Spousal coverage surcharge

A $50 premium surcharge may apply to you if you have a spouse or state-registered domestic partner enrolled on your SEBB medical coverage.

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What is the spouse or state-registered domestic partner coverage premium surcharge?

A $50 premium surcharge will be charged, in addition to your monthly medical plan premium, if you have a spouse or state-registered domestic partner (SRDP) enrolled on your SEBB medical coverage and they chose not to enroll in their employer-based group medical insurance that is comparable to the PEBB Program’s Uniform Medical Plan (UMP) Classic. The comparison must be to the PEBB Program’s UMP Classic, even if you are not enrolled in that plan.

You must attest (respond) to the premium surcharge to tell us whether it applies to your account.

Who needs to attest?

You must respond to this premium surcharge if you enroll your spouse or SRDP on your SEBB medical coverage.

You do not need to attest if you do not enroll your spouse or SRDP on your SEBB medical. The surcharge will not apply to your account.

How do I attest (respond)?

Respond to the surcharge on your enrollment form, change form, or in Benefits 24/7 when you enroll your spouse or SRDP.

Step one: find out if the surcharge applies

Answer the six questions on your enrollment form, change form, or in Benefits 24/7 to find out if the surcharge applies. You may also need to use the Spousal Plan Calculator (interactive tool) or (pdf).

If you answer NO to ANY of the questions the surcharge does not apply. 

If you answer YES to ALL six questions you will need to: 

  • Ask your spouse or SRDP to ask their employer for a Summary of Benefits and Coverage (SBC) for all medical plans that serve the county of residence for them, and have a monthly employee premium of $117.81 (2024) or $126.36 (2025).
  • Use the SBC information to answer the questions in the Spousal Plan Calculator (interactive tool) or (pdf) to determine if the surcharge applies to you.

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If you use the interactive version of the Spousal Plan Calculator, you must click Enable Content for the calculator to work. Do not print or submit the interactive tool.

Step two: complete your attestation

Sign in to Benefits 24/7 and select Attestations. Answer Yes or No to the questions 1 through 6. Or check the boxes on your enrollment/change form.

What happens if I do not attest?

You will be charged the $50 premium surcharge in addition to your monthly medical premium if you have a spouse or SRDP enrolled on your medical coverage.

Do I need to attest every year?

If you will cover your spouse or SRDP on your medical coverage for the next plan year, you may need to attest to the surcharge during open enrollment. You will get a letter from the SEBB Program if you need to attest. You are required to attest during open enrollment if you currently pay the $50 monthly premium surcharge or are not paying the surcharge because you attested your spouse's or SRDP's employer-based medical coverage was not comparable to UMP Classic.

When can I report a change?

You can only report a change to this surcharge in the following situations:

  • During open enrollment.
  • Within 60 days of a change in your spouse’s or SRDP’s employer-based group medical insurance.

How do I report a change or attest during open enrollment?

Use Benefits 24/7 or Premium Surcharge Attestation Change form.

Step one: find out if the surcharge applies

If you answer NO to ANY of the questions, the surcharge does not apply.

If you answer YES to ALL six questions you will need to:

  • Ask your spouse or SRDP to ask their employer for a Summary of Benefits and Coverage (SBC) for all medical plans that service their county of residence and that have a monthly premium of $117.81 (2024) or $126.36 (2025) per month for the employee.
  • Use the SBC information to answer the questions in the Spousal Plan Calculator (interactive tool) or (pdf) to determine if the surcharge applies to you.

Step two: complete your attestation

When will my attestation change take effect?

Changes that result in a premium surcharge will be effective the first day of the month after the date of the status change. If that day is the first of the month, the change begins that day. 

If the change results in removal of the premium surcharge, the change is effective the first day of the month after your attestation is received. If that day is the first of the month, the change begins that day.

Exception: If attesting during annual open enrollment, any change is effective January 1 of the following year.