Forms & publications

Use this form to enroll in or change your enrollment options for PEBB Continuation Coverage (Employer Group Ended Participation).

Use this form to enroll in or change your enrollment options for PEBB Continuation Coverage (Employer Group Ended Participation).

These are the 2024 PEBB Continuation Coverage (Employer Group Ended Participation) Premiums. These premiums do not include the monthly premium surcharges, if applicable to your account.

Use this form to enroll in or change your enrollment options for PEBB Continuation Coverage (Unpaid Leave).

This is the booklet you will receive when your Public Employees Benefits Board (PEBB) health coverage ends. This booklet explains how you and your dependents can continue your PEBB health coverage. To continue PEBB health coverage, you must complete the enclosed forms and follow the instructions.

This is the booklet you will receive when your Public Employees Benefits Board (PEBB) health coverage ends. This booklet explains how you and your dependents can continue your PEBB health coverage. To continue PEBB health coverage, you must complete the enclosed forms and follow the instructions.

Use this form to enroll in or change your enrollment options for COBRA coverage.

Use this form to enroll in or change your enrollment options for PEBB Continuation Coverage (Unpaid Leave).

These are the PEBB Continuation Coverage monthly premiums for 2024. These premiums do not include the monthly premium surcharges, if applicable to your account.

These are the monthly premiums for PEBB Continuation Coverage subscribers in 2025. These premiums do not include the monthly premium surcharges, if applicable.