Puget Sound Electrical Workers Trusts

January 1st through December 31st.

January 1st through December 31st.

Tier I and non-PPO network providers: Premiums, balance-billed charges, prescription drug copays, penalties for failure to obtain preauthorization, healthcare this plan does not cover, chiropractic, acupuncture, physical, occupational and speech therapy, home health care, hospice, orthotics, and diabetic education. Tier II: Premiums, balance-billed charges, penalties for failure to obtain preauthorization and health care this Plan doesn’t cover.

Premera Blue Cross (WA and AK), Blue Card-Blue Cross in all other States. (Does not apply to Medicare Retirees or Medicare eligible dependents.)

Visit www.premera.com, login as a visitor and select the Heritage and Heritage Plus 1 option or call 800-810-2583.

Your identification number is listed on your ID card. Your identification number begins with the letters LIT (Medicare Retirees and Medicare eligible dependents will not have leading letters in front of their identification number).

Click here for Costco’s prescription ordering FAQ.