Premera Plans Accepted at PacMed
Premera Exchange Plans:
Washington State school district employees will have standardized medical benefit options starting 1/1/2020 through the School Employees Benefits Board (SEBB). Open enrollment is 10/1/19 – 11/15/2019 and SEBB members can choose coverage through 1 of 3 insurance companies: Kaiser Permanente, Regence Blue Shield UMP (Uniform Medical Plan), or Premera Blue Cross.
Please note that PacMed is out-of-network with the 2020 Premera SEBB plans. SEBB members who currently have the Premera plan and wish to continue their care with PacMed at an in-network level should select a UMP or Kaiser plan listed in the in-network list below.
PacMed and PH&S Affiliates will participate in the Heritage Signature and Lifewise Connect exchange products
- Heritage Signature exchange plan - in network
The Premera Heritage Signature exchange plan is offered to individuals who reside in all WA counties outside of King, Snohomish, and Pierce for the benefit year. PacMed facilities and providers are in-network for the Heritage Signature plan
- Lifewise Connect exchange plan - in network
The Premera Lifewise Connect exchange plan is offered in all WA counties outside of King, Snohomish, and Pierce for the benefit year. PacMed facilities and providers are in-network for the Lifewise Connect plan
- Accountable Health System networks: PersonalCare Partner Systems and Personalized Care Alliance plans - out-of-network
The Premera Accountable Health System plans are ACO narrow network exchange plans offered in King, Snohomish, and Pierce counties in calendar year. ACO members must select a primary care provider within the ACO network. In the calendar year, ACO members have no out-of-network benefits outside of the ACO unless members receive a referral from the ACO provider with whom they enrolled, to a non-ACO provider
PacMed is not an in-network provider for Personal Care Partner Systems and Personalized Care Alliance (ACO) enrollees. However, individuals on these plans can seek care from PacMed facilities and providers at an in-network benefit level under the condition an authorized referral is received prior to service.
- Heritage Prime exchange plan - out-of-network
PacMed continues to remain out-of-network for all locations for the benefit year for the Premera Heritage Prime plan. Heritage Prime enrollees who seek care from out-of-network provider or facility may experience increased out-of-pocket expenses then if seeking care from a participating (in-network) provider or facility. If the individual Heritage Prime plan does not offer out-of network benefits, the enrollee will be responsible for incurred charges.