Defer coverage

What does deferring mean?

When you defer, you are pausing or postponing enrollment in medical, dental, and vision coverage. Retirees cannot enroll only in dental or vision coverage.

Deferring is a formal process that allows you to pause or postpone enrollment in PEBB retiree insurance coverage but lets you stay eligible to enroll in the future. The process involves checking that you are eligible to defer, then submitting forms and documents within a given timeframe.

If you defer, in most cases, you also defer enrollment for your dependents.

Steps to defer

If you are an employee who is determined to be eligible for disability retirement, contact the PEBB Program. 

Employee deferring when first eligible to retire or separate

What do I do? 

To defer enrollment, you must: 

• Submit your request in Benefits 24/7 or return the Retiree Election Form (form A) to the PEBB Program by the required deadline.
• Submit any other forms or documents, based on your situation.

By when? 

The PEBB Program must receive your form no later than 60 days after your employer-paid, COBRA, or continuation coverage ends.

Elected and full-time appointed officials: The PEBB Program must receive your form no later than 60 days after you leave public office. 

When does the deferral take effect? 

If you are eligible to defer and submit your form by the deadline, we will defer your enrollment the first of the month after the date your employer-paid, COBRA, or continuation coverage ends.

Elected and full-time appointed officials: If you are eligible and submit your form by the deadline, we will defer your enrollment the first of the month after the date you leave public office.

Enrolled members who want to defer

If you are already enrolled in PEBB retiree insurance coverage, and have a qualifying reason to defer, you may want to defer enrollment. 

What do I do? 

To defer enrollment: 

• Submit your request in Benefits 24/7 or return the Retiree Change Form (form E) to the PEBB Program.
• Submit any other required forms or documents, based on your situation.
• If you become eligible for the employer contribution toward PEBB or SEBB benefits, PEBB retiree insurance coverage will be automatically deferred. You will be exempt from the deferral form requirement.

By when?

We encourage you to submit your form before your other qualified medical coverage starts or before a permanent move outside of the United States if you are enrolled in Medicare.

When does the deferral take effect?

If you are eligible and submit your forms, we will defer your enrollment the first of the month after the date we receive all the required forms. If we receive the forms on the first day of the month, the deferral will be effective that day.

Exception: If you or a dependent are enrolled in a Medicare Advantage with Part D plan or UMP Classic Medicare with Part D (PDP), enrollment will be deferred effective the first of the month after the date we receive the Medicare Plan Disenrollment Form (form D).

Surviving dependents

If you are a survivor or a dependent becoming eligible as a survivor and are ready to defer, visit Survivors.

Automatic deferral

PEBB retiree insurance coverage is automatically deferred if you are: 

• Already enrolled in PEBB retiree insurance coverage and return to work and become eligible for the employer contribution toward PEBB or SEBB benefits. 
• Not on Medicare and permanently live outside of the United States, you become eligible for Medicare Parts A and B, and do not respond to HCA within the required timeframe. 

In either of these situations, you do not need to defer online or submit a form. 

Criteria you must meet

This is the criteria you must meet to be eligible to defer enrollment in PEBB retiree insurance coverage.

Be eligible

You must be eligible to enroll or are already enrolled in PEBB retiree insurance coverage to be eligible to defer. (Refer to Related laws and rules at the bottom of the page for details.)

If you have lost your eligibility to enroll, you cannot defer.

Have a qualifying reason

Employer-based group medical insurance as an employee or dependent

• This includes COBRA or continuation coverage.
• This does not include an employer's retiree coverage.

(Beginning January 1, 2001)

Dependent coverage in a:

• PEBB-sponsored medical plan
• SEBB-sponsored medical plan

This includes COBRA or continuation coverage.

Medical coverage as a retiree or dependent in:

• A TRICARE plan
• The Federal Employees Health Benefits Program

You will have a one-time opportunity to enroll in a PEBB retiree health plan.

(Beginning January 1, 2001)

Medicare Part A and Part B and a Medicaid program that provides creditable coverage

To be considered creditable coverage, your Medicaid coverage must include coverage for medical and hospital benefits.

Any dependents who are not eligible for creditable coverage under Medicaid may stay enrolled in a PEBB retiree health plan.

(Beginning January 1, 2006)

A qualified health plan coverage through a health benefit exchange established under the Affordable Care Act (and you are not eligible for Medicare Part A and Part B)

This does not include Medicaid coverage, known as Apple Health in Washington State.

You will have a one-time opportunity to enroll or reenroll in a PEBB retiree health plan.

(Beginning January 1, 2014)

Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA)

You will have a one-time opportunity to enroll in a PEBB retiree health plan.

(Beginning July 17, 2018)

Enrolled in Medicare and permanently live outside of the United States

You are enrolled in Medicare and permanently live in a location outside of the United States.

(Beginning January 1, 2025)

Become eligible for Medicare while permanently living outside of the United States

You are enrolled in PEBB retiree insurance coverage and permanently live outside of the United States, and becomes eligible for Medicare. If you do not respond to HCA within the required timeframe, you will be automatically deferred from PEBB retiree insurance coverage.

(Beginning January 30, 2025)

Stay enrolled in qualified coverage

You must provide proof of continuous coverage

To be eligible to enroll later, you must provide proof of continuous enrollment in qualifying medical coverages while you are deferred. 

You can have a gap of 31 days or less:

• Between the date you defer your PEBB retiree insurance coverage and the start date of a qualified coverage, and
• Between each period of qualified coverages during the deferral period.

We encourage you to collect proof of coverage annually and keep a file to provide to the PEBB Program in the event you want to return in the future.

If you defer enrollment while enrolled in Medicare and permanently living outside of the United States, and you permanently move back to the United States, you must provide proof of enrollment in Medicare Parts A and B to return to a PEBB retiree health plan after deferral. Evidence of continuous enrollment in a qualified coverage is waived while you live outside of the United States.

Submit your materials

Reminder: The PEBB Program must receive your materials by the enrollment period deadline. 

You can use Benefits 24/7 to defer your coverage. If you use forms, submit your forms and documentation using one of the following methods. 

Online

Send us a secure message through HCA Support, a secure website that allows you to log into your own account to communicate with us. Sign and date any forms you attach to a secure message. A typed signature is not acceptable.

To keep your personal information secure, you will need to register for a SecureAccess Washington (SAW) account (if you don't already have one) to submit your materials using this method.

By mail

Washington State Health Care Authority
PEBB Program
PO Box 42684
Olympia, WA 98504-2684

By fax

360-725-0771

Related laws and rules

Washington Administrative Codes (WAC) are the official rules used for PEBB Program eligibility and deferral.

For elected and full-time appointed officials, and their survivors

WAC 182-12-180: When is an elected and full-time appointed official of the legislative and executive branch of state government, or their survivor eligible to continue enrollment in public employees benefits board (PEBB) retiree insurance coverage?

For retiring employees or a retiree enrolled as a dependent

WAC 182-12-200: May a retiring employee, a retiring school employee, or a retiree enrolled as a dependent in a health plan sponsored by public employees benefits board (PEBB) or school employees benefits board (SEBB) defer enrollment under PEBB retiree insurance coverage?

For retiring employees, retirees, and survivors

WAC 182-12-205: May a retiree or a survivor defer enrollment or voluntarily terminate enrollment under public employees benefits board (PEBB) retiree insurance coverage?

For disability retirement

WAC 182-12-211: May an employee or a school employee who is determined to be retroactively eligible for disability retirement enroll or defer enrollment in a public employees benefits board (PEBB) retiree insurance coverage?