Changes to PEBB benefits for 2025

The Public Employees Benefits Board (PEB Board) has authorized the following changes effective January 1, 2025. The Public Employees Benefits Board (PEBB) Program will provide more information about these and other changes in October before annual open enrollment.

Annual open enrollment dates have changed and are October 28 through November 25, 2024.

Policy changes

All changes to PEBB rules will be available at PEBB rules and policies and take effect January 1, 2025, unless otherwise noted. The PEB Board has passed resolutions that make the following changes:

• Vision plans: Beginning January 1, 2025, the PEBB Program will offer standalone vision plans from EyeMed, Davis Vision by MetLife, and MetLife Vision.
• Default vision plan: Employees who do not make a timely vision plan election will be enrolled in MetLife Vision.
• Dual enrollment: Public employees or school employees and their dependents may be enrolled in medical, vision, and dental benefits in either the PEBB or SEBB Program (not both). If they try to enroll in some PEBB and some SEBB benefits, they will be auto-enrolled or disenrolled according to WAC 182-12-123 and 182-31-070.
• For subscribers enrolled in Medicare: Automatic enrollment – UMP Classic Medicare annual open enrollment 2024: All Medicare enrollees who are enrolled in UMP Classic Medicare as of December 31, 2024, and who did not make an election during PEBB annual open enrollment in 2024 will be auto-enrolled in UMP Classic Medicare with Part D drug coverage effective January 1, 2025.

Changes to PEBB plans

• Routine vision coverage will be removed from the medical plans for non-Medicare plans. There will be three separate vision plans available. State agency or higher-education employees must choose a vision plan or they will be enrolled in MetLife Vision. Note: If you work for a city, county, port, tribal government, water district, hospital, etc., contact your payroll or benefits office to check if your employer will offer this benefit.
• Vision hardware benefit under your new vision plan will increase to $200 (from $150) for prescription eyeglasses or contact lenses and will reset on odd years (2025, 2027, etc.). This benefit is for members enrolling in standalone vision coverage in 2025.
• Flexible spending arrangements (FSAs): The annual maximum contribution for the FSA and Limited Purpose FSA will increase to $3,200. Note: The FSA was formerly called the Medical FSA.
• Health savings accounts (HSAs): The IRS raised the health savings account annual maximum contribution to $4,300 for single subscribers and $8,550 for families.
• Deductible for CDHPs: The IRS raised the minimum deductible for high-deductible health plans to $1,650 for single subscribers and $3,300 for families.
• Reduction in cost for inhalers and epinephrine injectors: Out-of-pocket costs will be capped at $35 for a 30-day supply of inhaled corticosteroids or inhaled corticosteroids combination products, and epinephrine autoinjectors. (Exception: Does not apply to Medicare plans.)
• Increasing access to Human Immunodeficiency Virus (HIV) Post-Exposure Prophylaxis (PEP): Plans will be prohibited from cost-sharing or prior authorization requirements for at least one full PEP regimen.

Health plan changes

Kaiser Permanente of the Northwest (KPNW):

• myStrength discontinued: Members will no longer have access to myStrength, now known as Teladoc Health, as of July 31, 2024.
• Subscribers enrolled in Medicare:
  • Changing from an MA to an MAPD plan: The Senior Advantage plan is changing from Medicare Advantage to Medicare Advantage plus Medicare Part D for prescription drugs. The name will change to Kaiser Permanente NW Senior Advantage with Part D.
  • Hearing aids: Members can use the hearing aid benefit of $3,000 per ear every 36 months.
  • Vision hardware: Increasing from $150 to $200 every 24 months.

Kaiser Permanente of Washington (KPWA):

• Clinics closing. KPWA will close its Ballard, Gig Harbor, and Poulsbo medical facilities effective December 13, 2024. Visit Kaiser’s announcement for details.
• End stage renal disease dialysis benefit: Members who have end stage renal disease (ESRD) qualify for Medicare after a 90-day waiting period. Once a member becomes eligible for Medicare, the plan will waive cost-sharing for dialysis and reimburse members for the Medicare Part B premium.
• Advanced Care at Home program discontinued. Members will have access to services at home through their care providers, as available. Cost-shares will apply based on the services provided.
• myStrength discontinued: Members will no longer have access to myStrength, now known as Teladoc Health, as of July 31, 2024.
• Subscribers enrolled in Medicare:
  • Changing from an MA to an MAPD plan: The Kaiser Medicare Advantage plan is changing from Medicare Advantage to Medicare Advantage plus Medicare Part D for prescription drugs. The name will change to Kaiser Permanente WA Medicare Advantage with Part D.
  • Hearing aids: Members can use the hearing aid benefit of $3,000 per ear every 36 months.
  • Kaiser Permanente WA Original Medicare plan will no longer be offered. Kaiser members in Benton, Columbia, Franklin, Walla Walla, Whitman, Yakima, and Mason County ZIP code 98560 must choose a new plan.

Uniform Medical Plan

• Diagnostic and supplemental breast exam coverage: Diagnostic and supplemental breast exams will be covered without cost to members. UMP Consumer-Directed Health Plan (CDHP) members need to meet their deductible before the plan will pay.
• Diabetes management program: Non-Medicare members will have access to a new diabetes management program that will offer personalized support.
• UMP Plus–Puget Sound High Value Network (PSHVN) will no longer be available in Chelan or Douglas County. Members in Chelan and Douglas counties must change plans. Confluence Health will no longer be part of UMP Plus–PSHVN.
• Washington State Rx Services (WSRxS) has changed its name to ArrayRx.
• Subscribers enrolled in Medicare: UMP Classic Medicare will include Medicare Part D for prescription drugs. The plan name will change to UMP Classic Medicare with Part D (PDP).

UnitedHealthcare (UHC):

• Subscribers enrolled in Medicare: Hearing aids — Members can use the hearing aid benefit of $3,000 per ear every 36 months through a UnitedHealthcare Hearing provider.

LTD insurance

Employee-paid long-term disability (LTD) insurance rates will decrease effective January 1, 2025.

2025 monthly premiums: employees

The PEB Board has authorized the following monthly premiums for 2025. All figures are rounded to the nearest dollar. If you would like to see if the premiums are different from your current premiums, see 2024 premiums.

State agency and higher-education employees

Employees who work for a city, tribal government, county, port, hospital, etc., must contact their payroll or benefits office to get their monthly premiums.

Notes:

• SRDP is state-registered domestic partner.
• Kaiser Foundation Health Plan of the Northwest offers plans in Clark and Cowlitz counties in Washington and select counties in Oregon.

Subscribers may also have to pay the following monthly premium surcharges.

• Tobacco use premium surcharge if you or any enrolled dependents use tobacco products: $25
• Spouse or state-registered domestic partner coverage premium surcharge if you enroll your spouse or SRDP and they choose not to another employer-based group medical that is comparable to PEBB’s Uniform Medical Plan (UMP) Classic: $50