General Updates:
Enrolling A Newborn Baby on your Health Plan
Newborn children will be covered by the plan automatically when the mother is covered under a WCIF medical plan for the first 3 weeks (21 days) from their date of birth in accordance with RCW 48.43.115 (otherwise known as the “Erin Act”). To extend the child’s coverage beyond the 3-week period or to enroll the child from birth, if the child qualifies as an eligible dependent, a completed enrollment form is required within 60 days of birth.
If a newborn is not enrolled within 60 days, the newborn’s coverage will cease on the 22nd day of life and the child will be ineligible to enroll in the plan until the following open enrollment period.
Plan Booklets Now Available
We’re pleased to share that the Dental and Vision plan booklets are now available on the WCIF website at wcif.net/plan-information. These resources provide helpful details about plan coverage, benefits, and member information.
Medical plan booklets are in the process of being finalized and will be posted to the website soon. Please check for updates and feel free to share these materials with your team as needed.
Premera: Reminders & Updates
Premera Mailer Reminds Members to Set Up Online Account
The easiest way for members to access information about their health plan is by setting up an account on premera.com and using the Premera mobile app for when members are on the go. To encourage members to sign up for their accounts, Premera Blue Cross sent postcards in December 2025 and another mailing will go out in February 2026.
Why it’s important to have an online account
After setting up an online account, members can:
- Search providers, hospitals, and urgent care facilities specific to their network
- Review benefit details, explanation of benefits, and claim status
- Access virtual care services for a variety of conditions
- Create better healthcare solutions for all members by adding their demographic information
Deployment dates and recipients
December 2025 mailing: This mailing was sent to members with plan effective dates September through November who haven’t registered for an online account.
February 2026 mailing: This mailing will go to members with plans effective January 1 who haven’t registered for an online account.
Contact Premera customer service at 1-800-722-1471 for more information.
Annual Gag Clause Prohibition Compliance Attestation
The Consolidated Appropriations Act (CAA) of 2021 prohibits group health plans and health insurance issuers from entering into certain agreements with services providers. Specifically, agreements that would directly or indirectly restrict a group health plan or an insurer from providing provider-specific cost or quality of care information or data; electronically accessing de-identified claims and encounter information or data for each enrollee; or sharing that information or data with a business associate.
The CAA requires group health plans and issuers to report compliance with the Gag Clause Prohibition provision annually to the Department of Health and Human Services (HHS). The latest Gag Clause Prohibition Compliance Attestations (GCPCA) were due December 31, 2025.
Premera successfully submitted the annual Gag Clause Prohibition Compliance Attestation to HHS as required on behalf of our fully insured groups on December 18, 2025.
Subrogation Vendor Changes Name to Machinify
Effective immediately, the vendor Premera Blue Cross and Premera Blue Cross HMO uses for subrogation, coordination of benefits (COB), and other payment integrity cases has changed their name from Rawlings to Machinify.
Machinify, formerly known as The Rawlings Group, has played a leading role in all major legal issues that have impacted the subrogation/reimbursement industry. The company is well-versed in laws for each state.
Contact Premera customer service at 1-800-722-1471 for more information.
1095-B Forms Available Online
IRS rules no longer require Premera to mail 1095-B forms automatically. These forms will now be available digitally through members’ secure accounts at premera.com.
What you can do
Encourage your groups to promote premera.com account creation. In addition to the 1095-B forms, members can access their explanation of benefits claims status, virtual care offerings, and more.
WA HB 1971 – Access to Hormone Therapy Medication
Washington House Bill 1971 requires health plans to allow members to receive a full 12-month supply of prescription hormone medication at one time, if they choose. The bill aims to improve access to prescription hormone medications, especially for people in rural areas or with limited resources.
For information on which drugs are included, view the following Prescription Drug Hormone Lists.
This rule applies to drugs taken regularly that can be stored at room temperature. A smaller supply may be given if the patient asks for it, the provider orders it, or the drug is a controlled substance. For controlled substances, the plan covers up to the legal refill limit. Health plans may still use drug management strategies based on clinical guidelines to support safe and effective care.
The change applies to Washington fully insured groups beginning on or after January 1, 2026.
Machine-Readable File Link Update
On October 29, 2020, federal agencies released the Transparency in Coverage final rules. Among other provisions, the rules require that group health plans and health insurance issuers create and publish machine readable files containing certain pricing information on a publicly accessible website. Employers, particularly self-funded, may publish this link on their own internal or external websites for compliance purposes.
What’s changing?
Starting January 1, 2026, the link currently used to access Premera machine-readable files will change.
Employer Groups that use this link on their website or embedded in any digital materials must update it immediately to ensure uninterrupted access.
Kaiser Permanente: Tools for Members – kp.org and the Kaiser Permanente App
Members have access to information and tools to better manage their health so they can:
- Schedule, review, or cancel routine appointments
- Complete an e-visit, phone visit, or video visit
- Email their doctor
- Fill and refill most prescriptions
- View most test results and immunizations
- View their digital ID card
- Pay bills and see cost estimates
Around the clock care
Scheduled and no-appointment-needed 24/7 phone and video visits, e-visits, 24/7 advice, and the ability for employees to email their doctor nonurgent questions on kp.org are convenient alternatives that offer high quality care, comparable with an in-person visit. To find all the ways to obtain care, visit kp.org/getcare.
Delta Dental: The Tooth Fairy Experience
In this magical adventure, the Tooth Fairy travels (or virtually visits) to teach kids how to take care of their smiles.
The program includes three exciting lessons:
- Brushing, flossing, and dentist visits.
- The importance of baby teeth.
- How eating healthy helps keep teeth strong.
Each 30-minute session is packed with interactive activities like dental health puppets, or a sweet science experiment to show how much sugar is hiding in chocolate milk or soda, keeping kids engaged while they learn great dental habits!
The Tooth Fairy Experience also provides resources for parents, dentists, and participates in community events.
Contact hello@toothfairyexperience.com for more information or to schedule a visit.
Vision Service Plan (VSP): Helping You Choose the Right VSP Vision Plan for Your Employees
When offering multiple VSP plan options, one of the most common questions employees have during enrollment is, “Which plan is right for me?” Providing a clear understanding of how each plan functions can help your employees make more confident elections and better utilize their vision benefits throughout the year.
Here’s a helpful way to position each plan when communicating with your team:
- Extended Plan – Best for employees who plan to purchase more than one pair of glasses. Offers valuable discounts on additional eyewear beyond the primary pair.
- Standard Plan – Balanced, straightforward coverage with predictable costs. A practical choice for employees who want simple, dependable benefits.
- EasyOptions Plan – Provides flexibility at the doctor’s office by allowing employees to choose the lens upgrade that saves them the most. Ideal for those who need progressive lenses or premium enhancements.
- Budget Plan – Lowest monthly cost. Works well for employees who need basic vision care and are comfortable paying more out of pocket for lens enhancements if needed.
When communicating these options, encouraging employees to consider how often they purchase glasses, whether they use lens enhancements, and how they prefer to balance monthly costs with out-of-pocket expenses can help them select the plan that best aligns with how they use their vision benefits.