Benefits
Health/Dental/Vision
Benefit Plan Books
- 2024-2025 CBJ-Bartlett Premera Medical Plan Book
- 2024-2025 CBJ-Bartlett Premera Dental Plan Book
- 2024-2025 CBJ-Bartlett Premera Vision Plan Book
Benefit Plan Comparisons
Premera Plan Summary of Benefits
- CBJ *HDHP* Summary of Benefits 2023-2024
- JSD *HDHP* Summary of Benefits 2023-2024
- BRH *HDHP* Summary of Benefits 2023-2024
- CBJ *Economy Plan* Summary of Benefits 2023-2024
- JSD *Economy Plan* Summary of Benefits 2023-2024
- BRH *Economy Plan* Summary of Benefits 2023-2024
- CBJ *Standard Plan* Summary of Benefits 2023-2024
- JSD *Standard Plan* Summary of Benefits 2023-2024
- BRH *Standard Plan* Summary of Benefits 2023-2024
- CBJ *Economy Plan* Summary of Benefits 2022-2023
- JSD *Economy Plan* Summary of Benefits 2022-2023
- BRH *Economy Plan* Summary of Benefits 2022-2023
- CBJ *Standard Plan* Summary of Benefits 2022-2023
- JSD *Standard Plan* Summary of Benefits 2022-2023
- BRH *Standard Plan* Summary of Benefits 2022-2023
Medical Forms
Prescription Claim Forms
Other Employee Information
Transparency in Coverage – Public Access Requirement
The Public Access Requirement is a rule that requires group health plans and issuers to provide certain price information accessible to plan participants and other stakeholders. The files must be updated monthly and include the following detailed pricing information:
- In network: Negotiated rates for all covered items and services between the plan or issuer and in-network providers.
- Out of network: Historical payments to, and billed charges from, out-of-network providers. Files are not required if there are fewer than 20 claims for a service for a provider.
- Prescription drugs: In-network negotiated rates and historical net prices for all covered prescription drugs at the pharmacy location level (this requirement is delayed pending further rulemaking).
These files can be found here: https://premera.sapphiremrfhub.com.