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.
If you or a dependent enrolled on your PEBB medical coverage uses a tobacco product, the tobacco use premium surcharge will apply.
Sign in to Benefits 24/7 and select the "Attestations" tab. You can also submit the appropriate enrollment form as directed on the form.
Note: Pierce County, Washington State University, and University of Washington employees must attest through Workday.
You need to respond to this surcharge if you are one of the following medical plan subscribers:
You do not need to respond if you are not one of these subscribers. The premium surcharge will not apply to your account.
You will be charged the $25 surcharge in addition to your medical plan premium.
Use one of the following options to report a change to your previous attestation:
Note: Pierce County, Washington State University, and University of Washington employees must report a change through Workday.
You can report a change any time you or any enrolled dependents you reported as using tobacco products do any of the following:
You must also report a change if you or any enrolled dependent age 13 or older starts using a tobacco product, or stops participating in your PEBB medical plan’s tobacco cessation program.
Changes that result in a premium surcharge will begin the first day of the month following the status change (the date the family members started using tobacco products). If that day is the first of the month, the change to the surcharge begins on that day. Changes that result in removing a premium surcharge will begin the first day of the month following receipt of the attestation. If that day is the first of the month, the change to the surcharge begins on that day.
A $25 tobacco use premium surcharge is required in addition to your medical plan premium if you or a dependent (age 13 and older) enrolled on your PEBB medical uses a tobacco product.
You do not have to pay this surcharge if you attest (respond) that:
Enrolled dependents ages 12 and younger are automatically defaulted as non-tobacco-users.
Note: As long as any dependent covered under your PEBB medical plan uses a tobacco product, you will be charged the tobacco use premium surcharge.
Tobacco use is defined as any use of tobacco products within the past two months except for religious or ceremonial use.
Tobacco products are any product made with or derived from tobacco that is intended for human consumption, including any component, part, or accessory of a tobacco product. This includes, but is not limited to, cigars, cigarettes, pipe tobacco, chewing tobacco, snuff, and other tobacco products. Tobacco products do not include e-cigarettes or United States Food and Drug Administration (FDA) approved quit aids such as over-the-counter nicotine replacement products and prescription nicotine replacement products.
Employees: Your payroll or benefits office
Retirees and PEBB Continuation Coverage subscribers: The PEBB Program