Meetings and materials
Get the Public Employees Benefits (PEB) Board meeting schedule, along with agendas, briefing books, and minutes.
Members of the public are welcome to attend a PEB Board meeting and provide comment.
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2025 meeting schedule
All meetings start at 9 a.m., unless otherwise noted.
- January 30, 2025 (Board retreat)
- March 13, 2025
- April 10, 2025
- May 15, 2025
- June 12, 2025
- June 26, 2025
- July 10, 2025
- July 17, 2025
- July 24, 2025
- July 31, 2025
Meeting materials
2024
| Date | Meeting materials |
|---|---|
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August 5 Special meeting |
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| July 11 | |
| June 27 | |
| June 13 | |
| May 9 | |
| April 11 | |
| March 21 | |
| February 1 |
- 2023 meeting materials
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Date Meeting materials July 19 July 12 June 29 June 8 May 11 April 13 March 9 February 2 - 2022 meeting materials
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Date Meeting materials July 20 July 14 June 30 June 9 May 12 April 14 March 10 January 26 - 2021 meeting materials
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Date Meeting materials July 21 July 14 June 30 June 9 May 12 April 14 March 17 January 27
- 2020 meeting materials
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Date Materials July 22, 2020 July 15, 2020 June 17, 2020 May 28, 2020 April 15, 2020 April 2, 2020 January 30, 2020
Approved resolutions
- 2024 resolutions
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Date Title Description Number 08/05/24 Amending Resolution PEBB 2024-36 UMP 2025 Medicare premium Amending PEBB 2024-36 to read:
The PEB Board authorizes the Uniform Medical Plan (UMP) Classic Medicare with Part D (PDP) premium as presented at the August 5, 2024 Board meeting.
2024-37 07/11/24 Uniform Medical Plan (UMP) 2025 Medicare Premium The PEB Board authorizes the Uniform Medical Plan (UMP) Classic Medicare with Part D (PDP) premium.
On August 5, 2024, the PEB Board amended 2024-36. Please see resolution PEBB 2024-37 for new language.
2024-36 07/11/24 Premera 2025 Medicare Premiums The PEB Board authorizes the Premera Medicare Supplement premiums. 2024-35 07/11/24 UnitedHealthcare (UHC) 2025 Medicare Premiums The PEB Board authorizes the UnitedHealthcare Medicare Advantage with Part D premiums. 2024-34 07/11/24 Kaiser Foundation Health Plan of Washington (KPWA) 2025 Medicare Premium The PEB Board authorizes the Kaiser Foundation Health Plan of Washington Medicare Advantage with Part D premium. 2024-33 07/11/24 Kaiser Foundation Health Plan of the Northwest (KPNW) 2025 Medicare Premium The PEB Board authorizes the Kaiser Foundation Health Plan of the Northwest Senior Advantage with Part D premium. 2024-32 07/11/24 2025 Medicare Explicit Subsidy The PEB Board authorizes the calendar year 2025 monthly Medicare Explicit Subsidy of $183 or 50% of premium, whichever is less. 2024-31 07/11/24 Uniform Medical Plan (UMP) Non-Medicare 2025 Premiums The PEB Board authorizes the Uniform Medical Plan (UMP) employee and Non-Medicare retiree premiums. 2024-30 07/11/24 Kaiser Foundation Health Plan of WA (KPWA) Non-Medicare 2025 Premiums The PEB Board authorizes the Kaiser Foundation Health Plan of Washington employee and Non-Medicare retiree premiums. 2024-29 07/11/24 Kaiser Foundation Health Plan of the Northwest (KPNW) Non-Medicare 2025 Premiums The PEB Board authorizes the Kaiser Foundation Health Plan of the Northwest employee and Non-Medicare retiree premiums. 2024-28 06/27/24 Automatic Deferral - PEBB retiree insurance coverage for Medicare subscribers who permanently live in a location outside of the United States All Medicare enrollees who are enrolled in UMP Classic Medicare with creditable drug coverage as of December 31, 2024 and permanently live outside of the United States, where the subscribers did not make an election during the PEBB annual open enrollment period held in 2024, will be automatically deferred from PEBB retiree insurance coverage with an effective date of January 1, 2025. These subscribers will be exempt from the deferral form requirement. 2024-27 06/27/24 PEBB retiree insurance coverage deferral - permanently live in a location outside of the United States Effective January 1, 2025, retirees and survivors who are enrolled in Medicare may defer enrollment in PEBB retiree insurance coverage when they permanently live in a location outside of the United States. Evidence of continuous enrollment in a qualified coverage is waived while a retiree or survivor enrolled in Medicare lives outside of the United States.
A retiree or survivor enrolled in Medicare who defers enrollment while permanently living outside of the United States will have the opportunity to enroll in a PEBB health plan when they return to the United States by submitting the required forms and proof of enrollment in Medicare Parts A
and B within the HCA required enrollment timeframe.2024-26 06/27/24 Evaluation criteria for contracts under RCW 41.05.065(9) The provision of property, casualty, and accident insurance plans and any related evaluation criteria included in prior Board policy decisions and resolutions is rescinded and replaced with the following:
The Board adopts the evaluation criteria as presented at the June 27, 2024 Board meeting by which it shall evaluate contracts considered under RCW 41.05.065(9), as applicable.
2024-25 05/09/24 UMP diabetes management program Beginning January 1, 2025, the Uniform Medical Plan (UMP) will implement a Diabetes Management Program. 2024-24 05/09/24 UMP diagnostic and supplemental breast exam coverage Beginning January 1, 2025, diagnostic and supplemental breast exams to be covered at no cost share to Uniform Medical Plan (UMP) members. UMP CDHP members need to meet their deductible before the plan will pay any portion of the claim. 2024-23 04/11/24 When a subscriber is involuntarily terminated by a Medicare Part D plan When a subscriber or their dependent must be disenrolled by a Medicare Part D plan as required by federal law, the subscriber and their enrolled dependents will be enrolled in a PEBB medical plan as designated by the director or designee. The new medical plan coverage will begin the first day of the month following the date the UMP Classic Medicare plan is terminated. 2024-22 04/11/24 Amending PEBB 2022-03 Medicare Advantage Prescription Drug plan enrollment during gap months Amending PEBB 2022-03 to read:
If a subscriber elects to enroll in a Medicare Advantage Prescription Drug (MAPD) plan, and the required forms are received by the PEBB Program after the date the PEBB retiree insurance coverage is to begin, the subscriber and their enrolled dependents will be enrolled in transitional coverage as designated by the director or designee during the gap months prior to when the MAPD coverage begins.
2024-21 04/11/24 UMP Classic Medicare enrollment during gap months If a subscriber elects to enroll in the Uniform Medical Plan (UMP) Classic Medicare plan, and the required forms are received by the PEBB Program after the date the PEBB retiree insurance coverage is to begin, the subscriber and their enrolled dependents will be enrolled in transitional UMP coverage during the gap months prior to when the UMP Classic Medicare plan begins. 2024-20 04/11/24 UMP Classic Medicare enrollment If a subscriber selects the UMP Classic Medicare plan, any non-Medicare enrollees on the account will be enrolled in the UMP Classic. 2024-19 04/11/24 Automatic enrollment - UMP Classic Medicare - Annual open enrollment 2024 All Medicare enrollees who are enrolled in UMP Classic Medicare with creditable drug coverage as of December 31, 2024, where the subscriber did not make an election during the PEBB annual open enrollment period held in 2024, will be auto-enrolled in the UMP Classic Medicare with Medicare Part D drug coverage with an effective date of January 1, 2025. 2024-18 04/11/24 UMP Classic Medicare Part D coverage The UMP Classic Medicare prescription drug benefit will change from creditable drug coverage to Part D Medicare drug coverage effective January 1, 2025. 2024-17 04/11/24 Amending PEBB Policy Resolution "Error Correction" adopted on July 16, 2014 Amending PEBB Policy Resolution "Error Correction" to read:
If an employing agency fails to enroll an employee in benefits, medical, dental, and vision enrollment will be effective the first day of the month following the date the enrollment error is identified, unless the Health Care Authority determines additional recourse is warranted. If the enrollment error is identified on the first day of the month, enrollment is effective that day.
2024-16 04/11/24 Amending PEBB 2021-12 (amending PEBB 2020-04 Relating to default enrollments for an employee who fails to make a timely decision) Amending PEBB 2021-12 to read: The default election for an eligible employee who fails to timely elect coverage will be as follows: - Enrollment in employee-only medical coverage;
- Enrollment in employee-only dental coverage;
- Enrollment in employee-only vision coverage;
- Enrollment in basic life insurance;
- Enrollment in basic AD&D;
- Enrollment in employer-paid long-term disability insurance; and
- Enrollment in employee-paid long-term disability insurance at the 60% coverage level.
2024-15 04/11/24 Non-Medicare retiree enrollment requirement Non-Medicare retiree must enroll in PEBB medical to be able to enroll in PEBB dental, in PEBB vision, or in both PEBB dental and PEBB vision. 2024-14 04/11/24 Default enrollment if an employee did not enroll in a PEBB vision plan during the annual open enrollment in 2024 All employees who are eligible for the employer contribution towards PEBB benefits as of December 31, 2024 and did not make an election during an enrollment period established by the Health Care Authority in 2024, will be auto-enrolled in a PEBB vision plan as designated by the director or designee with an effective date of January 1, 2025. Any dependents on the account that are enrolled in PEBB medical will be enrolled in the same PEBB vision plan as the subscriber. 2024-13 04/11/24 Fully insured vision plans The benefit design for the embedded refraction vision exam and hardware coverage for Employees and non-Medicare Retirees included in prior Board Policy decisions and resolutions is rescinded and replaced with the following:
Beginning January 1, 2025, the PEBB Program will offer standalone fully-insured vision plans by EyeMed Vision, Davis Vision, and MetLife Vision as presented at the March 21, 2024, Board meeting.
2024-12 04/11/24 Amending PEBB 2022-04 Deferring PEBB retiree insurance coverage when the subscriber becomes eligible Amending PEBB 2022-04 to read:
PEBB retiree insurance coverage will be automatically deferred when the subscriber becomes eligible for the employer contribution towards PEBB or SEBB benefits. The subscriber will be exempt from the deferral form requirement.
2024-11 04/11/24 Rescinding Resolution PEBB 2022-02 Employees may waive enrollment in dental Effective January 1, 2025, Resolution PEBB 2022-02, as adopted on April 14, 2022 is rescinded. 2024-10 04/11/24 Amending Resolution PEBB 2021-25 PEBB Continuation Coverage eligibility for employees' dependents Amending PEBB 2021-25 to read:
If an employee's dependent was auto disenrolled from PEBB dental and PEBB vision because the employee was auto disenrolled from PEBB benefits to remain in SEBB benefits, the dependent may elect to enroll in PEBB dental and PEBB vision. These benefits will be provided for a maximum of 36 months on a self-pay basis.
2024-09 04/11/24 Amending Resolution PEBB 2021-09 Enrollment requirements when an employee loses dependent coverage in SEBB benefits Amending PEBB 2021-09 to read:
If an employee who is eligible for the employer contribution towards PEBB benefits was enrolled as a dependent in SEBB benefits and is dropped by the SEBB subscriber, HCA will notify the employee of their removal from the SEBB subscriber's account and that they have experienced a special enrollment event. The employee will be required to return from waive status and elect PEBB medical, PEBB dental, and PEBB vision. If the employee's employing agency does not receive the employee's required forms indicating their medical, dental, and vision elections within sixty days of the employee losing SEBB benefits, they will be defaulted into employee-only PEBB medical, PEBB dental, and PEBB vision.
2024-08 04/11/24 Amending Resolution PEBB 2021-08 PEBB benefit automatic enrollments when SEBB benefits are auto-disenrolled Amending PEBB 2021-08 to read:
If an employee's dependent, who is also a school employee, was auto-disenrolled from their SEBB dental and SEBB vision as a result of SEB Board Resolution 2021-04, the employee's dependent will be automatically enrolled in the employee's PEBB dental plan and PEBB vision plan, if they are not already enrolled.
2024-07 04/11/24 Amending resolution PEBB 2021-07 Resolving dual enrollment involving a member with multiple medical enrollments as a dependent Amending PEBB 2021-07 to read:
If an employee's dependent is enrolled in both PEBB medical and SEBB medical as a dependent and has been enrolled in SEBB benefits longer than they have been enrolled in PEBB benefits, but no action is taken to resolve the dual enrollment, the dependent will remain in SEBB benefits and will be auto-disenrolled from the employee's PEBB medical, dental, and/or vision plans if they are enrolled.
If an employee's dependent is not enrolled in any medical but is enrolled in both a PEBB and SEBB dental and/or vision plan as a dependent, the dependent will be kept in SEBB benefits and auto-disenrolled from PEBB benefits.
Exception: If there is a National Medical Support Order or a court order in place, enrollment will be in accordance with the order.
2024-06 04/11/24 Amending Resolution PEBB 2021-06 Resolving dual enrollments involving a PEBB dependent with multiple medical enrollments Amending PEBB 2021-06 to read:
If an employee's dependent is enrolled in any PEBB benefits and the dependent is also a SEBB eligible school employee who is enrolled in SEBB medical as a school employee, and no action is taken by either the employee or the dependent to resolve the dependent's dual enrollment, the dependent will remain in SEBB benefits and will be auto-disenrolled from the employee's PEBB medical, dental, and/or vision plans in which they are enrolled.
2024-05 04/11/24 Amending Resolution PEBB 2021-05 Resolving dual enrollment involving dual subscriber eligibility Amending PEBB 2021-05 to read:
If the employee is enrolled in PEBB medical as an employee and is also enrolled in SEBB medical as a school employee, and the employee has been enrolled in SEBB benefits longer than they've been enrolled in PEBB benefits, but no action is taken by the employee to resolve their dual enrollment, they will remain in their SEBB benefits and will be auto-disenrolled from their PEBB medical, PEBB dental, and PEBB vision plans. The employee's enrollments in PEBB Life, AD&D, and LTD will remain. If an employee is not enrolled in any medical but is enrolled in PEBB dental, PEBB vision, SEBB dental, and SEBB vision, the employee will be kept in SEBB benefits and auto-disenrolled from PEBB benefits.
2024-04 04/11/24 Amending Resolution PEBB 2021-04 Resolving dual enrollment when an employee's only medical enrollment is in SEBB Amending PEBB 2021-04 to read:
If the employee is enrolled only in PEBB dental and PEBB vision, and is also enrolled in SEBB medical, and no action is taken to resolve their dual enrollment, the employee will remain in their SEBB benefits and they will be auto-disenrolled from the PEBB dental plan and PEBB vision plan in which they are enrolled. The employee's enrollments in PEBB life, AD&D, and LTD will remain.
2024-03 04/11/24 Amending Resolution PEBB 2021-03 PEBB benefit enrollment requirements when SEBB benefits are waived Amending PEBB 2021-03 to read:
A school employee who waives SEBB medical, SEBB dental, and SEBB vision for PEBB medical must be enrolled in a PEBB dental plan and a PEBB vision plan. If necessary, they will be automatically enrolled in the associated subscriber's PEBB dental plan and PEBB vision plan.
2024-02 04/11/24 Amending Resolution PEBB 2021-02 Employees may waive enrollment in medical Amending PEBB 2021-02 to read:
An employee who is eligible for the employer contribution toward PEBB benefits may waive their enrollment in a medical plan if they are enrolled in other employer-based group medical.
Exception: An employee may waive their enrollment in a PEBB medical plan to enroll in a SEBB medical plan only if they are enrolled in a SEBB dental plan and SEBB vision plan. In doing so, the employee also waives their enrollment in PEBB dental and PEBB vision.
2024-01 - 2023 resolutions
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Meeting date Title Description Number 07/19/23 Uniform Medical Plan (UMP) non-Medicare 2024 The PEB Board authorizes the Uniform Medical Plan (UMP) employee and Non-Medicare retiree premiums. 2023-14 07/19/23 Kaiser Foundation Health Plan of Washington (KPWA) non-Medicare 2024 premiums The PEB Board authorizes the Kaiser Foundation Health Plan of Washington employee and Non-Medicare retiree premiums. 2023-13 07/19/23 Kaiser Foundation Health Plan of the Northwest (KPNW) non-Medicare 2024 premiums The PEB Board authorizes the Kaiser Foundation Health Plan of the Northwest employee and Non-Medicare retiree premiums as presented on July 19. 2023-12 07/12/23 Uniform Medical Plan Medicare 2024 premiums The PEB Board endorses the Uniform Medical Plan Classic Medicare plan premiums. 2023-11 07/12/23 Premera Medicare 2024 premiums The PEB Board endorses the Premera Medicare Supplement plan premiums. 2023-10 07/12/23 UnitedHealthcare Medicare 2024 premiums The PEB Board endorses the UnitedHealthcare Medicare plan premiums. 2023-09 07/12/23 Kaiser Permanente Washington Medicare 2024 premiums The PEB Board endorses the Kaiser Foundation Health Plan of Washington Medicare plan premiums. 2023-08 07/12/23 Kaiser Permanente Northwest Medicare 2024 premiums The PEB Board endorses the Kaiser Foundation Health Plan of the Northwest Medicare plan premiums. 2023-07 07/12/23 Medicare Explicit Subsidy The PEB Board endorses the calendar year 2024 monthly Medicare Explicit Subsidy of $183 or 50% of the premium, whichever is less. 2023-06 06/29/23 UMP COVID-19 over-the-counter test coverage Beginning July 1, 2023, all Uniform Medical Plan (UMP) plans will cover up to two over-the-counter COVID-19 diagnostic tests per member per month, up to $12 per test, without member cost-share. If the IRS issues future guidance that requires the deductible to be met prior to plan payment for over-the-counter COVID-19 diagnostic tests in high deductible health plans, the UMP Consumer-Directed Health Plan shall be amended to comply with IRS guidance. 2023-05 06/29/23 UMP CDHP IRS minimum deductible For plan years beginning on or after January 1, 2024, HCA shall set the annual deductible for the UMP Consumer-Directed Health Plan (CDHP) at the minimum annual deductible level established by the Internal Revenue Service (IRS) to qualify the plan as a high deductible health plan. 2023-04 6/8/23 UMP hearing instruments Beginning January 1, 2024, prescribed hearing instruments in all Uniform Medical Plan (UMP) plans will be covered up to $3,000 per ear with hearing loss, at least every 36 months, without member cost share.
- Coverage for members enrolled in UMP Classic, UMP Select, and UMP Plus are not subject to the member meeting the plan deductible.
- Coverage for members enrolled in UMP Consumer-Directed Health Plan (CDHP) are subject to the member meeting the plan deductible.
2023-03 4/13/23 When a subscriber is involuntarily terminated by a MA or MAPD plan When a subscriber or their dependent must be disenrolled by a Medicare Advantage (MA) plan or Medicare Advantage Prescription Drug (MAPD) plan as required by federal law, the subscriber and their enrolled dependents will be enrolled in a PEBB medical plan as designated by the director or designee. The new medical plan coverage will begin the first day of the month following the date the MA or MAPD plan is terminated. 2023-02 4/13/23 When a subscriber has a change in residence that affects medical plan availability After a change in residence, the subscriber must elect a new medical plan if a subscriber’s current medical plan is no longer available based on residence. If they do not elect a new medical plan within the time period allowed by special open enrollment rules, the subscriber will be enrolled in a PEBB medical plan as designated by the director or designee. 2023-01 - 2022 resolutions
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Meeting date Title Description Number 7/20/22 UMP Non-Medicare Premium The PEB Board endorses the Uniform Medical Plan (UMP) employee and non-Medicare retiree premiums. 2022-19 7/20/22 KPWA non-Medicare premium The PEB Board endorses the Kaiser Foundation Health Plan of Washington employee and non-Medicare retiree premiums. 2022-18 7/20/22 KPNW non-Medicare premium The PEB Board endorses the Kaiser Foundation Health Plan of the Northwest employee and non-Medicare retiree premiums. 2022-17 07/14/22 UMP accumulators Beginning January 1, 2023, when a subscriber enrolled in a SEBB Program Uniform Medical Plan changes their enrollment to a PEBB Program Uniform Medical Plan during the plan year (excluding Open Enrollment), accumulated deductibles and out-of-pocket maximum expenses (medical and pharmacy) will transfer. 2022-14 06/30/22 Postpone action on closure of UMP Classic Medicare Resolved that the PEB Board postpone action on closure of the UMP Classic Medicare plan until at least January 2024 to allow staff to interact in earnest with stakeholders. 2022-16 06/30/22 UMP Medicare premiums The PEB Board endorses the Uniform Medical Plan (UMP) Classic Medicare plan premium for plan year 2023. 2022-15 06/30/22 Premera Medicare premiums The PEB Board endorses the Premera Medicare Supplement plan premiums. 2022-11 06/30/22 UnitedHealthcare premiums The PEB Board endorses the UnitedHealthcare Medicare Advantage plus Prescription Drug (MAPD) plan premiums. 2022-10 06/30/22 KPWA Medicare premiums The PEB Board endorses the Kaiser Foundation Health Plan of Washington Medicare plan premiums. 2022-09 06/30/22 KPNW Medicare premiums The PEB Board endorses the Kaiser Foundation Health Plan of the Northwest Medicare plan premium. 2022-08 06/30/22 Medicare premium - Explicit subsidy The PEB Board endorses the calendar year 2023 monthly Medicare Explicit Subsidy of $183 or 50 percent of premium, whichever is less. 2022-07 06/30/22 UMP CDHP pharmacy preventive care Beginning January 1, 2023, the UMP Consumer Directed Health Plan (CDHP) will cover the drug list presented to the Board on June 9, 2022, prior to meeting the plan deductible. Thereafter, HCA may alter this drug list to allow for pre-deductible coverage based on clinical evaluation and in accordance with IRS guidance. 2022-06 06/30/22 IRS minimum deductible for consumer directed health plan Beginning January 1, 2023, the deductible in the UMP Consumer Directed Health Plan (CDHP) will be increased to $1,500 for single subscribers and $3,000 for all other tiers. 2022-05 04/14/22
Deferring PEBB retiree insurance coverage when the subscriber becomes eligible for the employer contribution
PEBB retiree insurance coverage will be automatically deferred when the subscriber becomes eligible for the employer contribution towards PEBB benefits. The subscriber will be exempt from the deferral form requirement.
On April 11, 2024, the PEB Board amended 2022-04. Please see resolution PEBB 2024-11 for new language.
2022-04
04/14/22
Medicare Advantage Prescription Drug plan enrollment during gap month(s)
If a subscriber elects to enroll in a Medicare Advantage Prescription Drug ( MAPD ) plan, and the required forms are received by the PEBB Program after the date the PEBB retiree insurance coverage is to begin, the subscriber and their enrolled dependents will be enrolled in Uniform Medical Plan (UMP) Classic during the gap month(s) prior to when the MAPD coverage begins.
On April 11, 2024, the PEB Board amended 2022-03. Please see resolution PEBB 2024-21 for new language.
2022-03
04/14/22
Employees may waive enrollment in dental
An employee who is eligible for the employer contribution toward PEBB benefits and who waives enrollment in a PEBB medical plan when they are enrolled in TRICARE, Medicare, or other employer based group medical, and are not enrolled in SEBB medical, may waive their PEBB dental only if they are enrolled in both a SEBB dental plan and SEBB vision plan as a SEBB eligible dependent.
On April 11, 2024, the PEB Board Rescinded 2022-02. Please see resolution PEBB 2024-10.
2022-02
04/14/22 Employees returning to work from active duty When an employee who is called to active duty in the uniformed services under USERRA loses eligibility for the employer contribution toward PEBB benefits, they regain eligibility for the employer contribution toward PEBB benefits the day they return from active duty. Employer paid PEBB benefits will begin the first day of the month in which they return from active duty. 2022-01 - 2021 resolutions
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Meeting date Title Description Number 7/21/21 UMP non-Medicare Premium The PEB Board endorses the Uniform Medical Plan (UMP) employee and non-Medicare retiree premiums. 2021-28 7/21/21 KPWA non-Medicare Premium The PEB Board endorses the Kaiser Foundation Health Plan of Washington employee and non-Medicare retiree premiums. 2021-27 7/21/21 KPNW non-Medicare Premium The PEB Board endorses the Kaiser Foundation Health Plan of the Northwest employee and non-Medicare retiree premiums. 2021-26 7/14/21 PEBB Continuation Coverage Eligibility for Employees' Dependents If an employee's dependent was auto disenrolled from PEBB dental because the employee was auto disenrolled from PEBB benefits to remain in SEBB benefits, the dependent may elect to enroll in PEBB dental. These benefits will be provided for a maximum of 36 months on a self-pay basis.
On April 11, 2024, the PEB Board amended 2021-25. Please see resolution PEBB 2024-09 for new language.
2021-25 7/14/21 UMP Chiropractic, Acupuncture, and Massage Benefits Effective January 1, 2022, the Uniform Medical Plan (UMP) benefit design, for all Medicare and non-Medicare plans, of the Chiropractic, Acupuncture, and Massage (CAM) benefits included in prior Board policy decisions and resolutions is rescinded and replaced with the following CAM benefit design:
Treatment limitations will be as follows:
- Chiropractic visits are limited to 24 per plan year;
- Acupuncture visits are limited to 24 per plan year;
- Massage visits are limited to 24 per plan year;
Cost sharing for all UMP plans will be as follows:
- In network services will have a copay and neither the services nor the copay will apply toward the deductibles (except for UMP Consumer Directed Health Plan (CDHP) as described below), but the copay will apply toward the annual out of pocket maximums;
Out of network services will not have copays and will have:
- a 40% member coinsurance of the allowed amount for all UMP plans except UMP Plus, which will be a 50% member coinsurance, applies after the deductible is met and the coinsurance applies to the annual out of pocket maximum;
- no charges above the allowed amount apply toward UMP plan deductibles or the annual out of pocket maximum; and
- coverage only for Chiropractic and Acupuncture services,
UMP CDHP members need to meet their deductible before the plan will pay any portion of the allowed amount for any claim, for both in network and out of network services; and
Medicare claims will be processed in accordance with coordination of benefits rules.
This benefit design applies only if approved by both the PEB Board and SEB Board.
2021-24 7/14/21 UMP CDHP Preventive Care Beginning January 1, 2022, the UMP Consumer Directed Health Plan will allow coverage to treat certain chronic conditions, those presented at the July 14, 2021 PEB Board Meeting, before having to meet the plan deductible. 2021-23 6/30/21 Premera Medicare Premiums The PEB Board endorses the Premera Medicare Supplement plan premiums. 2021-22 6/30/21 UnitedHealthcare Premiums The PEB Board endorses the UnitedHealthcare Medicare Advantage plus Prescription Drug (MAPD) plan premiums. 2021-21 6/30/21 UMP Medicare Premiums The PEB Board endorses the Uniform Medical Plan (UMP) Medicare plan premiums. 2021-20 6/30/21 KPWA Medicare Premiums The PEB Board endorses the Kaiser Foundation Health Plan of Washington Medicare plan premiums. 2021-19 6/30/21 KPNW Medicare Premiums The PEB Board endorses the Kaiser Foundation Health Plan of the Northwest Medicare plan premiums. 2021-18 6/30/21 Medicare Premium The PEB Board endorses the calendar year 2022 monthly Medicare Explicit Subsidy of $183 or 50% of premium, whichever is less. 2021-17 6/30/21 UMP Accumulators Beginning January 1, 2022, when a subscriber enrolled in a PEBB Program Uniform Medical Plan (UMP) changes their enrollment to another PEBB Program UMP plan during the plan year (excluding open enrollment), the amounts accrued toward insurance accumulators (such as deductibles, out-of-pocket maximums, and benefit and visit limits) will transfer into their new UMP plan. 2021-16 4/14/21 Rescinding PEBB Policy Resolution #4 SmartHealth (as adopted on July 12, 2017) Effective January 1, 2022, PEBB Policy Resolution #4, as adopted on July 12, 2017 is rescinded. 2021-15 4/14/21 Authorizing a gap of 31 days or less between periods of enrollment in qualified coverages during the deferral period Effective January 1, 2022, an eligible retiree or survivor who deferred enrollment while enrolled in qualified coverage may later enroll themselves and their dependent in a PEBB health plan by submitting the required form and evidence of continuous enrollment in one or more qualifying coverages, except that a gap of 31 days or less is allowed between the date PEBB retiree insurance coverage is deferred and the start date of a qualified coverage, and between each period of enrollment in qualified coverages, during the deferral period. 2021-14 4/14/21 Employer-paid long-term disability insurance The benefit design of the employer-paid (or basic) long-term disability benefit included in prior Board policy decisions and resolutions is rescinded and replaced with the following employer-paid LTD benefit design:
- The following Benefit Waiting Period (the longer of):
- 90 days;
- The entire period of sick leave (excluding shared leave) for which the employee is eligible;
- The Fractionated Period of Paid Time Off (PTO) for which the employee is eligible, if your employer has a PTO plan, as those terms are defined in the policy;
- The entire period of other non-vacation salaried continuation leave for which the employee is eligible; or
- The end of Washington Paid Family and Medical Leave for which the employee is receiving benefits
- No Choice Sick Leave
- Choice Pension
- Maximum Monthly Benefit $240 (60% of $400)
2021-13 4/14/21 Amending Resolution PEBB 2020-04: Relating to default enrollments Amending PEBB 2020-04 to read:
the default election for an eligible employee who fails to timely elect coverage will now be as follows:
- Enrollment in employee-only medical coverage;
- Enrollment in employee-only dental coverage;
- Enrollment in basic life insurance;
- Enrollment in employer-paid long-term disability insurance; and
- Enrollment in employee-paid long-term disability insurance at the 60% coverage level.
On April 11, 2024, the PEB Board amended 2021-12. Please see resolution PEBB 2024-15 for new language.
2021-12 4/14/21 Employee-paid long-term disability enrollment procedures - All employees who are eligible for the employer contribution towards PEBB benefits as of December 31, 2021 and not already enrolled in supplemental LTD insurance or did not make an election (reducing or declining coverage) during an enrollment period established by the Health Care Authority in 2021, will be auto-enrolled in employee-paid LTD insurance at the 60% coverage level with an effective date of January 1, 2022 without Evidence of Insurability (EOI).
- An employee who becomes eligible for the employer contribution towards PEBB benefits on or after January 1, 2022 must make an election (reducing or declining coverage) during the benefit election period. If the employee fails to timely elect coverage, the employee will be defaulted into coverage according to Resolution PEBB 2021-12 without EOI. The effective date of coverage will be according to the policy established in May 1995.
- After January 1, 2022, an employee at any time may elect to reduce employee-paid LTD to the 50% coverage plan without EOI or fully decline employee-paid LTD. The effective date of the change in coverage will be the first day of the month following the date the employer receives the required election.
- An employee who seeks to increase coverage from the 50% coverage plan to the 60% coverage plan, or access previously declined employee-paid LTD, will be subject to evidence of insurability. The effective date of the change in coverage will be the day of the month the contracted vendor approves the required form.
- Any employee who declines employee-paid LTD insurance will remain enrolled in employer-paid LTD insurance.
2021-11 4/14/21 Employee-paid long-term disability the benefit design of the supplemental (or optional) long-term disability benefit included in prior Board policy decisions and resolutions is rescinded and replaced with the following employee-paid LTD benefit design:
Two separate employee-paid LTD insurance choices including: (a) coverage at 60% or (b) coverage at 50%. Both choices will have the following features:
- The following Benefit Waiting Period (the longer of):
- 90 days;
- The entire period of sick leave (excluding shared leave) for which the employee is eligible;
- The Fractionated Period of Paid Time Off (PTO) for which the employee is eligible, if your Employer has a PTO plan, as those terms are defined in the policy;
- The entire period of other non-vacation salaried continuation leave for which the employee is eligible; or
- The end of Washington Paid Family and Medical Leave Law for which the employee is receiving benefits
- No Choice Sick Leave
- Choice Pension
- A Maximum Monthly Benefit of $10,000 for the 60% coverage and $8,333 for the 50% coverage
2021-10 4/14/21 Enrollment requirements when an employee loses dependent coverage in SEBB benefits
If an employee who is eligible for the employer contribution towards PEBB benefits was enrolled as a dependent in SEBB benefits and is dropped by the SEBB subscriber, HCA will notify the employee of their removal from the SEBB subscriber's account and that they have experienced a special enrollment event. The employee will be required to return from waive status and elect PEBB medical and PEBB dental. If the employee's employing agency does not receive the school employee's required forms indicating their medical and dental elections within sixty days of the employee losing SEBB benefits, they will be defaulted into employee-only PEBB medical and PEBB dental.
On April 11, 2024, the PEB Board amended 2021-09. Please see resolution PEBB 2024-08 for new language.
2021-09 4/14/21
PEBB benefit automatic enrollments when SEBB benefits are auto-disenrolled
If an employee's dependent, who is also a school employee who was auto-disenrolled from their SEBB dental and SEBB vision as a result of SEBB Board Resolution 2021-04, the employee's dependent will be automatically enrolled in the employee's dental plan if they are not already enrolled.
On April 11, 2024, the PEB Board amended 2021-08. Please see resolution PEBB 2024-07 for new language.
2021-08 4/14/21 Resolving dual enrollment involving a member with multiple medical enrollments as a dependent If an employee's dependent is enrolled in both PEBB medical and SEBB medical as a dependent and has been enrolled in SEBB benefits longer than they have been enrolled in PEBB benefits, but no action is taken to resolve the dual enrollment, the dependent will remain in SEBB benefits and will be auto-disenrolled from the employee's PEBB medical and/or dental plans if they are enrolled.
If an employee's dependent is not enrolled in any medical but is enrolled only in PEBB dental and SEBB vision (with or without SEBB dental) as a dependent, the dependent will be kept in SEBB benefits and auto-disenrolled from PEBB dental.
Exception: If there is a National Medical Support Order or a court order in place, enrollment will be in accordance with the order.
On April 11, 2024, the PEB Board amended 2021-07. Please see resolution PEBB 2024-06 for new language.
2021-07 4/14/21 Resolving dual enrollment involving a PEBB dependent with multiple medical enrollments If an employee's dependent is enrolled in any PEBB benefits and the dependent is also a SEBB eligible school employee who is enrolled in SEBB medical as a school employee, and no action is taken by either the employee or the dependent to resolve the dependent's dual enrollment, the dependent will remain in SEBB benefits and will be auto-disenrolled from the employee's PEBB medical and/or dental plans in which they are enrolled.
On April 11, 2024, the PEB Board amended 2021-06. Please see resolution PEBB 2024-05 for new language.
2021-06 4/14/21 Resolving dual enrollment involving dual subscriber eligibility If the employee is enrolled in PEBB medical as an employee and is also enrolled in SEBB medical as a school employee, and the employee has been enrolled in SEBB benefits longer than they've been enrolled in PEBB benefits, but no action is taken by the employee to resolve their dual enrollment, they will remain in their SEBB benefits and will be auto-disenrolled from their PEBB medical and PEBB dental plans. The employee's enrollments in PEBB Life, AD&D, and LTD will remain. If an employee is not enrolled in any medical but is enrolled only in PEBB dental and SEBB vision (with or without SEBB dental), the employee will be kept in SEBB benefits and auto-disenrolled from PEBB dental.
On April 11, 2024, the PEB Board amended 2021-05. Please see resolution PEBB 2024-04 for new language.
2021-05 4/14/21 Resolving dual enrollment when an employee's only medical enrollment is in SEBB If the employee is enrolled only in PEBB dental, and is also enrolled in SEBB medical, and no action is taken to resolve their dual enrollment, the employee will remain in their SEBB benefits and they will be auto-disenrolled from the PEBB dental plan in which they are enrolled. The employee's enrollments in PEBB life, AD&D, and LTD will remain.
On April 11, 2024, the PEB Board amended 2021-04. Please see resolution PEBB 2024-03 for new language.
2021-04 4/14/21 PEBB benefit enrollment requirements when SEBB benefits are waived A school employee who waives SEBB medical, SEBB dental, and SEBB vision for PEBB medical must be enrolled in a PEBB dental plan. If necessary, they will be automatically enrolled in the associated subscriber's PEBB dental plan.
On April 11, 2024, the PEB Board amended 2021-03. Please see resolution PEBB 2024-02 for new language.
2021-03 4/14/21 Employees may waive enrollment in medical Effective January 1, 2022, the Waiver of Coverage policy, as adopted in May 1995, is rescinded and is replaced with the following: An employee who is eligible for the employer contribution toward PEBB benefits may waive their enrollment in a medical plan if they are enrolled in other employer-based group medical. Exception: An employee may waive their enrollment in a PEBB medical plan to enroll in a SEBB medical plan only if they are enrolled in a SEBB dental plan and SEBB vision plan. In doing so, the employee also waives their enrollment in PEBB dental.
On April 11, 2024, the PEB Board amended 2021-02. Please see resolution PEBB 2024-01 for new language.
2021-02 4/14/21 Removing the retiree two-year dental enrollment requirement
The PEBB Program requirement that retiree dental must be maintained for at least two years if a PEBB Program retiree enrolls in a dental plan is rescinded as of January 1, 2022. 2021-01
Location and directions
Washington State Health Care Authority
Cherry Street Plaza
Sue Crystal Center, Conference Rooms 106A and 106B
626 8th Ave. SE
Olympia, WA 98501
Need an accommodation?
All meetings sponsored by the Health Care Authority meet Americans with Disabilities Act (ADA) requirements. To request an accommodation, email PEB Board.