• John Casper
    Director, Western WA Mid-Market Sales
    Trevor Moore
    Director, Eastern Washington Sales and Marketing

    New Utilization Management digital magazine

    Our Medical Services and Quality staff develops and adopts medical policies that support safe, quality medical care and treatments for our members. These policies also help reduce waste and harm of unnecessary treatments. Take a look at our new easy-to-view quarterly Utilization Management Digital Magazine.

    Highlighted in this edition:

    • UM Performance Reports
      • ESA Policy
      • Home Sleep Study Policy
    • Lumbar Spine Decompression

    Feel free to share this with your group administrators and let your sales team know if you have any questions.

    Network update in the Bellingham area

    We are pleased to announce that we have been able to reach an agreement with Bellingham Anesthesia Associates (BAA) that allows us to keep them in our network, while also controlling costs for our members. BAA provides anesthesiology services at hospitals and surgery centers in the Bellingham and Mount Vernon areas.

    Our goal is to build a network that ensures our members can access high-quality cost-efficient care in their local area. We negotiate with healthcare providers to agree on rates for the services they provide to our members. The cost of medical services is responsible for at least 80% of our members’ monthly rates so it’s vital that we continually look for ways to keep costs down for our members.

    Communicating with our customers

    In April, we notified Group and Individual members who live in and near Bellingham, WA, that BAA chose to no longer participate in the Premera network. We are happy to have BAA back in our network as of May 9, 2014. This month we'll mail another letter to Group and Individual members who live within a 50-mile radius of Bellingham, telling them about the update. In addition, we'll mail a letter to group administrators to inform them of the network update and the mailing to their employees.

    Please contact your sales executive if you have questions.

    The summer issue of Premera For Your Health is almost here!

    The summer issue will be packed with information for your groups' employees about how to avoid health problems while out enjoying the summer, plus how to get care no matter where adventures take you.

    In keeping with the theme of our previous issue, the summer edition is a quick read with details where they count. It's another way to reach out and teach members about:

    • How their health plan works
    • How to save on out-of-pocket costs
    • The proactive health support their plan offers

    Expect to see a link to the summer newsletter in the July bulletin.

    Dates and details

    Starting on June 19 we will be sending employer groups the summer issue of Premera For Your Health.

  • John Mychalishyn
    Director, Individual Market Segment

    New Individual accident, critical illness and life coverage available

    Premera is pleased to offer Individual accident, critical illness and life coverage through our new relationship with Washington National Insurance Company. The first effective date for coverage on these plans was June 1, 2014.

    We selected Washington National to help you provide your clients with the additional financial protection they need.

    Supplemental protection against accidental injuries with Accident Assure®.

    Critical care
    Critical illness coverage for cancer, heart, stroke and kidney conditions with Critical Solutions®.

    Straightforward, assured life insurance with Life AssureSM.

    Product webinars will be posted online as a resource for you next week. If you want information about Washington National coverage, please contact your sales executive.

    The dentist is coming! The dentist is coming!

    Special dental open enrollment June 1 – July 31, 2014

    Did you know Paul Revere was a dentist? 1 He’d likely be amazed that, according to the American Dental Association, 100 million Americans fail to see a dentist each year. 2

    You can help change that. Now is the time to talk to your Premera clients about enrolling in our Select Dental Plan for Adults during a special open enrollment period of June 1 - July 31, 2014, for effective dates of July 1 or August 1. This plan is available to your clients age 19 and older who are enrolled on a Premera Individual metallic plan.

    With Premera Individual adult dental plans your clients get:

    • Choice of deductible – choose either a $50 or $75 annual deductible plan (Individual)
    • Predictability of costs – clients pay a set copay for each of the over 200 covered services
    • Wide range of coverage – clients are covered for the most commonly used preventive, minor and major dental services
    • Choice of providers – an extensive and growing list of dental providers.

    With the strong connection between dental health and overall wellness, this is a good opportunity to encourage your clients to consider a Premera dental plan to round out their medical plan. Just remember, common enrollment is required.

    For more information about our dental plans, please contact your sales executive or Producer Support at 877-205-9725, Option 1.

    1Dental Buzz

    2American Dental Association

    Individual special enrollment FAQ updated

    Revision clarifies qualifying events when Group coverage is cancelled

    Producers have asked us many questions about Individual special enrollment periods during the past two months. We created a Frequently Asked Questions (FAQ) document and posted it on our producer web pages as a resource for you last March.

    Since that time, we’ve updated it twice to reflect new information we’ve learned. Some of you have asked us more questions about qualifying events. For example, is it a qualifying event for the employee and employer when the employer voluntarily cancels Group coverage?

    This latest version of the FAQ provides the answer. (See Nos. 15 and 16 in the FAQ.)

    Contact your sales executive or Producer Support at PBCWA 877-205-9725, Option 1, if you have additional questions.

    New summer hours for Individual Producer Support team

    Plus a big thanks to this hard-working crew

    There’s a team of dynamos working behind the scenes to help you get the information you need and fast. It’s the Individual Producer Support team, and they are here to get many of your questions addressed, so you can keep your business running smoothly.

    In the summer, call volumes are much higher earlier in the day, with few calls after 4:30 p.m. So through August, we’re going to shorten the lunch hour and close at 4:30 p.m. We’ll resume regular hours in September.

    New summer Producer Support hours

    June 2 – August 29
    Monday through Friday
    Open at 8 a.m. – noon PDT
    Close for lunch - 12:30 – 1 p.m. PDT
    Reopen at 1 – 4:30 p.m. PDT

    The Producer Support team covers a wide range of issues for you:

    • Client application status
    • Eligibility information
    • Web-selling assistance
    • Supply requests
    • Product questions
    • Book of business report requests
    • Navigating the website.

    You can reach the team at Producer.Support@Premera.com 877-205-9725, Option 1.

  • Trevor Moore
    Director, Eastern WA Sales and Marketing

    Small Group dental plan summaries available now

    Check out our newly created dental plan summaries

    We’ve recently added more resources on Premera.com to support our Small Group dental plans - we’re excited to share our newly added dental plan summaries with you.

    Plan details for 2014 dental plans

    To review details of 2014 plans, please refer to the DentalBlue plans brochure or check out our new summaries that we’ve broken out by plan:

    Want more information about our Small Group plan options?

    If you have any questions about our Small Group product portfolio, please visit Premera.com or contact one of our general agent distribution partners.

    Thank you for working with us.

  • John Casper
    Director, Western WA Mid-Market Sales
      Trevor Moore
      Director, Eastern WA Sales and Marketing

    Check out the Express Scripts Drug Trend Report

    Annually we share the Express Scripts Drug Trend Report with our self-funded employer groups. We like to promote the newly released results, discuss some of the trends and explain what Premera is doing to stay ahead of them. The 2013 annual report was recently released and it includes a few areas where Premera is either ahead of the trend, or where we have active work underway to address these areas of opportunity. 

    Here are some quick links to the Express Scripts information:

    2013 Drug Trend Report – for the complete 90 pages of charts and analysis.
    2013 Drug Trend Report Highlights – for a summary of the key findings.

    Check out the message that Premera Account Managers will be sharing with self-funded employer groups in early June.