Please note that producer commissions will not be impacted by this announcement nor will it impact rate quotes for renewals. Employers do not need to apply for the relief and can expect to see premium relief applied to their August billing cycle.
Premera Blue Cross has announced that more than 200,000 of its commercial and individual customers across Washington and Alaska will receive up to $65 million in premium relief funds and premium rebates over the coming months.
These represent the latest steps Premera has taken to support its customers, health care providers and local communities during this pandemic.
“These are unprecedented times for our healthcare system. As hospitals and clinics cleared space for COVID-19 patients, many of our customers have paid for care they have been unable to fully access. While we believe demand for care will increase as restrictions are lifted, we also believe it is important to do what we can to help our customers and our communities manage this crisis,” said Jeff Roe, CEO and President of Premera Blue Cross.
Premera is committing up to $25 million to provide premium relief for small and large group commercial customers, many of whom have been particularly hard hit by the economic crisis in the wake of the COVID-19 pandemic. These employers can expect to see premium relief applied to their August billing cycle.
In addition, Premera is working to accelerate nearly $40 million in rebates required under the Affordable Care Act to Washington and Alaska customers who purchased their insurance in the individual market due to a requirement under the Affordable Care Act.
Health insurance carriers participating in the Affordable Care Act are federally required to spend at least 80% of the premiums they collect on health care services, like paying doctors and hospital bills, and efforts to improve health care quality, like improving patient safety. When payers don’t spend at least 80% on these services, they must return funds to individuals. Normally, customers would not see these rebates until late in the year. Premera is working to accelerate distribution of those rebates to later this summer.
Premera has also previously announced the following steps taken to support its customers:
- Waiving cost shares and deductibles for COVID-19 testing and related office visits and suspending prior authorization requirements on COVID-19 testing and treatment
- Increasing access to prescription medications by waiving early medication refill limits on 30-day prescription maintenance medications as well as encouraging customers to access their 90-day mail order benefit
- Waiving all telehealth cost shares and deductibles for virtual health services from both virtual vendors and brick-and-mortar providers offering telehealth services, as well as rapidly expanding its telehealth offerings with 98point6, Doctor on Demand, Workit Health and Boulder Care to meet increased demand for at-home virtual primary care, mental health care and substance use disorder treatment visits, at little to no cost
- Contributing more than $450,000 to community foundations across Washington and Alaska to support our communities’ vulnerable populations, through Premera Social Impact, the corporate social giving arm of the company The group is also actively working with existing nonprofit partners to meet short- and long-term needs in response to COVID-19
Additional steps Premera has taken to support its providers during the COVID-19 pandemic include the following:
- Providing up to $100 million in financial support in the form of advance payments of claims to medical, dental and behavioral health providers facing significant financial pressures due to the pandemic
- Removing prior authorization for skilled nursing facility admissions and expediting or removing prior authorizations for services required to discharge patients
- Extending medical and pharmacy prior authorization effective dates to reduce the need for resubmission after the COVID crisis and lifting restrictions on early medication refills
- Implementing CMS guidance on place-of-service billing for telehealth claims during the public health emergency
- Expanding and encouraging use of telehealth access and removing cost shares for those services
- Removing member cost share for COVID-19 testing and medically proven treatment during the crisis
- Delaying recoupment of overpayments during the healthcare crisis
Learn more about Premera’s response to the COVID-19 outbreak for our customers.
If you have any questions on our small group plans and processes, please contact Connexion’s PBC WA Small Group Team