Changes to PEBB retiree benefits for 2025

The Public Employees Benefits Board (PEB Board) has authorized the following changes effective January 1, 2025. The Public Employees Benefits Board (PEBB) Program will provide more information about these and other changes in October before annual open enrollment.

Annual open enrollment dates have changed and are October 28 through November 25, 2024.

Policy changes

All changes to PEBB rules will be available at PEBB rules and policies and take effect January 1, 2025, unless otherwise noted. The PEB Board has passed resolutions that make the following changes:

• Automatic enrollment – UMP Classic Medicare annual open enrollment 2024: All Medicare enrollees who are enrolled in UMP Classic Medicare as of December 31, 2024, and do not make an election during PEBB annual open enrollment in 2024 will be auto-enrolled in UMP Classic Medicare with Part D drug coverage effective January 1, 2025.
• PEBB retiree insurance coverage deferral: Retirees and survivors who are enrolled in Medicare may defer enrollment in PEBB retiree insurance coverage when they permanently live outside of the United States.
• Automatic deferral: All Medicare enrollees who are enrolled in UMP Classic Medicare as of December 31, 2024, who permanently live outside of the United States and do not make an election during the PEBB annual open enrollment in 2024 will be automatically deferred from PEBB retiree insurance coverage effective January 1, 2025.
• Premium waiver for month of death: Effective June 6, 2024, the Health Care Authority will waive the retiree’s PEBB medical, dental, and vision premium, as well as any applicable surcharges, for the month in which their death occurred.

Changes to PEBB plans

• Routine vision coverage will be removed from the medical plan for non-Medicare plans. There will be three separate vision plans to choose coverage from.
• Vision hardware benefit will increase up to $200 (from $150) for prescription eyeglasses or contact lenses and will reset on odd years (2025, 2027, etc.). This benefit is for members who are enrolling in standalone vision coverage in 2025.
• Reduction in cost for inhalers and epinephrine injectors: Out-of-pocket costs will be capped at $35 for a 30-day supply of inhaled corticosteroids or inhaled corticosteroids combination products, and epinephrine autoinjectors. (Exception: Does not apply to Medicare plans.)
• Increasing access to Human Immunodeficiency Virus (HIV) Post-Exposure Prophylaxis (PEP): Plans will be prohibited from cost-sharing or prior authorization requirements for at least one full PEP regimen.
• Health savings accounts (HSAs) (non-Medicare): The IRS raised the health savings account annual maximum contribution to $4,300 for single subscribers and $8,550 for families.
• Deductible for CDHP (non-Medicare): The IRS raised the minimum deductible for high-deductible health plans to $1,650 for single subscribers and $3,300 for families.

Health plan changes

Kaiser Permanente of the Northwest (KPNW)

• Changing from an MA to an MAPD plan: The Senior Advantage plan is changing from a Medicare Advantage to a Medicare Advantage plus Medicare Part D prescription drug plan. The name will change to Kaiser Permanente NW Senior Advantage with Part D.
• Hearing aids (Medicare): Members can use the hearing aid benefit of $3,000 per ear every 36 months.
• Vision hardware (Medicare): Increasing from $150 to $200 every 24 months.

Kaiser Permanente of Washington (KPWA)

• Clinics closing. KPWA will close its Ballard, Gig Harbor, and Poulsbo medical facilities effective December 13, 2024. Visit Kaiser’s announcement for details.
• Changing from an MA to an MAPD plan: The Kaiser Medicare Advantage plan is changing from a Medicare Advantage to a Medicare Advantage plus Medicare Part D prescription drug plan. The name will change to Kaiser Permanente WA Medicare Advantage with Part D.
• Hearing aids (Medicare): Members can use the hearing aid benefit of $3,000 per ear every 36 months.
• Kaiser Permanente WA Original Medicare plan will no longer be offered. Kaiser WA members in Benton, Columbia, Franklin, Walla Walla, Whitman, Yakima, and Mason County ZIP code 98560 must choose a new plan.
• Advanced Care at Home program discontinued. Members will have access to services at home through their care providers, as available. Cost-shares will apply based on the services provided.
• End stage renal disease dialysis benefit (non-Medicare plans): Individuals who have end stage renal disease (ESRD) qualify for Medicare after a 90-day waiting period. Once a member becomes eligible for Medicare, the plan will waive cost-sharing for dialysis and reimburse members for the Medicare Part B premium.

Uniform Medical Plan

• UMP Classic Medicare will include Medicare Part D prescription drug coverage. The plan name will change to UMP Classic Medicare with Part D (PDP).
• Diagnostic and supplemental breast exam coverage: Diagnostic and supplemental breast exams will be covered without cost to members. UMP Consumer-Directed Health Plan (CDHP) members need to meet their deductible before the plan will pay.
• Diabetes management program: Non-Medicare members will have access to a new diabetes management program that will offer personalized support.
• Deductible for UMP CDHP: The IRS raised the minimum deductible for high-deductible health plans to $1,650 for single subscribers and $3,300 for families.
• UMP Plus–Puget Sound High Value Network (PSHVN) will no longer be available in Chelan or Douglas County. Members in Chelan and Douglas counties must choose a new plan. Confluence Health will no longer be part of UMP Plus–PSHVN.
• Washington State Rx Services (WSRxS) has changed its name to ArrayRx.

UnitedHealthcare

Hearing aids: Members can use the hearing aid benefit of $3,000 per ear every 36 months through a UnitedHealthcare Hearing provider.

2025 monthly premiums: Medicare retirees

Medicare retiree premiums for subscriber and spouse/state-registered domestic partner; subscriber & children; and subscriber, spouse/state-registered domestic partner, & children will be available by October 4 on our website, and in the customized letter retirees will receive in early October (mailed separately from their October newsletter). If you would like to see if the premiums are different from your current premiums, see 2024 premiums.

Note: The PEB Board authorized a new, lower rate for UMP Classic Medicare with Part D (PDP) on August 5, 2024. This lower rate is included in the table below.

2025 monthly premiums: non-Medicare retirees

The PEB Board has authorized the following monthly premiums for 2025. If you would like to see if the premiums are different from your currently premiums, see 2024 premiums.

Notes

• SRDP is state-registered domestic partner.
• Kaiser Foundation Health Plan of the Northwest offers plans in Clark and Cowlitz counties in Washington and select counties in Oregon.

Subscribers may also have to pay the following monthly premium surcharges.

• Tobacco use premium surcharge if you or any enrolled dependents use tobacco products: $25
• Spouse or state-registered domestic partner coverage premium surcharge if you enroll your spouse or SRDP and they choose not to another employer-based group medical that is comparable to PEBB’s Uniform Medical Plan (UMP) Classic: $50