Large Business Plans (51+ Employees)

  • Premera knows how important it is for you to provide your clients with a comprehensive healthcare plan. That's why we offer medical, dental, and pharmacy plans that help control costs while providing coverage that balances personal responsibility and freedom of choice.

    We make it easy and simple for you to support your clients by setting up new groups quickly and providing consultation that helps you and your clients better understand costs.

    Our producer news center is the best source for tips and sales tools. You also get access to B’link – our ready-to-share communications that can help you address client and employee questions.

    2018 and 2019 plans

  • Our custom plans provide coverage for the whole health of your employees while keeping your costs in mind. Check out the following guides to find the best plan for your employees' needs.

    2019 complete guide to health benefit plans (100+ employees)
    2018 complete guide to health benefit plans (100+ employees)

    2019 PersonalCare Plans (51+ employees)
    2018 PersonalCare plans (51+ employees)

    Essentials pharmacy plan guide (51+ employees)

    Flex Advantage is part of our high-value care solutions. It's designed to increase your clients' savings by encouraging their employees to make healthcare decisions that maximize their benefits. 

    Learn more about Flex Advantage

    For self-funded, OptiFlex, and Preferred Choice group clients with 51+ employees.

    For group clients headquartered in the Pierce County area.

    Peak Care is an exclusive provider organization (EPO) plan that will:

    • Save employers as much as 15% on the cost of a traditional preferred provider organization (PPO) plan*
    • Offer benefits to employees that attract and retain
    • Uncover better ways to meet employees’ needs with transparent, integrated care
    • Help employers manage their health plan online through our secure employer website

    Go to the Peak Care producer toolkit. Here you will find videos, brochures, and resources all in one place, making it easy to find all the resources you need to sell this new plan.

    *Comparison of Premera preferred provider organization plan pricing

    Choosing your health plan is as easy as 1-2-3 with Preferred Choice – a collection of our most popular medical, pharmacy, and dental health plans.

    2019 Guide

    Our new Preferred Choice guide now includes detailed benefit highlights. This makes it easier for you to help your clients choose a Preferred Choice plan.

    2019 Premera Preferred Choice plans

    Are you assisting new or renewing group clients with a proposal? You’ll find all the forms you need to help your clients complete their enrollment – plus employee-facing benefit highlights – on the Preferred Choice employer page.

    2018 Guide

    2018 Premera Preferred Choice plans

    2018 Preferred Choice medical benefit highlights

    2018 Preferred Choice pharmacy benefit highlights

    2018 Preferred Choice dental benefit highlights 

    When your group clients combine medical and pharmacy plans, they benefit from deeper, real-time insights into their complete healthcare costs and their employees benefit from whole-health care.

    Here are a few other advantages of integrated care:

    1Blue Cross Blue Shield Association Pharmacy Benefit Integration Study

    Your group clients may choose from two pharmacy plans:

    Preferred is a more comprehensive list of prescription drugs and provides access to a full spectrum of brand-name medications.

    Essentials is a restricted list of prescription drugs that meets basic pharmacy needs. Essentials keeps costs as low as possible by focusing on high-value drugs that are approved by the U.S. Food and Drug Administration (FDA). Share our Essentials pharmacy plan guide with your clients looking for more information.

    Specialty Pharmacy Program

    Premera’s Specialty Pharmacy Program is for member who may require specialty medications usually used to treat complex or rare conditions. Premera partners with Specialty Pharmacies that help these members manage their specialty medications through:

    • Patient education
    • Clinical support for dosing and potential side effects
    • Medication ordering and delivery options
    • Working with the member to assure they are taking their medications correctly and compliant with the drug therapy

    Exclusive Specialty Pharmacy for Self-Funded Groups

    As the specialty pharmacy market rapidly evolves, Premera Blue Cross continues to work toward providing the best quality and savings on high-cost prescriptions for our members with complex or rare conditions. That’s why we offer our self-funded groups a more focused approach to specialty pharmacy providers that maximizes plan savings while delivering individualized patient care to these members. Share this flyer on Exclusive Specialty Pharmacy with your group clients who want to learn more about the benefits.

    Fully insured

    Get predictable costs without the risk. We will assume all of the financial risk and pay your employees' claims. You pay a stable, monthly premium.

    Self-funded

    Opt for a payment option that directly reflects your employees' health needs. With this option, you assume the financial risk. However, this option may also give you the opportunity to reduce your costs by encouraging your employees to actively engage in their healthcare.

    OptiFlex

    A combination of both fully insured and self-funded. Get the protection and flexibility of a self-funded plan without being overly expensive or complicated.

    Best-in-class benefits

    Competing for talent means offering a comprehensive benefits package. Premera Blue Cross partners with best-in-class companies to allow you to offer life and disability products to your clients while extending additional cost savings.

    Did you know…

    When your group clients with 51-199 employees add life and disability products to their Preferred Choice plan, they may be eligible for discounts on Premera Blue Cross medical premiums.

    Your group clients with 10 or more enrolled employees can choose from the following:

    Group Life Insurance

    • Group Term Life
    • Accidental Death and Dismemberment
    • Dependent Life
    • Disability Coverage
    • Supplemental Life and AD&D

    Disability coverage

    • Short-Term Disability Coverage
    • Long-Term Disability Coverage

    Preferred carriers

    • MetLife
    • Symetra
    • The Hartford

    MetLife, Symetra, and The Hartford, are independent companies offering life and disability products to Premera Blue Cross employer groups and members, are solely responsible for their products and services, which are not Blue Cross Blue Shield products or services.

    LifeWise Assurance Company assists your group clients with creating the right medical stop loss for their needs. If they elect to self fund their medical plan, this product provides a reinsurance contract to protect them from catastrophic losses.

    LifeWise Assurance Company is an independent company offering life and disability products to Premera Blue Cross employer groups and members. LifeWise Assurance Company do not provide Blue Cross Blue Shield products or services.

  • Plan features

  • Premera's large business medical plans include convenient options for employees to access care or their health plan information online, with our mobile app, or by phone.

    24-Hour NurseLine

    Members get free, confidential health advice from a registered nurse by phone any time, day or night, with our 24-Hour NurseLine.

    Virtual care

    Every medical plan comes with virtual care options. Video or phone consultations with a Teladoc® physician are available any time for a low copay.

    The Premera mobile app

    Our redesigned mobile app enables employees to find their health plan information, or search for a doctor at any time.

    We believe a network is more than just a collection of contracts. For decades, Premera has maintained the large network of doctors and medical facilities in Washington. As a result, we offer greater network stability and deep discounts for covered in-network services.

    For employers with 51 or more employees, we offer a choice of networks so your clients can select the level of provider access and cost that works best for their employees and business needs.

    Heritage Network

    Our broadest provider network offers access to 100% of Washington hospitals and 99% of primary care doctors in Washington state. Includes CHI Franciscan Health and Providence Health & Services systems.

    Heritage Prime Network

    This tailored provider network offers access to more than 33,200 doctors, clinics, and hospitals across Washington state that commit to quality care, managed costs, and a focus on the customer. Does not include CHI Franciscan Health and Providence Health & Services systems.

    Check out the Heritage Prime flyer to see the key benefits of this network and a partial list of current providers.

    The power of choice

    Whether your client and their employees want access to the most providers in Washington state, or the highest savings, give them the ability to choose their network by offering both Heritage and Heritage Prime networks.

    Help your clients decide which network is right for their business, or if a dual offering is the way to go with the Heritage or Heritage Prime flyer.

    National and worldwide network coverage with BlueCard™

    With any Premera health plan, you have access to the BlueCard Program, which provides access to networks of contracted preferred and participating Blue Cross Blue Shield providers across the country. Just like here at home, these networks provide valuable discounts on billed charges and the added advantage of direct billing.

    The BlueCard Program includes the added benefit of worldwide coverage with Blue Cross Blue Shield Global Core. This program provides members access to an international network of participating doctors and hospitals for a broad range of medical care services so they can feel safe wherever they go.

    The Premera Flex Advantage network option

    Premera Flex Advantage is designed to give your group clients broad access to providers. All the while, it uses financial incentives to encourage their employees with a Premera medical plan to select the providers who can deliver the most cost-efficient services.

    Premera Flex Advantage flyer

    *Consortium Health Plans, Inc. Network Compare Key Findings as of June 5, 2015. Available at chpmarketquest.com.

    We care about our members' health, nutrition, and fitness. That's why Premera offers members special perks at no extra costs.

    Members get a variety of discounts on products and services, including:

    • Diet, nutrition, and supplements
    • Fitness clubs and gyms
    • Eye care services and hardware
    • Hearing aids and screenings
    • Newborn services and products

    Learn more about the member discounts that your client's employees can receive.

    Note: Offers might not be available in all locations. Please have your employees check with the company offering the discount before making their purchase.

    Take advantage of our personal funding account options to combine quality healthcare coverage with access to health savings accounts (HSAs), health reimbursement arrangements (HRAs), and flexible spending accounts (FSAs). These accounts are ideal for employers who are looking to control healthcare costs or increased employee responsibility for healthcare expenses and decisions.

    Personal funding account benefits

    • Employees have more choices and control over their healthcare spending
    • Employees can offset out-of-pocket expenses with potential tax advantages
    • Potential tax savings for employers

    HSA On Demand

    Offered through ConnectYourCare, HSA on Demand gives employees up-front funds when they don’t have enough money in their HSA account to cover qualified medical expenses. (This option is available for self-funded groups.)

    Learn more about personal funding accounts and HSA On Demand

    Because healthier employees often lead to better bottom lines

    Effective July 1, 2017, new and renewing large groups (51-499 employees) will have access to Premera's Wellness Program. The program offers fully insured and Optiflex groups support for creating a culture of wellness. It is a part of our health plan offering and is simple to administer.

    More information is available in the Wellness Program brochure. We encourage you to share this new program with your large group prospects and current clients.

    Getting started

    Employers are automatically enrolled in the Premera Wellness Program as a part of their health plan benefits.

    Want more?

    Are your prospects or current clients looking for additional wellness support? We can help with that too. Our packaged wellness options feature consulting time with wellness experts, incentive assistance, and health education sessions. Learn more.

  • Resources

  • Preferred Choice creditable coverage status report

    2018-2019 Preferred Choice creditable coverage status report

    2017-2018 Preferred Choice creditable coverage status report

    Medicare Part D testing options

    Premera Blue Cross offers employers two options to support their Medicare Part D testing obligations. The testing tells if the pharmacy plan you offer meets the creditable coverage standard as compared with Medicare Part D.

    The Centers for Medicare and Medicaid Services (CMS) says drug coverage is creditable if the actuarial value of the coverage equals or exceeds the actuarial value of standard Medicare prescription drug coverage.

    Your choices for testing are:

    • Premera can give you some of the data to do your own testing.
    • Premera's underwriting team can do the testing for you, for a fee, using General Guidance methods.

    The CMS website offers general Information about Medicare Part D.

    To learn more about Medicare Part D testing and to discuss your options, contact your producer or Premera account representative.

    Important reminder

    Premera no longer sends creditable coverage status notices to members on behalf of groups with pharmacy plans.

    Employers will need to provide the notifications as 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 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:

    Submission of CMS Medicare Part D Disclosure Form

    Federal law requires employer groups to notify the Centers for Medicare and Medicaid Services (CMS) if their prescription drug coverage for Medicare beneficiaries is creditable. CMS requires employer groups to submit a Creditable Coverage Disclosure Form each year or upon any change that could affect whether the drug coverage offered is creditable.

    Premera is dedicated to helping our members get the best care after an illness or injury. Our outpatient rehabilitation management program reviews treatment plans to help your client's employees get care at the right time.

    Learn more about how the outpatient rehabilitation management program works and what steps your client's employees can take if a treatment plan is denied.

    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.

    View summary of benefits coverage.