• Health Plans

  • 2014 Open Enrollment Ended March 31, What Are My Options?

    If you did not sign up for a health plan between October 1, 2013 and March 31, 2014, your next opportunity to enroll will begin November 15, 2014 for a January 1, 2015 effective date.

    Individuals who experience a qualifying event (for example a loss of employer sponsored coverage, marriage, divorce) may still sign up for a health plan during the special enrollment period. To speak to a Premera representative about qualifying events and required documents, call us at 877-PREMERA.

    Understanding Your 2014 Plan Benefit and Options 

    All plans have the same benefits. The monthly amount you pay for your medical care will vary depending on:

    • Metallic Plan Level: Bronze, Silver or Gold
    • Number of people to be covered by the health plan
    • Ages of people covered
    • Tobacco usage
    • Location

    Medical Care Pay Chart 

    10 Essential Benefits

    Healthcare reform says all health plans must include ten essential benefits. The basic benefits include:

    1. Outpatient Care – the care you receive without being admitted to a hospital
    2. Emergency Room – trips to the emergency room
    3. Inpatient Care – treatment in the hospital for inpatient care
    4. Maternity and Newborn Care - care before and after your baby is born
    5. Mental Health and Substance Use Disorder Services – this includes behavioral health treatment, counseling, and psychotherapy
    6. Prescription drug coverage
    7. Rehabilitative and Habilitative Services – services and devices to help you recover if you are injured, or have a disability or chronic condition. This includes physical and occupational therapy, speech-language pathology, psychiatric rehabilitation, and more
    8. Laboratory Services - lab tests
    9. Preventive and Wellness Services – services including counseling, screenings, and vaccines to keep you healthy and to manage a chronic illness
    10. Pediatric Services– including dental and vision care for children*

    * Health plans offered by all carriers outside of Washington Healthplanfinder include pediatric dental regardless of dependents covered on the plan. The additional cost for this benefit is minimal. If you are shopping inside the Washington Healthplanfinder, you are not required to buy pediatric dental if no one in your family is under 19 years of age as that benefit is sold separately. 

    2014 Health Plan Options

    Premera has a variety of plans (Gold, Silver, Bronze) and funding options such as HSAs available to fit your health care needs. Premera can help you learn more about the options and to find a plan that is right for you.

    Information on our 2014 Health Plans 

    It’s easy to compare plans, determine your monthly rate or apply online. Simply visit our online enrollment portal.

    Questions? Call us at 877-PREMERA to speak to a customer service representative.

    You can also review any one of our rate sheets based on your county of residence.

    Adams, Asotin, Benton, Chelan, Columbia, Douglas, Franklin, Garfield, Grant, King, Kittitas, Okanogan, Walla Walla, Whitman, and Yakima counties (Area 1,5) 

    Clallam, Cowlitz, Grays Harbor, Island, Jefferson, Mason, Lewis, Kitsap, Klickitat, Pacific, Pierce, San Juan, Skagit, Skamania, Snohomish, Thurston, Wahkiakum and Whatcom counties (Area 2,3) 

    Ferry, Lincoln, Pend Oreille, Spokane, and Stevens counties (Area 4) 

    Sales Brochure – includes high-level comparison of plan benefits

    Enrollment Application – be sure to review Eligibility and Enrollment information.

    Dental Benefits 

    What about dental benefits?

    If you're interested in adding adult dental coverage, or have questions, call us at 1-877-PREMERA to discuss your options. You can also apply with our Individual Adult Dental application.

    Help with Cost

    You can get help paying for your new plan if you qualify.

    Financial help comes in the form of the federal health premium tax credit, also referred to as a subsidy. You can use it to lower your monthly health plan amount or lower the amount you pay at tax time.

    Learn more about whether you qualify.

    Premera representatives can quickly confirm your subsidy eligibility, sign you up through Washington Healthplanfinder or enroll you directly in a Premera health plan. Call us at 1-877-PREMERA and we’ll help you choose the best health plan for you and your family.

    More Information

    Individual Supplemental Guide - Includes Privacy Policy, Provider Organization, Key Utilization Management Procedures, Pharmaceutical Management Procedures

    Summary of Benefits and Coverage