U.S. benefits-eligible employees and spouses/domestic partners who are enrolled in a Premera or Kaiser Foundation Health Plan of Washington medical plan through Microsoft may be eligible to participate in the weight management program. Dependents are not eligible for this program.

 Eligibility criteria include:

• Having a Body Mass Index (BMI) greater than or equal to 30

• Or having a BMI greater than or equal to 27 and being diagnosed with two or more of the following conditions: Congestive heart failure, Coronary heart disease, Depression, Diabetes, High cholesterol (hyperlipidemia), High blood pressure (hypertension), Sleep Apnea.

   

What’s covered

The Weight Management Program includes:

• One-on-one meetings with a physician who oversees your personalized program

• Individual counseling with a registered dietician 

• Exercising with a certified personal trainer

• Group meetings for lifestyle modification

   

The initial minimum 10-week period of frequent sessions with program professionals is followed by a minimum three-month maintenance period, which includes regular follow-up visits.

How it works 

Using the Weight Management Program is simple. Here’s how you can get started:

1. Download the Weight Management Recommendation Form and have your primary care or regular physician complete and submit it to Premera (even if you or your spouse/domestic partner are Kaiser Foundation Health Plan of Washington enrollees). Your physician may also require lab work to confirm cholesterol and glucose readings. Premera will then confirm eligibility to the physician.

1. Select an approved provider within six months of receiving approval to participate in the program. If you do not hear from your physician within seven business days, please contact your physician or Premera directly.

    

Select a provider 

Within six months of receiving approval to participate in the program, you must select an approved provider. You can select either a virtual provider, South Health Connects, or an approved provider in your state. To view a list of virtual or in-person providers, go to the  Approved Weight Management Providers list. 

Can't Find a Provider in Your Area?

The Weight Management Program is administered by Premera. For this reason, all eligible weight management providers must be approved by Premera. This applies to Premera and Kaiser Foundation Health Plan of Washington enrollees. 

If you can't find a provider in your area and want to submit a recommendation for a new one, you must complete a nomination form and then send it to Premera for consideration. To submit your recommendation, submit a Premera Provider Nomination Form. 

Note: Not all recommended providers meet the criteria to become a Microsoft weight management provider. It can take several months before new providers are approved to provide services to Microsoft participants. 

Request reimbursement

Reimbursement for the Weight Management Program occurs in one of two ways. The program you attend determines which claims methods applies. 

Method 1: Direct Reimbursement to Enrollee 

With this method, the weight management provider bills you directly and then you request reimbursement from Premera. To receive reimbursement:

Submit a Weight Management Program Interim Billing Claim Form to Premera with receipts for services paid. If an initiation fee was charged, it can be reimbursed if you haven't maximized your benefit and completed the program. Final confirmation of program completion must be submitted with your final biometric information on the Weight Management Program Final Billing Claim Form.

Method 2: Direct Reimbursement to Provider

With this method, Premera reimburses the weight management provider directly on a monthly or quarterly basis. 

The provider may collect a deposit from you at the start but will bill Premera for ongoing participation.

Flexible Spending Accounts and Reimbursement

If enrolled in the Health Savings Plan (Premera), you can use the Health Savings Account (HSA) for out-of-pocket expenses related to the weight management program. You can request reimbursement for your 20 percent cost share, as well as any amount that exceeds the $6,000 lifetime maximum, for eligible expenses. Program fees aren't subject to the deductible and the coinsurance maximum doesn't apply.

You cannot use Limited Purpose Health Care FSA funds for weight management program expenses. 

Note: If you don't complete the Weight Management Program, you may be responsible for certain costs depending on the length of participation. Check with your program provider for specific cost information.