Premera Blue Cross in contract negotiations with MultiCare

Washington State Health Care Authority sent this bulletin at 05/14/2024 01:09 PM PDT

5.14.2024

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Premera Blue Cross in contract negotiations with MultiCare; also affects UMP members in Spokane County

Premera Blue Cross is currently in negotiations with MultiCare to extend its contract, which is scheduled to end May 31, 2024. This affects Premera Blue Cross PPO members in the School Employees Benefits Board (SEBB) Program. This does not affect SEBB members enrolled in Premera’s HMO plan with the Sherwood HMO network. Affected Premera Blue Cross members may continue to receive care from MultiCare at the network rate through May 31, 2024.

Note: This also affects Uniform Medical Plan (UMP) members in the Public Employees Benefits Board (PEBB) and SEBB Programs in Spokane County, as Premera is the exclusive BlueCross BlueShield plan for Spokane County. MultiCare facilities in Spokane include MultiCare Deaconess Hospital, MultiCare Valley Hospital, and Rockwood Clinic. This does not affect PEBB members who have coverage through a Premera Medicare Supplement plan (Plans F and G).

According to its announcement, Premera Blue Cross is working with MultiCare on a new contract and hopes to reach an agreement to avoid any disruption in care. If an agreement is reached, Premera will send a follow-up letter to its affected members. HCA will update this announcement as more information is available.

What will happen if an agreement is not reached?

On or after June 1, 2024, members receiving non-emergency services from MultiCare will be responsible for out-of-network charges.

Members currently receiving services from MultiCare for certain conditions may have the right to continue treatment at the in-network rate for a limited time under a continuity of care provision.

Eligible conditions for continuity of care include:

Seeing the provider for a serious or complex condition.
Undergoing a course of institutional or inpatient care.
Being scheduled for a nonelective surgery, including post-operative care.
Being pregnant and receiving pregnancy-related care.
Receiving treatment for a terminal illness.

Members may check their plan’s benefits booklet for more information or call their plan’s Customer Service.

Who can I contact with questions?

SEBB members:

If you’re enrolled in Premera Blue Cross: Call Premera Blue Cross Customer Service at 1-800-807-7310 (TRS: 711) or visit the Premera SEBB website.
If you’re enrolled in UMP: Call UMP Customer Service at 1-800-628-3481 (TRS: 711) or visit the UMP SEBB website.

PEBB members enrolled in UMP: Call UMP Customer Service at 1-888-849-3681 (TRS: 711) or visit the UMP PEBB website.

Premera Blue Cross Contract Negotiations

About the Health Care Authority (HCA)

Functioning as both the state's largest health care purchaser and its behavioral health authority, the Washington State Health Care Authority (HCA) is a leader in ensuring Washington residents have the opportunity to be as healthy as possible.

There are three pillars of our work: Apple Health (Medicaid); the Public Employees Benefits Board (PEBB) and School Employees Benefits Board (SEBB) programs; and behavioral health and recovery. Under these pillars, HCA purchases health care, including behavioral health treatment for more than 2.7 million Washington residents and provides behavioral health prevention, crisis, and recovery supports to all Washington residents.

Please do not reply directly to this message. For more information, visit the HCA website, where you'll also find contact information.

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