Medical

image

Who is eligible?

All Full-time employees scheduled to work at least 30 hours/week and are in a full-time position in UKG are eligible for coverage the 1st of the month following your date of hire.  For more information regarding who’s eligible, please visit the Eligibility page.

Premera Medical Plans

Aegis Living offers all full-time employees your choice of three medical plans through Premera Blue Cross:

  • The Low Cost Plan
  • Core Plan
  • Buy-Up Plan

 




Each of these plans give you access to a network of providers and hospitals who have agreed to accept pre-negotiated fees for their services – known as in-network providers. When you see an in-network provider, the amount you pay out of your pocket is usually lower than if you see an out-of-network provider. All plans provide in-network preventive services covered at 100% (deductible waived).

They also offer comprehensive services aimed at promoting overall well-being and addressing medical needs efficiently. We prioritize preventive care, providing regular check-ups, screenings, and vaccinations to help our members maintain optimal health and catch potential issues early. They also include prescription drug coverage ensuring access to necessary medications at affordable prices, fostering better management of chronic conditions and improving overall quality of life. With a focus on both prevention and treatment, our healthcare plan is committed to supporting the holistic health of our members, ensuring they receive the care they need when they need it most.

 

Low-Cost Medical Plan (In WA Heritage Prime Network Only.  In CA BlueCard Network)

This plan provides coverage for employees only at a cost of only $25 per pay period. This is a high deductible plan with allowable expenses covered in full after the calendar year deductible is met. This covers only in-network services. This may be a good option for employees who are healthy and have a history of minimal medical expenses.

 

Core Medical Plan and Buy-Up medical plans

These plans offer comprehensive coverage with lower deductible and out of pocket options than the Low Cost Plan. These plans have a higher cost per pay period but lower out of pocket costs.  In Washington you must choose between the Heritage (more comprehensive) network or the Heritage Prime network.  The California and Nevada plans use the BlueCard Network.

 

Flexible Spending Accounts

With all our plans, if you anticipate you will have out of pocket costs during the plan year, you may want to consider enrolling in the Healthcare Flexible Spending Account. This account allows you to set aside a fixed amount of dollars from your paycheck on a tax-free basis. Funds in the account can be used pay for covered out-of-pocket expenses for medical, dental, vision and prescription drugs without paying income tax. Please visit the Flexible Spending Accounts section for more information.

Network Options


Washington Network

There are two network options in Washington, the Heritage and Heritage Prime. The Heritage Prime network does not include certain providers, so claims from these providers will be processed with the out-of-network (lower) level of coverage, resulting in a higher out of pocket cost for you. The plans with the Heritage network will have higher monthly employee contributions than the plans with the Heritage Prime network because it gives you access to more in-network providers.


Low Cost Plan

Heritage Prime

  • Does not include: Providence, Swedish, Pacific Medical Group, CHI Franciscan Health, and Kadlec Regional Medical Center, or affiliated doctors and clinics.


Core Plan

Heritage Prime

  • Does not include: Providence, Swedish, Pacific Medical Group, CHI Franciscan Health, and Kadlec Regional Medical Center, or affiliated doctors and clinics.


Core Plan

Heritage

  • (Includes providers listed above)


Buy-Up Plan

Heritage Prime

  • Does not include: Providence, Swedish, Pacific Medical Group, CHI Franciscan Health, and Kadlec Regional Medical Center, or affiliated doctors and clinics.


Buy-Up Plan

Heritage

  • (Includes providers listed above)

 

California and Nevada

The California and Nevada plans use BlueCard network.

 

Other Network and Provider Options

 

Kinwell Primary Care – Washington Only

Washington employees also have access to primary care services just for Premera Blue Cross members! As a Premera member, you and your family have access to Kinwell clinics, which are delivering a new standard for primary care in Washington. You will have no cost shares for going to a Kinwell Clinic.

 

The Kinwell clinic experience includes:

  • Same- and next-day appointments
  • High quality, accessible, and patient-centered health care for the whole family
  • Integrated preventive services and behavioral health care
  • Virtual or in-person appointments with your provider of choice
  • Easy online scheduling
  • In-clinic lab tests


Schedule a virtual or in-person appointment today at www.kinwellhealth.com.

 

Designated Centers of Excellence (COE)

Premera’s goal is to make it as simple as possible for you to make a smooth recovery and get back to your life. Members have enhanced benefits at a Premera Designated Centers of Excellence for specific medical procedures.

 

Designated Centers of Excellence facilities are recognized for higher efficiency, lower costs and better patient outcomes for delivering specialty care. The eligible procedures for enhanced benefits are:

  • Maternity
  • Total hip & knee replacement

 

With Premera-Designated Centers of Excellence, you get handpicked doctors and hospitals that deliver quality care AND do it at a fair price. Besides saving on hospital costs, you can receive travel and care support so you can focus on getting back to feeling better.

 

Exclusive benefits and providers for

  • Lower cost surgery
  • Support services
  • Locations with proven records of exceptional patient experience and surgical outcomes


Please call 1-800-722-1471 or visit www.premera.com/specialty-care

 

 

ID cards


Once your enrollment paperwork has been processed, Premera will mail an ID card to your home address. You will receive an ID card for every family member you enrolled. When you receive your ID card, show it to your medical providers and pharmacy. You can also print an ID card from your online Premera account or access it on the Premera Blue Cross mobile app.

 

Premera Mobile App


Premera has a mobile app for you

Get your health plan info on the go with the Premera mobile app.


You’ll have convenient, anywhere access to your health plan information with Premera’s redesigned mobile app. With the app in hand, you can:

  • Find Care: Know where to go for care. Find in-network doctors, hospitals, urgent care, and more.
  • Access your ID card: Forgot your insurance card? Don’t worry. You can use your digital ID card to show your proof of coverage.
  • Check claims: View detailed claims information, including when we receive your claim, when we pay it, and what the provider may bill you.
  • Track your spending: Know exactly how close you are to meeting your deductible and out-of-pocket maximum.
  • Use touch ID to sign in to your Premera account: You won’t have to remember a password to sign in.
  • Be on top of prescription and pharmacy needs: Seamlessly move from the Premera mobile app to the ExpressScripts app, where you can set up reminders, order and refill prescriptions, and check drug prices.

 

Download the mobile app today so it’s ready when you need it. It’s free to download on Android and iOS.

 

You can also check claims, see your spending, and access ExpressScripts when you sign in to your account at www.premera.com.

 

Virtual Care—Primary Care/Urgent Care and Mental Health


Get care anytime, anywhere

 

Get care from your couch or on the go with virtual care. Get low cost, convenient and high-quality care for general medical and mental health needs through virtual care options provided through your health plan.

 

Get care virtually for:

  • Fast treatment and diagnosis for common ailments like flu, cold, UTIs
  • Routine checkups and management of chronic conditions
  • Therapy and medication management

 

Virtual care is available from the following providers as part of your health plan:

 

Connect to your virtual health apps directly on the Premera app or through the MyCare app.

 

Benefit Guides, Formularies and Summaries

 

 

Questions?

 

Contact Premera directly at:

 

Premera
www.premera.com
Group # 1007261
Customer Service: 1-800-722-1471
Out of Area Travel: 1-800-810-2583
24-Hour Nurse Line: (800) 841-8343
Mail Order Prescription Drugs: 1-800-391-9701


For assistance with benefits or provider bills, claim issues, pharmacy or prescription issues or guidance around difficult situations like denied procedures or appeals contact the Aegis Living Benefits Advocate at:


Aegis Living Benefits Advocate
bac.aegisliving@ajg.com
Phone (833) 262-1832 (toll free)
8:00 a.m. - 6:00 p.m. Monday - Friday
Language assistance is available.

 

If you need assistance with benefit plan eligibility or enrollment, contact the Aegis Living Benefits Department at:


Aegis Living Benefits Department
benefits@aegisliving.com
Phone: 1(425) 364-5190

 

If you need assistance accessing UKG, please reach out to Aegis IT Support at:


Aegis IT Support
support@aegisliving.com
www.helpdesk.aegisliving.com
Hours | Mon-Fri: 6am-11pm | Sat-Sun: 10am-2pm
Phone: 1-425-284-1626

 

 


Back