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Premera to expand HMO service area, add doula reimbursement and site‑of‑service discount
Summary
Premera plans for 2027 will expand an HMO service area to Snohomish County, offer a $1,000 per‑pregnancy doula reimbursement (receipt and claim form required), add a 10% coinsurance discount for certain in‑network birthing centers/ASCs and change urgent‑care and ER cost shares.
Premera Blue Cross representatives (via the agency presentation) told the board the carrier will expand its HMO service area to include Snohomish County in 2027 and that its doula benefit will use a reimbursement model requiring member submission of receipts and a doula claim form for up to $1,000 per pregnancy.
Staff also described a site‑of‑service incentive: an across‑the‑board 10% discount on coinsurance for in‑network freestanding birthing centers and ambulatory surgical centers intended to steer members to high‑quality, cost‑effective care. The presentation noted urgent‑care and emergency‑care copays are increasing in several plan designs while some deductible waivers will change how members pay at point of service.
