Premera & Providence - Big Network Changes. Part 1: changes to preferred provider status

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​Beginning 1/1/17, the entire Providence network will only have PPO status on some Premera plans.

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They’ve been negotiating back and forth, but finally Premera and Providence have come to an agreement that Providence providers will be included in SOME of the Premera networks. Here’s a quick overview of what you need to know:

• The change to the network access for these providers is effective 1.1.2017.
• This will affect ALL groups, regardless of their current renewal date.
• The Heritage Signature (small group) and Heritage Prime (large group) networks will move these providers to nonPPO.
• The Heritage (small group) and Heritage Plus (large group) networks will continue to provide PPO coverage for these providers
• Providence includes not only Providence, but also Swedish, Pacific Medical, and Kadlec.
• This affects not only the hospitals, but all clinics and providers under these groups as well.

In more breaking news...
 
Premera has just announced that if you have groups whose regular group renewal will occur after 1.1.2017 who will be affected by this network change, you can ask for an off-renewal quote.  Premera will provide a 1.1.2017 effective quote, illustrating plans/pricing for the larger network programs – but if you move a group on 1.1.2017 to one of these plans, you will be locking in 12-month rates and your group will now be part of the January 1st renewal cycle going forward. 

Not all plans are available with the larger network.  More to come on that!

​Now if we could just get Premera to change the names of their networks to something we can all keep straight!