Find information on the open enrollment page that’s right for you: PEBB retirees, PEBB employees and PEBB continuation coverage subscribers, and SEBB employees and SEBB continuation coverage subscribers.
A $50 premium surcharge may apply if you have a spouse or state-registered domestic partner (SRDP) enrolled on your medical coverage.
A monthly $50 surcharge will apply in addition to your medical plan premium if you have a spouse or SRDP enrolled on your medical coverage, and they chose not to enroll in their employer-based group medical insurance that is comparable to Uniform Medical Plan (UMP) Classic. The Comparison must be to UMP Classic even if you are not enrolled in the plan.
You must attest (respond) to the premium surcharge to tell us whether it applies to your account.
You need to respond to this surcharge if you enroll your spouse or SRDP on your medical coverage and you are not enrolled in Medicare Part A and Part B.
You do not need to respond if you are enrolled in Medicare Part A and Part B or if you do not enroll your spouse or SRDP on your medical coverage. The surcharge will not apply to your account.
Respond to the surcharge in Benefits 24/7 or on your enrollment/change form when you enroll your spouse or SRDP. Note: Pierce County, Washington State University (WSU), and University of Washington (UW) employees must respond through Workday.
Answer the six questions on your enrollment/change form (or in Workday) 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.
Answer YES to ALL six questions you will need to:
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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.
Check the corresponding boxes in Benefits 24/7 or on your enrollment/change form.
Note: Pierce County, WSU, and UW employees use Workday.
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.
If you will cover your spouse or SRDP on your medical for the next plan year, you may need to attest to the surcharge during open enrollment. You will get a letter from the PEBB 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 or SRDP's employer-based medical coverage was not comparable to UMP Classic.
You can only report a change to this surcharge:
Use Benefits 24/7 or the PEBB Premium Surcharge Attestation Change form. Pierce County, WSU, and UW employees must attest through Workday.
Answer the six questions in Benefits 24/7 or on your Premium Surcharge Attestation Change form 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:
Log in to Benefits 24/7 or submit the Premium Surcharge Attestation Change form.
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.
Employees: Your payroll or benefits office
Retirees and continuation coverage subscribers: The PEBB Program