VibrantUSA remains committed to assisting all of our clients navigate market changes. Premera recently announced some significant changes to their Individual plan offerings (Affordable Care Act plans) in Washington state. In 2017 Premera will be offering reduced service areas for their plans in 24 counties, which will only be available on the Washington Health Benefit Exchange. In addition, some providers will be leaving Premera’s Heritage Signature network. [Note: These changes do not apply to those Medicare eligible.]
- Premera plans will only be available through the Washington Health Plan Finder (state benefit exchange).
- Premera will no longer offer Individual plans in Chelan, Douglas, Ferry, Kittitas, Klickitat, Lewis, Lincoln, Mason, Pend Oreille, San Juan, Skagit, Skamania, Stevens and Yakima counties.
- Residents in King and Pierce counties will only have the option of more limited PersonalCare plans, coordinated care from a select group of providers. Members may choose from: Evergreen Health, Multicare, Northwest Physicians Network, UW Medicine and Virginia Mason. PersonalCare plans are also available in Snohomish County.
- Some providers from Swedish, Providence and CHI Franciscan health systems will be leaving Premera’s network. In areas where members have few other in-network options, select facilities will remain in-network.
Premera believes these changes will better manage quality and costs and lead to improvements in the future. Jim Havens, vice president and general manager for Premera’s individual market said the following:
We are committed to serving customers in the individual market … with providers and health plans across the nation searching for the right business model that delivers excellent patient care and customer experience, while also assuring long-term stability. By making these changes, we can better manage quality and costs, and offer more competitive prices.
For the majority of our clients, the impact is as follows:
| County | Changes/Impact |
|---|---|
| Whatcom | Plans Available on Exchange Only |
| Skagit | Plans NOT Available |
| Snohomish | Plans Available on Exchange Only (PersonalCare option as well) |
| King | Plans Available on Exchange Only (only PersonalCare option) |
| Clark | LifeWise Plans NOT Available |
Things to keep in mind if you currently have a Premera Individual plan:
- You should receive a letter from Premera sometime this Fall stating how these changes will impact you. If your plan is still offered in your county, we suggest carefully reviewing the change in in-network providers.
- If you are a current client of VibrantUSA, we will be reaching out to you. Rest assured that we will assist you in finding the right plan for you in 2017.
- Open Enrollment is November 1, 2016 to January 31, Plan benefits for 2017 will not be available to view until October.
- If you initially enrolled in your plan on the Exchange, you may still need to go into your account to renew your plan selection for it to continue into 2017.
- If you did not enroll in your plan on the Exchange and would like to select a Premera plan for 2017, you will need to create an account at https://www.wahealthplanfinder.org
- Contact VibrantUSA with any questions. We’re here to help!
