISA Business Associate Agreement - For Metallic Groups
• Non-ERISA Business Associate Agreement - For Metallic Groups
• Group Verification of Medicare Coverage
• Late Enrollment Acknowledgement Form
• Quick Reference Guide for Plan Administrators
• Key Employee Verification Form

Member enrollment

2017

• Member Enrollment and Change Application
• Member Enrollment and Change Application Spanish Version

2016 & 2017

• Affidavit of Domestic Partnership Group Plans
• Deductible Credit Form
• 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
• Personal Funding Accounts Enrollment and Change Application
• Request for Certification of Disabled Dependent
• Waiver of Coverage

Member, Other

• Transition of Care Form
• HRA Electronic Funding Authorization

Member, UMB Bank Forms

• UMB HSA Beneficiary Designation Form
• UMB HSA Name Change Request Form
• UMB HSA Account Closure/Withdrawal Request
• UMB HSA Funds Transfer
• HSA Expense Manual Claim Form

Helpful Tools For Your Clients

• Find a Doctor
• Rx Search
• 24 Hour NurseLine
• Virtual Care Flyer

Save Money Now...

...with special discount offers for Premera Blue Cross members.

• No extra fees!
• Make purchases in person, over the phone, or online with your health plan ID card
• Available to most members of Premera Blue Cross.