Going on or returning from layoff

Information about the requirements and processes when employees are laid off due to an employer's lack of funds or an organizational change.

General information and requirements

The employer must inform an employee in writing whether or not he or she is eligible for benefits and the employer contribution whenever there is a change in work patterns, such that the employee’s eligibility status changes (WAC 182-12-113).
Employees who are no longer eligible for the employer contribution toward insurance coverage due to layoff may continue insurance coverage by self-paying the full premium set by the Health Care Authority (HCA) from the date the employer contribution is lost (WAC 182-12-133)(1)).
The employer contribution toward PEBB benefits cease for employees and their enrolled dependents the last day of the month in which employees are eligible for the employer contribution. Exception: If the employer deducted the employee's premium for PEBB insurance coverage after the employee was no longer eligible for the employer contribution, PEBB insurance coverage ends the last day of the month for which employee premiums were deducted (WAC 182-12-131(7)).
Employees who are laid off and are eligible to retire may choose to elect PEBB retiree coverage (WAC 182-12-171).
Employees who return to another state agency or institution position of higher education within 24 months may be eligible for the employer contribution toward benefits with eight or more hours of pay status per month (WAC 182-12-129 and WAC 182-12-131). The employee, upon hire, must notify the employer that he or she may be potentially eligible under WAC 182-12-129.

Employer must...	...no later than...	...or this will happen
Complete Worksheet C-7 Layoff.	30 days after the date employment ends, or as soon as the employee’s end date is known.	Eligibility errors may occur and the employee will not receive the required notice and information about layoff provisions provided in the worksheet.
Terminate employee PEBB insurance coverage in Benefits 24/7.	Immediately after the date the employee loses eligibility for the employer contribution, or as soon as the employee's end date is known.	The Continuation of Coverage Election Notice will be delayed, resulting in increased employer cost for coverage, insurance coverage enrollment delays, and possible payment hardships. Refer to Termination Due to Loss of Eligibility (Policy 19-1, Addendum 19-1A) for more information.

HCA will mail the Continuation of Coverage Election Notice to the employee after coverage is terminated in Benefits 24/7. (This can take up to 14 days after insurance coverage is terminated).

Employees applying for self-pay must...	...no later than...	...or this will happen
Complete the PEBB Leave Without Pay (Unpaid Leave) Continuation Coverage Election form.	60 days after the postmark date of the Continuation of Coverage packet.	PEBB insurance coverage will end based on when the termination is entered in Benefits 24/7. Refer to the Termination Due to Loss of Eligibility (Policy 19-1, Addendum 19-1A) for more information.
Mail or hand-deliver the Leave Without Pay (Unpaid Leave) Continuation Coverage Election form to the PEBB program (address provided in packet).	60 days after the postmark date of the Continuation of Coverage packet	Employee will lose their right to continue coverage.
Choose to continue any optional life coverage that was in force as an active employee and pay the premium directly to MetLife.	60 days after the postmark date of the Continuation of Coverage packet.	Coverage that was reduced or not self-paid will require evidence of insurability when reapplying upon return to work.
Make the first full premium payment to HCA.	45 days after the date coverage is elected.	Employee will lose their right to continue coverage.

Additional information

For employees

Employees who have...	...may...	...no later than
A spouse or state-registered domestic partner (SRDP) also eligible for employer-paid PEBB benefits.	Enroll under the spouse or SRDP's medical and/or dental coverage as a dependent.	60 days after the date the employee lost eligibility for the employer contribution.
A Medical or Limited Purpose Flexible Spending Arrangement (FSA) through Navia Benefit Solutions.	Apply for Continuation of Coverage through Navia to extend their period of coverage, so that they may claim expenses incurred after employment ends.	60 days after the date the employee lost eligibility for the employer contribution.

For spouse/domestic partner

Employees who have...	...the spouse/domestic partner may...	...no later than
A spouse or SRDP also covered by PEBB benefits.	Enroll in or change their election through Navia Benefit Solutions for a Medical or Limited Purpose Flexible Spending Arrangement (FSA).	60 days after the date the employee lost eligibility for the employer contribution.

*FSA enrollment is available to employees of state agencies and institutions of higher education only.

Employees applying for PEBB retiree coverage must...	...no later than...	...or this will happen
Complete the PEBB Retiree Election Form A to enroll in or defer coverage.	The PEBB Program must receive the completed election form no later than 60 days after employer-paid or continuation coverage ends.	PEBB coverage will end on the last day of the month in which employment ends or in which the maximum continuation coverage period ends.
Mail, hand-deliver, or fax the election form to the PEBB program (address and fax number provided in the guide).	The PEBB Program must receive the completed election form no later than 60 days after employer-paid or continuation coverage ends.	Employee will lose their future right to enroll in PEBB retiree coverage.
Make the first full premium payment to HCA (if not electing pension deduction from Department of Retirement Systems).	45 days after the 60-day election period ends.	Employee will lose their future right to enroll in PEBB retiree coverage.

*The employee may access the Retiree Enrollment Guide and enrollment forms on the PEBB Retirees website.

Guidance resources

Employees retiring under plans administered by the Department of Retirement Systems must contact DRS for information about retirement eligibility. Information is available at www.drs.wa.gov or by calling their toll-free number at 1-800-547-6657.
The employee may contact HCA at 1-800-200-1004 to request a Retiree Enrollment Guide.

Related rules and policies

WAC 182-08-180 - Premium payments and refunds.
WAC 182-08-190 - The employer contribution for all eligible employees
WAC 182-08-200 - Employer contribution when changing agency employment
WAC 182-12-129: What happens when an employee moves from an eligible to an otherwise ineligible position or job due to a layoff?
WAC 182-12-131: How do eligible employees maintain the employer contribution toward PEBB benefits?
182-12-133 - Options for continuing coverage eligible when on certain types of leave or Layoff?
182-12-141 - Revert from an eligible position to another position
182-12-171 - Retiree eligibility