February 16, 2023
EvergreenHealth officials have notified Premera that it does not intend to renew its health plan contracts with Premera Blue Cross for any lines of business effective April 1, 2023. This termination applies to EvergreenHealth’s hospital in Kirkland, as well as their specialists, urgent care, primary care, and specialty care facilities throughout King and Snohomish counties. EvergreenHealth’s hospital in Monroe is not included in the termination. It is important to note that we are still meeting with EvergreenHealth regularly and are focused on reaching an agreement that allows our members to continue seeing their providers in-network at EvergreenHealth.
We have been working hard on your behalf to reach a reasonable agreement with EvergreenHealth. We value the diversity of our provider partners, but we are disappointed in EvergreenHealth’s decision to terminate as it is incredibly disruptive to our members.
EvergreenHealth’s initial renewal rate increase request was far beyond what we believe is reasonable, and after our last offer, they sent us a termination notice. We understand we are in unprecedented economic times, and we want to do our part to help. However, our role is to be an advocate for our customers’ dollars. Unreasonable rate increases cause financial harm to our shared customers at a time when we’re all focused on making healthcare work better by reducing costs while keeping quality high.
Along with a reasonable rate increase, we are committed to working with EvergreenHealth on realistic, practical solutions that drive down costs. Premera’s role is to be good stewards of your dollars, while also helping set EvergreenHealth up for long-term financial success.
For impacted groups, here are some key points that you and your employees should know:
- We are currently in active negotiations with EvergreenHealth. We will keep you updated on the status of these negotiations, especially as we get closer to the April 1 deadline.
- Members will receive notification of the effective date of the EvergreenHealth termination on March 1 if an agreement isn’t reached by then. This notification will also list nearby facilities that are in-network.
- The Washington State Office of the Insurance Commissioner requires Premera to provide notification of any provider termination 30 days in advance.
- If we are not able to reach an agreement with EvergreenHealth by April 1:
- Urgent and emergency care will still be covered at EvergreenHealth Hospital in Kirkland.
- Non-urgent or non-emergent care may not be covered, or will cost more out of pocket, if members see a provider associated with EvergreenHealth.
- Members can use our Find a Doctor tool in our mobile app or on the website to find nearby in-network care.
For additional information, contact your Premera representative or producer.