How do I enroll?
To enroll in PEBB Continuation Coverage there are forms you need to submit by certain deadlines. Learn more about the steps you need to take.
Important deadlines
To enroll in PEBB Continuation Coverage (COBRA or Unpaid Leave): The PEBB Program must receive your request in Benefits 24/7 or forms and supporting documentation no later than 60 days after your PEBB health plan coverage ends or from the postmark date on the PEBB Continuation Coverage Election Notice, whichever is later.
To enroll in PEBB Continuation Coverage (Employer Group Ended Participation): The PEBB Program must receive your request in Benefits 24/7 or forms and supporting documentation no later than 60 days after your employer group ended their participation
On this page
What coverage can I continue?
If you are enrolling in COBRA or Unpaid Leave, you may continue the PEBB medical and/or dental coverage you were enrolled in on the day before your qualifying event. In some cases, you may continue life and accidental death and dismemberment (AD&D) insurance, long-term disability insurance (LTD), and your flexible spending arrangement (FSA). Visit Am I eligible? for more information about your coverage options.
If you are enrolling in PEBB Continuation Coverage (Employer Group Ended Participation), you may only enroll in medical and dental coverage.
What forms do I need?
We will not enroll you until you submit forms to continue your PEBB coverage and make the first premium payment, including applicable premium surcharges, within the timelines provided.
Medical, dental, and vision coverage
Use Benefits 24/7 or depending on the coverage you are eligible for, submit either:
- PEBB Continuation Coverage (COBRA) Election/Change form
- PEBB Continuation Coverage (Unpaid Leave) Election/Change form
- PEBB Continuation Coverage (Employer Group Ended Participation) Election/Change form
Life insurance and AD&D insurance
Life and AD&D insurance are available to continue for PEBB Continuation Coverage (Unpaid Leave) subscribers. Make your election to continue life and AD&D insurance in Benefits 24/7 or on the PEBB Continuation Coverage (Unpaid Leave) Election/Change) form. If you do not continue your life and AD&D insurance while on leave, you must reapply for supplemental life and AD&D insurance when you regain eligibility.
If you are a PEBB Continuation Coverage (COBRA) subscriber and wish to continue your life insurance under portability or conversion, submit the form sent to you by MetLife. MetLife must receive your form no later than 60 days after your PEBB employee life insurance ends.
Learn more about life and AD&D insurance.
Long-term disability (LTD) insurance
PEBB Continuation Coverage (Unpaid Leave) subscribers may self-pay for LTD insurance when you are on approved educational leave or called to active duty under the uniformed services as defined under USERRA. Make your election to continue LTD insurance in Benefits 24/7 or on the PEBB Continuation Coverage (Unpaid Leave) Election/Change form.
If you are eligible to continue employee-paid LTD insurance but choose not to, you will have to provide evidence of insurability when you regain eligibility.
You will receive the same coverage of LTD insurance before leave on the first day of the month you regain eligibility. You do not need to submit forms.
Learn more about LTD insurance.
Flexible spending arrangements (FSAs)
Both COBRA and Unpaid Leave subscribers can continue FSAs.
If you are eligible to continue your FSA, Navia Benefit Solutions will mail a COBRA election notice to you. Navia must receive your election no later than 60 days from the date PEBB health plan coverage ended or the postmark date on Navia’s COBRA election notice, whichever is later.
Learn more about FSAs.
Can I enroll later?
You can enroll in coverage as long as the PEBB Program receives your forms no later than 60 days from the date your PEBB health plan coverage ended, or the postmark date on the PEBB Continuation Coverage Election Notice, whichever is later. After this date, you will lose your opportunity to enroll.
Exception
To enroll in PEBB Continuation Coverage (Employer Group Ended Participation), your request in Benefits 24/7 or the PEBB Continuation Coverage (Employer Group Ended Participation) Election/Change form must be received no later than 60 days after your employer group ended their participation. After this date, you will lose your opportunity to enroll.
Where do I submit my materials?
Submit your enrollment form and any other documents to the PEBB Program one of the following ways:
- Benefits 24/7
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Use the online enrollment system, Benefits 24/7 to enroll in coverage and upload your supporting documents.
- Secure online message
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Submit your forms through HCA Support. Attach them to a secure message. Be sure to sign them (typed signatures are not allowed). To keep your personal information secure, you will need to register for an account (if you don't already have one) to submit your materials using this method.
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Washington State Health Care Authority
PEBB Program
PO Box 42684
Olympia, WA 98504-2684 - Fax
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360-725-0771
- First payment
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If you're sending payment with your forms, enclose your check or money order payable to Health Care Authority and mail to:
Washington State Health Care Authority
PO Box 42691
Olympia, WA 98504-2691
How much does coverage cost?
View PEBB Continuation Coverage premiums for Medicare and non-Medicare. You will self-pay the premium and applicable premium surcharges.
If you are enrolling in PEBB Continuation Coverage (Employer Group Ended Participation), you will not be eligible for the Medicare subsidy provided to Medicare-eligible retirees. Learn more about paying for benefits.
Contact
The PEBB Program
Phone: 1-800-200-1004
TRS: 711
HCA Support (secure, login portal with your personal account)
Send us a secure message through HCA Support, a secure website that allows you to log into your own account to communicate with us. You will need to set up a SecureAccess Washington (SAW) account to use this option.