Premera Blue Cross

Learn about the Premera plans.

On this page: Full benefits | Summary of benefits | Costs | Find providers | Plan options | About Premera
Return to Medical plans and benefits: School employees | SEBB Continuation Coverage

Full benefits

The following documents—called a Benefits Booklet—provide in-depth descriptions of the benefits for each plan.

2025

• Premera High PPO Benefits Booklet (2025)
• Premera HMO Benefits Booklet (2025)
• Premera Standard PPO Benefits Booklet (2025)

2024

• Premera High PPO Benefits Booklet (2024)
• Premera HMO Benefits Booklet (2024)
• Premera Standard PPO Benefits Booklet (2024)

Summary of benefits

The following documents—called a Summary of Benefits and Coverage (SBC)—provide summaries of what each plan covers and what it costs.

2025

• Premera High PPO SBC (2025)
• Premera HMO SBC (2025)
• Premera Standard PPO SBC (2025)

2024

• Premera High PPO SBC (2024)
• Premera HMO SBC (2024)
• Premera Standard PPO SBC (2024)

Costs

2025

• School employee monthly premiums (2025)
• SEBB Continuation Coverage monthly premiums (2025)

2024

• School employee monthly premiums (2024)
• SEBB Continuation Coverage monthly premiums (2024)

Find providers

Visit one of Premera's online provider directories.

• High PPO and Standard PPO (Heritage Prime network)
• Premera HMO (Sherwood network)

Plan options 2025

Premera High PPO

The High PPO Plan comes with in-network access to over 2 million providers and hospitals nationwide. Watch a video to learn more about the High PPO plan or view the plan summary.

Annual costs

• Medical deductible: $750 per person / $1,875 family
• Prescription drug deductible: $125 per person / $312 family, waived for generic drugs
• Out-of-pocket limit: $3,500 per person / $7,000 family

Key features

• $0 preventive care
• No referrals for specialty care
• 24 annual visits each for massage, chiropractic and acupuncture
• Virtual care
• Access to 63,000 in-network pharmacies

Available counties

In most cases, you must live or work in the medical plan's service area to join the plan. All school employees are offered a selection of plans based on their county of residence or the county where their employment location is based. Some school employees may have more plan options if they work in a district that crosses county lines.

You can choose this plan if you live or work in one of these counties:

• Adams
• Asotin
• Benton
• Chelan
• Columbia
• Cowlitz
• Ferry
• Franklin
• Garfield
• Grant
• King
• Kitsap
• Kittitas
• Lewis
• Lincoln
• Okanogan
• Pend Oreille
• Pierce
• Skagit
• Skamania
• Spokane
• Stevens
• Thurston
• Wahkiakum
• Walla Walla
• Whatcom
• Whitman
• Yakima

If you move out of your plan's service area or change jobs to a different employment location, and your plan is no longer available, you must select a new plan. If you do not, the SEBB Program will enroll you in one. You must report your new address and any request to change your medical plan no later than 60 days after your move.

Who should consider this plan?

This plan is great for those looking for a lower deductible and predictable office visit copays.

Premera HMO

The Premera HMO provides in-network access to over 22,000 healthcare providers, including 28 hospitals, dozens of urgent care, primary care, and specialty care clinics. The growing network includes: EvergreenHealth, MultiCare Health System, Kinwell (primary care clinics), Mary Bridge Children's Hospital, Shriners Hospital for Children, Seattle Children's, and Virginia Mason. There is no out-of-network coverage except for urgent and emergency care (covered nationwide). Watch a video to learn more about Premera HMO or view the Plan summary.

Annual costs

• Medical deductible: $750 per person /$1,500 family
• Prescription drug deductible: none
• Out-of-pocket limit: $3,500 per person / $7,000 family

Key features

• $0 preventive care
• Referrals required for specialty care and some specialty prescriptions
• 24 annual visits each for massage, chiropractic, acupuncture
• Virtual care
• Access to 1,300 in-network pharmacies in Washington.

Available counties

In most cases, you must live or work in the medical plan's service area to join the plan. All school employees are offered a selection of plans based on their county of residence or the county where their employment location is based. Some school employees may have more plan options if they work in a district that crosses county lines.

You can choose this plan if you live or work in one of these counties:

• King
• Pierce
• Spokane
• Thurston

If you move out of your plan's service area or change jobs to a different employment location, and your plan is no longer available, you must select a new plan. If you do not, the SEBB Program will enroll you in one. You must report your new address and any request to change your medical plan no later than 60 days after your move.

Who should consider this plan?

This plan is great for those who want the lowest cost monthly premium available and low out-of-pocket costs.

Premera Standard PPO

Premera’s Standard PPO Plan comes with in-network access to over 2 million providers and hospitals nationwide. Watch a video to learn more about the Standard PPO plan or view the Plan summary.

Annual costs

• Medical deductible: $1,250 per person / $3,125 family
• Prescription drug deductible: $250 per person / $750 family, waived for generic drugs
• Out-of-pocket limit: $5,000 per person / $10,000 family

Key features of the plan

Best-in-class customer service, 24-hour virtual care, $0 preventive care, no referrals for specialty care, 24 annual visits each for massage, chiropractic, acupuncture, and access to 63,000 in-network pharmacies.

Available counties

In most cases, you must live or work in the medical plan's service area to join the plan. All school employees are offered a selection of plans based on their county of residence or the county where their employment location is based. Some school employees may have more plan options if they work in a district that crosses county lines.

You can choose this plan if you live or work in one of these counties:

• Adams
• Asotin
• Benton
• Chelan
• Columbia
• Cowlitz
• Ferry
• Franklin
• Garfield
• Grant
• Grays Harbor
• King
• Kitsap
• Kittitas
• Lewis
• Lincoln
• Okanogan
• Pacific
• Pend Oreille
• Pierce
• Skagit
• Skamania
• Snohomish
• Spokane
• Stevens
• Thurston
• Wahkiakum
• Walla Walla
• Whatcom
• Whitman
• Yakima

If you move out of your plan's service area or change jobs to a different employment location, and your plan is no longer available, you must select a new plan. If you do not, the SEBB Program will enroll you in one. You must report your new address and any request to change your medical plan no later than 60 days after your move.

Who should consider this plan?

This plan is great for those looking for a lower employee monthly premium and predictable office visit copays.

Plan options 2024

Premera High PPO

The High PPO Plan comes with in-network access to over 1.7 million providers nationwide. Watch a video to learn more about the High PPO plan or view the plan summary.

Annual costs

• Medical deductible: $750 per person / $1,875 family
• Prescription drug deductible: $125 per person / $312 family, waived for generic drugs
• Out-of-pocket limit: $3,500 per person / $7,000 family

Key features

• $0 preventive care
• No referrals for specialty care
• 24 annual visits each for massage, chiropractic and acupuncture
• Virtual care
• Access to 63,000 in-network pharmacies

Available counties

In most cases, you must live or work in the medical plan's service area to join the plan. All school employees are offered a selection of plans based on their county of residence or the county where their employment location is based. Some school employees may have more plan options if they work in a district that crosses county lines.

You can choose this plan if you live or work in one of these counties:

• Adams
• Asotin
• Benton
• Chelan
• Clallam
• Columbia
• Cowlitz
• Ferry
• Franklin
• Garfield
• Grant
• King
• Kitsap
• Kittitas
• Lewis
• Lincoln
• Mason
• Okanogan
• Pend Oreille
• Pierce
• Skagit
• Skamania
• Spokane
• Stevens
• Thurston
• Wahkiakum
• Walla Walla
• Whatcom
• Whitman
• Yakima

If you move out of your plan's service area or change jobs to a different employment location, and your plan is no longer available, you must select a new plan. If you do not, the SEBB Program will enroll you in one. You must report your new address and any request to change your medical plan no later than 60 days after your move.

Who should consider this plan?

This plan is great for those looking for a lower deductible and predictable office visit copays.

Premera HMO

The Premera HMO provides in-network access to over 22,000 healthcare providers, including 28 hospitals, dozens of urgent care, primary care, and specialty care clinics. The growing network includes: EvergreenHealth, MultiCare Health System, Kinwell (primary care clinics), Mary Bridge Children's Hospital, Shriners Hospital for Children, Seattle Children's, and Virginia Mason. There is no out-of-network coverage except for urgent and emergency care (covered nationwide). Watch a video to learn more about Premera HMO or view the Plan summary.

Annual costs

• Medical deductible: $750 per person /$1,500 family
• Prescription drug deductible: none
• Out-of-pocket limit: $3,500 per person / $7,000 family

Key features

• $0 preventive care
• Referrals required for specialty care and some specialty prescriptions
• 24 annual visits each for massage, chiropractic, acupuncture
• Virtual care
• Access to 1,300 in-network pharmacies in Washington.

Available counties

In most cases, you must live or work in the medical plan's service area to join the plan. All school employees are offered a selection of plans based on their county of residence or the county where their employment location is based. Some school employees may have more plan options if they work in a district that crosses county lines.

You can choose this plan if you live or work in one of these counties:

• King
• Pierce
• Spokane
• Thurston

If you move out of your plan's service area or change jobs to a different employment location, and your plan is no longer available, you must select a new plan. If you do not, the SEBB Program will enroll you in one. You must report your new address and any request to change your medical plan no later than 60 days after your move.

Who should consider this plan?

This plan is great for those who want the lowest cost monthly premium available and low out-of-pocket costs.

Premera Standard PPO

Premera’s Standard PPO Plan comes with in-network access to over 1.7 million unique providers nationwide. Watch a video to learn more about the Standard PPO plan or view the Plan summary.

Annual costs

• Medical deductible: $1,250 per person / $3,125 family
• Prescription drug deductible: $250 per person / $750 family, waived for generic drugs
• Out-of-pocket limit: $5,000 per person / $10,000 family

Key features of the plan

Best-in-class customer service, 24-hour virtual care, $0 preventive care, no referrals for specialty care, 24 annual visits each for massage, chiropractic, acupuncture, and access to 63,000 in-network pharmacies.

Available counties

In most cases, you must live or work in the medical plan's service area to join the plan. All school employees are offered a selection of plans based on their county of residence or the county where their employment location is based. Some school employees may have more plan options if they work in a district that crosses county lines.

You can choose this plan if you live or work in one of these counties:

• Adams
• Asotin
• Benton
• Chelan
• Clallam
• Columbia
• Cowlitz
• Ferry
• Franklin
• Garfield
• Grant
• Grays Harbor
• Jefferson
• King
• Kitsap
• Kittitas
• Lewis
• Lincoln
• Mason
• Okanogan
• Pacific
• Pend Oreille
• Pierce
• Skagit
• Skamania
• Snohomish
• Spokane
• Stevens
• Thurston
• Wahkiakum
• Walla Walla
• Whatcom
• Whitman
• Yakima

If you move out of your plan's service area or change jobs to a different employment location, and your plan is no longer available, you must select a new plan. If you do not, the SEBB Program will enroll you in one. You must report your new address and any request to change your medical plan no later than 60 days after your move.

Who should consider this plan?

This plan is great for those looking for a lower employee monthly premium and predictable office visit copays.

About Premera Blue Cross

Premera Blue Cross has provided health plans to school employees across the state since 1962. Premera is headquartered in Washington State and provides health benefits to 2.8 million people nationwide. Our SEBB plans are designed with school employees in mind and are backed by best-in-class customer service and the Blue Cross Blue Shield Association.