Spousal coverage surcharge
A $50 premium surcharge may apply 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 do not need to respond to this surcharge if you do not enroll a spouse or SRDP on your medical coverage.
On this page
How to respond
Respond to the surcharge on your enrollment/change form or in Benefits 24/7 when you enroll your spouse or SRDP.
- Step one: Find out if the surcharge applies
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Answer the six questions on your enrollment/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 $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.
Download the calculator and Enable content
If you use the interactive version of the Spousal Plan Calculator, you must download and save the calculator. Be sure to click Enable Content for the calculator to work. Do not print or submit the interactive tool.
- Step two: Complete your attestation
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Check the corresponding boxes in Benefits 24/7 or on your enrollment/change form.
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 respond 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 PEBB's UMP Classic.
If you don't respond
You will be charged the $50 premium surcharge in addition to your monthly medical premium.
When can I report a change?
You can only report a change to this surcharge:
- During open enrollment.
- Within 60 days of a change in your spouse’s or SRDP’s employer-based group medical insurance.
To change your response, use Benefits 24/7 or the SEBB Premium Surcharge Attestation Change form.
When do changes take effect?
If you submit a change that results in paying the premium surcharge, the change is effective the first day of the month after the date of the status change. If that occurs on 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 occurs on 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.