Taking great care of our customers is important to us. That’s why we offer a range of benefits that support your clients, bring them more value - which makes it easier for you to retain your clients. Other benefits you get with Premera include
the ease of enrolling your clients online and an onboarding process that we handle so you don't have to.
Our producer news center is the best source for the latest 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.
Choice plans paired with our broadest selection of in-network providers under the Heritage network. HSA-qualified plans offer tax savings for both employers and employees.
2022 Benefit Highlights (pending approval)
Balance plans paired with Heritage Signature, a slightly smaller network than Heritage, but providing added cost savings for employers.
Peak Care is an exclusive provider organization (EPO) plan that will:
The Tahoma network includes MultiCare Connected Care Clinically Integrated Network, Physicians of Southwest Washington, MultiCare Capital Medical Center, and Vivacity Care Clinics. The network also includes contracted healthcare facilities, chiropractors,
acupuncturists, naturopaths, and massage therapists. With over 4,100 providers, the breadth of providers available in the Tahoma network ensures access to a full range of services to meet the needs of your employee population in the Pierce, Thurston,
and Spokane County areas.
Check out the Peak Care producer toolkit for videos, brochures, and resources to help you talk to your clients about this new plan.
*Comparison of Premera preferred provider organization plan pricing.
Medical plans with family dental benefits built right in—and the opportunity for employees to choose their desired network. By bundling pediatric and adult dental benefits with medical coverage, employees get well-rounded health coverage for their whole
family and access to our large provider network. All the while, employers get a one-stop-shopping experience for managing your benefits.
We also offer 2 separate dental plans. Employers can pair these to provide adult dental coverage with any medical plan you choose. With Adult Dental Optima, employers can offer their employees comprehensive coverage and flexibility to choose their dentist. Specifically for employers with 5 employees or more, Adult Dental Optima Voluntary provides dental coverage at little or no cost.
Add a vision plan for adults to offer a complete benefits package. Pediatric vision benefits are included in each health plan.
Premera's small group medical plans include convenient options for employees to access care or their health plan information online, with our mobile app, or by phone.
Members get free, confidential health advice from a nurse by phone any time, day or night, with our 24-Hour NurseLine.
Every medical plan comes with virtual care options.
Our redesigned mobile app enables employees to find their health plan information, or search for a doctor at any time.
Premera's qualified, high-deductible health plans with a health savings account (HSA) offer members great basic coverage and a chance to save money and invest it for future IRS-approved medical expenses. HSA-qualified health plans allow employers to reduce their taxable income and receive lower monthly rates due to the higher annual plan deductibles.
Learn more about HSA accounts.
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
For employers with up to 50 employees, we offer a choice of networks so they can select the level of provider access and cost that works best for their employees and business needs.
Our broadest provider network offers access to 100% of Washington hospitals and 99% of primary care doctors in Washington state.
This tailored provider network offers access to more than 37,000 doctors, clinics, and hospitals across Washington state that commit to quality care, managed costs, and a focus on the customer.
Check out the Heritage Signature flyer to see the key benefits of this network and a partial list of current providers.
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 Signature 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 or Heritage Signature flyer.
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.
At Premera, we know how important wellness is to your small group clients. Healthier employees are happier and more productive employees. That's why we include a Premera Wellness Program with every fully insured small group medical plan–at no additional cost to your group clients.
2021 Choice PPO
2021 Choice HSA Qualified
2021 Balance PPO
2021 Balance EPO
2021 Balance HSA Qualified
2021 Peak Care
2021 Balance Medical + Family Dental
2021 Choice Medical + Family Dental
2021 Adult Dental Optima
2021 Adult Dental Optima Enhanced
2021 Adult Dental Optima Voluntary
2020 Choice PPO
2020 Choice HSA Qualified
2020 Balance PPO
2020 Balance HSA Qualified
2020 Peak Care
2020 Balance Medical + Family Dental
2020 Choice Medical + Family Dental
2020 Adult Dental Optima
2020 Adult Dental Optima Enhanced
2020 Adult Dental Optima Voluntary
2021-2022 small group creditable coverage status report: If your plan year straddles 2021–2022, reference this report. It shows 2021 small group creditable coverage tested against 2022 Medicare Part D threshold amounts.
2021 small group creditable coverage status report
2020 small group creditable coverage status report
The CMS website offers general information about Medicare Part D.
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:
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.
Employers offering group health plans must comply with the Medicare Secondary Payer (MSP) statute and regulations (the MSP laws). These laws establish Medicare as the secondary payer to group health plan coverage in certain instances of dual healthcare coverage. The MSP laws are complex and can be confusing even to a seasoned healthcare administrator.
This section has been designed to provide a general overview of what your group clients need to know about MSP and related issues. It's purely informational, does not modify their policy or coverage in any way, and should not be construed as legal advice or opinion.
MSP change form – Form used for employer groups to report group size and Medicare beneficiary changes to Premera that may impact MSP rules.
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.
Contact one of our small group general agent distribution partners:
These independent Premera affiliates distribute but do not provide Blue Cross products or services and are solely responsible for their services.