Spousal coverage surcharge

What is the spouse or SRDP coverage premium surcharge?

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.

Who needs to attest (respond)?

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.

How do I attest (respond)?

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.

Step one: find out if the surcharge applies

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:

• Ask your spouse or state-registered domestic partner (SRDP) for a Summary of Benefits and Coverage (SBC) for all medical plans that serve their county of residence, and have a monthly employee premium of less than $117.81 (2024) or $126.36 (2025).
• Use the SBC information to answer the questions in the Spousal Plan Calculator (interactive tool) or (pdf) to find out if the surcharge applies.

Step two: complete your attestation

Check the corresponding boxes in Benefits 24/7 or on your enrollment/change form.

Note: Pierce County, WSU, and UW employees use Workday.

What happens if I do not respond?

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.

Do I need to attest every year?

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.

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

How do I report a change or attest during open enrollment?

Use Benefits 24/7 or the PEBB Premium Surcharge Attestation Change form. Pierce County, WSU, and UW employees must attest through Workday.

Step one: find out if the surcharge applies

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:

• Ask your spouse or SRDP for a Summary of Benefits and Coverage (SBC) for all medical plans that serve their county of residence, and have a monthly employee premium of less than $117.81 (2024) or $126.36 (2025).
• Use the SBC information to answer the questions in the Spousal Plan Calculator (interactive tool) or (pdf) to find out if the surcharge applies.

Step two: complete your attestation

Log in to Benefits 24/7 or submit the Premium Surcharge Attestation Change form.

When will my attestation or change take effect?

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.