FAQs for PEBB benefits administrators

If an employee brings in physical dependent verification documents to their benefits administrator to verify, does the benefits administrator verify them, or should the documents be uploaded to Benefits 24/7 for verification?

The local benefits administrator must verify or deny it and enter that decision in Benefits 24/7. The benefits administrator doesn't need to upload the document or keep it.

If an employee waives medical coverage, does the employer continue to pay the full employer contribution to the HCA?

Yes. The employer pays the entire employer contribution for all eligible employees and their enrolled dependents (WAC 182-08-190).

Employees can waive medical (with vision) coverage but generally cannot waive other benefits for which they are eligible (dental, basic life and AD&D insurance, and basic long-term disability insurance). However, dual enrollment rules do allow employees to waive PEBB medical (with vision) and dental to enroll in School Employees Benefits Board (SEBB) medical, vision, and dental. 

 

If an employee's spouse has a retiree policy that covers the employee, can they waive medical?

No. They can only waive SEBB medical coverage if they are enrolled in other employer-based group medical insurance, a TRICARE plan, or Medicare. Retirement policies are not employer-based, so they do not qualify.

If employees waive medical coverage, do they have to pay the premium surcharges?

No. The tobacco use and spouse or state-registered domestic partner coverage premium surcharges do not apply if medical coverage is waived.

What are the differences between the PEBB and SEBB Programs?

Both programs are administered by the Health Care Authority. The Public Employees Benefits Board (PEBB) Program provides benefits primarily for employees of state agencies and higher education institutions. The School Employees Benefits Board (SEBB) provides benefits for employees of school districts and charter schools, and for represented employees of ESDs. They have similarities in benefit design and premiums but differ in eligibility criteria and rules.

When new employees enroll, can they use Benefits 24/7 to enroll in all their benefits?

New employees use Benefits 24/7 to enroll in their medical and dental plans, as well as basic life, basic accidental death and dismemberment (AD&D), and basic and supplemental long-term disability insurance.

Employees go to different websites to enroll in supplemental life and supplemental accidental death and dismemberment insurance, and for Medical Flexible Spending Arrangement (FSA), and Dependent Care Assistance Program (DCAP). They can access those websites from within Benefits 24/7.

A paper form is available for employee contribution elections in health savings accounts (HSA) and should be completed by the employee if they are enrolling in a consumer directed health plan with an HSA and provided to the benefits administrator for processing.

Where can benefits administrators and employees learn about PEBB Continuation Coverage?

Benefits administrators (BAs) and employees can review the current PEBB Continuation Coverage Election Notice and visit the PEBB Continuation Coverage section of the Employee and retiree benefits website to learn about eligibility and enrollment requirements. 

Information about continuation coverage is also available to BAs on the PEBB BA website.

For state agencies and higher ed:

For employer groups:

Where can benefits administrators and employees learn about PEBB Retiree Insurance?

Benefits administrators (BAs) and employees can review the current PEBB Retiree Insurance Enrollment Guide and visit the Retirees section of the Employee and retiree benefits website to learn about PEBB Retiree Insurance and the eligibility and enrollment requirements. 

Information about retiree insurance is also available to BAs on the PEBB BA website:

Where can employees learn about PEBB benefits, eligibility, and enrollment?

The current PEBB Employee Enrollment Guide is a great resource for employees to learn about PEBB benefits, eligibility, and enrollment. 

Employees can also access the Public employees section of the Employee and retiree benefits website to learn more.