Affiliation Documents
Plan Information
Premera Forms
- Small Group Employer Forms
- Individual Member Enrollment and Other Forms
Having trouble? Try this link.
Important New Group Submission Due Dates for 2025
Effective Date of Coverage
December
2024
January
2025
February
2025
March
2025
April
2025
May
2025
June
2025
July
2025
August
2025
September
2025
October
2025
November
2025
December
2025
January
2026
Submission Due Date
November 20
2024
December 20
2024
January 20
2025
February 20
2025
March 20
2025
April 21
2025
May 20
2025
June 20
2025
July 21
2025
August 20
2025
September 22
2025
October 20
2025
November 20
2025
December 22
2025