Negotiation towards a settlement continues
Dear Local 29 Member,
We are contacting you today to let you know that the provider contract between Premera and MultiCare is expiring June 1, 2024. Both sides continue to negotiate towards a settlement and an extension prior to the June 1st termination date. We expect these contract negotiations will eventually be resolved, and we
believe it is likely MultiCare will remain in network with Premera. We also must acknowledge it is likely this will not happen before the June termination date.
The potential termination of the provider agreement between Premera and MultiCare could affect you in the following ways:
- First, state law requires Premera to notify their subscribers (meaning you and family members) within 30 days of any pending termination of a provider agreement. This means any participants who have seen a MultiCare provider in the past 12 months should receive a notification from Premera. This notification will outline what Premera believes will be the consequences of the termination of the provider agreement; how to access care; and which facilities will be impacted by this termination if it occurs.
- Second, should the termination stand, any care received from a MultiCare provider or at a MultiCare facility on/after June 1, 2024, will be paid at an out-of-network benefit level. This means higher cost shares for participants as most benefits will default to be subject to the Plan’s deductible, and the Plan will pay the out-of-network claims at 60% rather than the in-network rate of 80%.
- Third, the annual fire fighter exam itself, if completed at Rockwood Spokane Valley Primary Care, should not be impacted as Premera is not involved with the contract between the Trust and this clinic location. If you are seen for a routine primary care visit though or referred for follow up care or testing outside of the scope of the FF exam, these services would be billable through the Trust Health Plan. When the provider and/or facility is associated with MultiCare these services would be paid at the out of network benefit level (deductible then 60%).
NOTE: This does not impact our prescription drug benefit which is provided through Sav-Rx and NOT part of the MultiCare/Premera contract.
We recognize this is a significant inconvenience and potential financial hardship for many of you. Protection of provider choice is of key importance to all of us. We will continue to follow the negotiations very closely with great interest and keep you updated with developments as we are made aware. In the meantime, please call the Trust Office for specific questions about your coverage.
We appreciate your patience!