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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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2024-01 |