A few things to know about Premera Group Plans:
Premera covers more people in the state of Washington than any other carrier. Their group plans are extremely popular due to their great benefits, competitive pricing and ease of enrollment.
Premera offers two sets of plans, Balanced and Choice: The Choice plans use the Heritage Prime provider network which includes nearly every provider and hospital in the state. It is rare to find a provider that is not a Heritage Prime participant.
The Balance plans use the Heritage Signature network. There are a few provider groups/hospitals that are not contracted in this network. These include: CHI Franciscan and it’s affiliates (includes: St. Anthony, St. Joseph, St. Clare, St. Elizabeth, St. Francis, Highline Medical Center). In Eastern WA: Lourdes. If these are not of concern then the Balance plans are a much better value.
Both plans are very popular because they DO NOT require a primary care provider (PCP) and you DO NOT need referrals in order to see specialists.
A tremendous benefit of both plans is that they include the BlueCard system. BlueCard is a national program that enables members of one Blue Cross and BlueShield (BCBS) Plan to obtain health care services while traveling or living in another BCBS Plan's service area which makes this a great plan if you are ever out of state.
IMPORTANT: Before proceeding, it's important to establish that you are eligible for a Premera group plan. Not Eligible: Sole proprietors with no common-law (W-2) employees and self-employed individuals. Premera will consider you eligible if you are registered as an LLC or Corporation (they will verify online) and you are a W-2 employee of the business or have at least one other non-spouse W-2 employee you are enrolling. You will have to provide your 2022 W-2 to verify eligibility.
>>>Benefit Summaries, SBCs & Booklets: greenfinancial.com/group-benefit-summaries
Enrollment Forms:
For New Group Enrollment Forms and Documents, please email Julie@GreenFinancial.com .
Employee Application (Add/Change/Terminate)
Attestation Form for Group of One-Two
Important: Requirements if only one or two employees are enrolling:
For groups of 1-2 employees, Premera requires a copy of your 2022 W-2 for at least one enrolling employee in addition to the group of one attestation form.
If set up W-2 compensation in 2022 for the first time you will not be eligible for coverage until 2/1/2023. If setting up W-2 income for the first time in 2023, then you won't be eligible until 2024.
Call Green Financial if you will not be able to accommodate the W-2 request as there are other options.
If three or more employees are enrolling you do not have to submit W-2s or wait until the next year! Enrollment is much easier!
Find a Doctor/Hospital: Online Search
- Update your location (zip)
- Choose your network: Heritage Signature for Balance Plans, Heritage Prime for Choice Plans (several networks are listed but only these two apply to small group plans).
- Search by provider name.
Prescriptions Online Search
A formulary is a list of prescription drugs that are covered under your benefit plan. With Premera small group plans (2-50), medications are organized into four levels, or tiers. What you pay depends on which tier your medication is in.
Choose M4 (2018) from the drug list search for all plans except HSA.
Choose M1 (2018) form the drug list search for all HSA plans.
Dental & Vision
For Vision Insurance we recommend VSP: Individuals Groups 2+
For Dental: Individuals/Groups of 2-4 Groups 5+
For Existing Premera Groups:
Group Administration: 855-756-0796 1 for enrollment, 2 for billing (be ready with account number)
Member Services/Claims: 800-722-1471
EMPLOYEE TERMINATIONS: Simply send an email. Typically an employee remains covered through the end of the month they were terminated in.
Send email to: premeramembership@premera.com and CC: Brandy@GreenFinancial.com
Subject: Employee Term Request, Group Name, Group Number
Body Example: Please terminate insurance coverage for employee, John Smith and his family effective 10/31/2019. His last date of employment was 10/15/18.
EMPLOYEE ADDITIONS: Employee to complete and sign: Enrollment Application Be sure to add group name and account number. Employee must sign form. Date of hire dictates effective date: Example: IF 60 day wait, then first of month following. In this case, if DOH = January 15th, Effective date = April 1st.
Email (same as above - see subject and body example), or
Fax: 888-251-7319 (safest), or
Mail: Premera Blue Cross, P.O. Box 327, MS 737, Seattle, WA 98111-0327
Premera Online Admin: Online administration is available for additions, deletions, billing etc. To log in or set up, visit: Premera Employer Login
>>>Please advise Green Financial of employee changes so we can keep our records updated for renewal information.