Retiring and PEBB retiree insurance

PEBB retiree coverage is available to employees who meet procedural and substantive eligibility requirements described in WAC 182-12-171. Coverage is also available to:

• Elected and full-time appointed officials of the legislative and executive branches of state government who voluntarily or involuntarily leave public office and meet the procedural requirements.
• The surviving spouse, state-registered domestic partner, or dependent children of a deceased eligible employee or retiree.
• The surviving spouse, state-registered domestic partner, or dependent children of an emergency service employee killed in the line of duty.
• When enrolling in retiree coverage, an employee may change the medical plan they had while employed. If eligible dependents are enrolling, they must be covered under the same medical and dental plan as the retiree with the exceptions specified for Medicare Supplement Plan F.

To enroll or defer retiree coverage, PEBB must receive the Retiree Enrollment form (form A) no later than 60 days after the employer-paid coverage, COBRA coverage, or continuation of coverage ends.

Retirees may choose to enroll in:

• Medical, or
• Medical and Dental, and/or
• Retiree term life insurance (if eligible)

Retirees and permanently disabled employees of employer groups who discontinue participation with PEBB may be eligible for PEBB Extension of Coverage on a self-pay basis for up to 18 months.

Employer process

Complete the appropriate C-series worksheet and provide the PEBB Retiree Health Insurance Checklist to employees who are:

• Leaving employment due to retirement who may be eligible for PEBB retiree insurance coverage.
• Retirees who returned to work and are retiring again.
• Applying for disability retirement who may be eligible for PEBB retiree insurance coverage.

The worksheets are located on the Eligibility worksheets page for state agencies and institutions of higher education or the Notification requirements page for employer groups.

Who determines eligibility for retirement and PEBB retiree insurance?

Eligibility for retirement is determined by the Department of Retirement Systems (DRS) and eligibility for PEBB retiree insurance is determined by the PEBB program.

Eligibility for PEBB retiree insurance

The PEBB Program determines eligibility based on when an application is received and PEBB rules.

In general, employees must be eligible to retire under a Washington State-sponsored retirement plan when the employee’s employer-paid coverage or COBRA coverage ends.

• DRS plan 1 and 2 members must immediately receive a monthly retirement plan payment or lump sum payment as allowed by the plan.
• DRS Plan 3 members are not required to receive a retirement plan or lump sum payment but must be at least age 55 and have at least 10 years of service under Plan 3.
• Employees who are members of a Washington higher education retirement plan (i.e., TIAA-CREF) are eligible if they immediately begin to receive a monthly retirement plan payment, meet their plan’s retirement eligibility criteria, or are at least age 55 with 10 years of service.
• Employees not retiring under a Washington State-sponsored retirement plan must meet the same age and years of service had the person been a member of either PERS Plan 1 or 2 for the same period of employment.

The PEBB Program

• Phone: 1-800-200-1004 (this number is for retiree, COBRA and Unpaid Leave subscribers only.).
• PEBB Retirees website
• Send a secure message: HCA Support

Department of Retirement Systems (DRS) (if applicable)

• Phone: 1-800-547-6657
• DRS website

Procedural requirements

Procedural requirements include:

• The employee must submit the Retiree Enrollment form (form A) to enroll or defer. The PEBB program must receive the form no later than 60 days after the employer-paid coverage, COBRA coverage, or continuation of coverage ends.
• Employees not entitled to Medicare Part A and Part B, and wanting to enroll dependents, must provide verification documents.
• If eligible, the subscriber and/or dependents must enroll and maintain enrollment in both Medicare Part A and Part B to qualify for PEBB retiree coverage.
• PEBB will not enroll subscribers until it receives the first premium payment unless they choose to have their premiums deducted from their monthly pension check.

Retiree life insurance options

PEBB provides life insurance through the Metropolitan Life Insurance Company (MetLife). PEBB retirees may be eligible to purchase the following life insurance options:

• Portability provision
• Conversion of life insurance provision
• Retiree term life insurance

Portability provision

Employees may apply to continue their PEBB employee basic life and optional life insurance until age 100 if certain conditions are met.

Coverage may be decreased but cannot be increased.

The minimum an employee can continue under the portability provision is $5,000. The approved amount will not exceed $2,000,000.

Dependent basic life and any spouse or state-registered domestic partner optional life insurance can be continued, but only if the employee continues their life insurance.

Conversion of life insurance provision

Retiring employees and their dependents may be entitled to convert their life insurance to an individual policy without evidence of insurability (proof of good health).

The amount of the individual policy will be equal to (or at the employee's option, less than) the amount of coverage as of the termination date of the policy being converted.

MetLife will send information and an application to employees eligible for portability or conversion due to termination or other reasons. Employees can contact MetLife directly at 1-877-275-6387 with any questions about the portability and/or conversion provisions.

Retiree term life insurance

This insurance is only available to those who meet the PEBB Program’s retiree eligibility requirements and had life insurance through the PEBB Program as an employee.

Enrolling requires PEBB receive the Retiree Enrollment form (form A) no later than 60 days after the employer-paid coverage ends.

Dependents are not eligible for retiree term life insurance.

Retiree term life coverage is not available to those who:

• Enroll in COBRA
• Have a break in life insurance coverage

For more information concerning retiree life insurance options with MetLife please refer to the Certificates of Coverage (COC) for Washington and non-Washington residents.

Related rules and policies

• WAC 182-12-171: When is a retiring employee or a retiring school employee eligible to enroll in PEBB retiree insurance coverage?
• WAC 182-12-146: When is an enrollee eligible to continue PEBB benefits under COBRA?
• WAC 182-12-200: May a retiring employee, a retiring school employee, or a retiree enrolled as a dependent in a health plan sponsored by PEBB, a Washington state educational service district, or SEBB defer enrollment under PEBB retiree insurance coverage?
• WAC 182-12-205: May a retiree or a survivor defer enrollment or voluntarily terminate enrollment under PEBB retiree insurance coverage?