Enhanced OON Savings Solution helps Alaska employers manage costs with greater precision

Beginning 2027, Premera is enhancing the Out-of-Network (OON) Savings Solution to give Alaska self-funded and fully insured employers additional tools to manage healthcare cost volatility without disrupting member access to care. Although in-network utilization remains high, averaging 98%, there continues to be areas of intervention where Premera can help clients save. The updated approach is designed to support long-term affordability while strengthening protections where out-of-network pricing has become increasingly unpredictable.

Self-funded enhancements

A small number of out-of-network service categories have become significant drivers of cost volatility. In some cases, billed charges have moved well beyond market norms, creating unpredictable costs for employers and increasing the potential for member balance-bill exposure. Premera will use category-specific reimbursement approaches that better align with market realities which can help employers reduce exposure to disproportionate claim costs.

OON Savings Solution will also include a targeted member advocacy safety net. When an eligible high-dollar balance bill arises and standard repricing or negotiation efforts are unsuccessful, Premera will engage directly with the provider to help resolve the situation and reduce member stress during complex billing scenarios.

The evolution of OON Savings Solution doesn’t replace existing out-of-network oversight. All OON claims continue to be managed through our broader cost-protection framework, which includes:

• Single Case Agreements
• No Surprises Act administration
• Dialysis management
• Supplemental network
• Supplemental negotiations

The result is a balanced evolution of the OON Savings Solution—one that combines more precise cost management with enhanced member support.

What’s changing for fully insured groups

In 2027, OON Savings Solution for fully insured groups will expand to include supplemental networks and negotiations. When a Single Case Agreement doesn’t meet the need, Premera leverages secondary pre-negotiated network arrangements and post-service negotiations. This design includes built-in contractual safeguards to save on the claim and protect the member from balance billing.

For Alaska employers, the approach is intended to create greater predictability, improve stewardship of healthcare dollars, and support sustainable affordability over time.

Contact your Premera account representative to learn more about OON Savings Solutions for your clients.