PEBB - How to Enroll (New Employee | State Agency and Higher-Education)

  If you have questions or need help with enrollment, contact your personnel, payroll, or benefits office.

  Related links

Welcome to PEBB

The information here will help you:

  1. Choose which plans are right for you and your family.
  2. Know how and when to enroll.

This is only a brief summary. For details, see our Employee Enrollment Guide. (See recent amendment to this guide)

Premiums

See monthly premiums for PEBB medical coverage.

You only need to pay premiums for medical coverage, supplemental life insurance, and optional long-term disability insurance (if you choose to enroll), and premium surcharges if they apply to you. Your employer will pay premiums for your dental, basic life, and basic long-term disability benefits.

Benefits and how to enroll

Follow the steps below.

Give all enrollment forms and documents to your personnel, payroll, or benefits office unless directed otherwise.

Submit your forms within 31 days, or else you may lose certain benefit rights. (Exceptions: You have 60 days to enroll in supplemental life insurance if you want the coverage. The deadline to submit a SmartHealth Wellness Program Attestation Form is described below.)

Step 1 | Choose a medical plan

  Plan choices   How to enroll

Group Health

  • Group Health Classic
  • Group Health Value
  • Group Health Options CDHP

Kaiser Permanente

  • Kaiser Permanente Classic
  • Kaiser Permanente CDHP

Uniform Medical Plan (UMP),
administered by Regence BlueShield

  • UMP Classic
  • UMP CDHP

1) Choose one plan.
(If you have other comprehensive group medical coverage, you can opt to waive PEBB medical coverage in section 1 of the enrollment form.)

2) Fill out an Employee Enrollment/Change form

List who you want to enroll* in sections 1-3 of the enrollment form and select the medical plan in section 4.

3) Submit the form to your personnel, payroll, or benefits office within 31 days after you become eligible.

If you don't select a plan and submit your forms on time, you'll be enrolled in UMP Classic as a single subscriber. Your dependents won't be enrolled.

Premium surcharges ​How to respond

​A monthly $25 surcharge will be required in addition to your premium if you or a family member enrolled on your PEBB medical coverage uses a tobacco product.
AND
A monthly $50 surcharge will be required in addition to your premium if you have a spouse or domestic partner enrolled on your PEBB medical coverage, and your spouse or domestic partner has chosen not to enroll in medical coverage through his or her employer that is comparable to Uniform Medical Plan (UMP) Classic.

​If you are enrolling in PEBB medical coverage, you must also complete and submit the Premium Surcharge Attestation Form to your personnel, payroll, or benefits office no later than 31 days after the date you become eligible for benefits to attest whether the premium surcharges apply to you.

If you don’t submit the form on time and complete a response for each family member you enroll, you will pay the monthly tobacco use surcharge and the monthly spouse or domestic partner coverage surcharge (if you enroll a spouse or domestic partner on your PEBB medical coverage). These surcharges begin July 1, 2014.

 

 ​Do the premium surcharges apply to me?

About tobacco product use

About spousal coverage

* To add family members, you must provide verification and may need certification to show they're eligible.
   Submit these documents with your enrollment form(s).   

Step 2 | Choose a dental plan

  ​Plan choices ​How to enroll

Delta Dental of Washington

  • Uniform Dental Plan (UDP)
    (preferred-provider plan)
  • DeltaCare
    (managed-care plan)

Willamette Dental

  • Willamette Dental Group Plan
    (managed-care plan)

1) Choose one plan.
(You can't waive PEBB dental coverage.)

2) Follow the same steps listed for medical enrollment (above). Include your dental choice on the same form.

If you don't select a plan, you'll be enrolled in Uniform Dental Plan as a single subscriber. Your dependents won't be enrolled.

  Which plan is right for me?

Use these resources to decide:

Dental plans overview

Dental network comparison

Dental benefit comparison

Find providers by plan

Contact the plans for detailed questions.

Step 3 | Consider a flexible spending account and/or Dependent Care Assistance Program (optional)

  Benefit options ​  How to enroll
Voluntary flexible spending arrangement (FSA) and Dependent Care Assistance Program (DCAP) through Flex-Plan Services Inc.

1) Fill out an FSA/DCAP Enrollment Form (same form for one or both programs).

2) Submit the form within 31 days after you become eligible. Follow the instructions on the form to submit it.

  Should I enroll?

Use these resources to decide:

FSA overview

- FSA eligible expenses

DCAP overview

- DCAP eligible expenses

Contact the plan for detailed questions.

Step 4 | Consider supplemental life insurance (optional)

​  Benefit options ​  How to enroll

Life insurance policies through ReliaStar Life Insurance Company.

You will automatically receive $25,000 basic life insurance and $5,000 accidental death and dismemberment (AD&D) insurance at no cost.

You can build on your basic coverage with supplemental plans that add coverage for you and/or your family members.​

You automatically receive basic employee life and AD&D insurance.

To enroll in supplemental coverage, first see if you need to provide evidence of insurability.
 

If you don't need evidence of insurability:

1) Fill out a Life and AD&D Insurance Enrollment/ Change Form.

2) Submit the form to your personnel, payroll, or benefits office within 60 days after you become eligible.
 

If you do need evidence of insurability:

1) Fill out a Life and AD&D Insurance Enrollment/ Change Form.

2) Submit the form to your personnel, payroll, or benefits office.

3) Ask your personnel, payroll, or benefits office to fill out their portion of a Life Insurance Evidence of Insurability Form.

4) Once your employer completes their portion,fill out your portion and submit the form to ReliaStar Life Insurance Company (at the address on the form).

Step 5 | Consider long-term disability coverage (optional)

  Benefit options ​  ​ How to enroll

Long-term disability (LTD) plans through Standard Insurance Company.

You will automatically receive basic LTD insurance at no cost.

You can add on to your basic plan with an Optional LTD Plan that lowers your benefit waiting period and increases your benefit amount.

You'll automatically be enrolled in basic LTD insurance as an employee.

To enroll inthe Optional LTD Plan:

1) Fill out a Long Term Disability (LTD) Enrollment/Change Form.

2) Submit the form to your employer’s personnel, payroll, or benefits office within 31 days after you become eligible.

  Should I enroll?

Use these resources to decide:

LTD overview

- Optional LTD Plan premiums

LTD booklet

Contact the plan for detailed questions.

Step 6 | Consider the SmartHealth Wellness Program (optional)

  Benefit options ​ How to enroll

SmartHealth is a wellness incentive program that offers a $125 incentive in 2015 to eligible subscribers who complete three requirements.

​To be eligible to receive the incentive you must do the three health-related tasks no later than 60 days after your medical benefits become effective and submit the SmartHealth Wellness Program Attestation Form to your employer. (Note: Employees with an effective date of December 1, 2014 have until December 31, 2014 to complete the three activities and attest to the wellness incentive for 2015.)

  Should I enroll?

Use these resources to decide:

Program overview

Wellness activity helpsheet 

Frequently asked questions

Step 7 | Consider PEBB auto and home insurance (optional)

  Benefit option   How to enroll
Group auto and home insurance through Liberty Mutual Insurance Company.

See auto and home insurance overview for information on how to request a quote.

You can apply for this coverage at any time.

  Should I enroll?

Use this resource to decide:

Auto and home insurance overview

Step 8 | Consider long-term care insurance (optional)

  Benefit option ​  How to enroll
Group long-term care insurance through John Hancock Life Insurance Company (U.S.A.).

​Call John Hancock Life Insurance Company (U.S.A.) at 1-800-399-7271 for an enrollment packet. (Allow 7-10 days for an enrollment kit to arrive.)

If you apply by July 31, 2014, you'll have simplified underwriting. This benefit closes to new applicants effective August 1.

  Should I enroll?

Use this resource to decide:

LTC insurance overview

When does my coverage start?

If you're newly eligible:

Medical, dental, basic life, and basic LTD insurance coverage begins on the first day of the month after you become eligible for PEBB benefits (generally the first day of employment). If you become eligible on the first working day of the month, benefits begin on that day.

If you're a faculty member hired on a quarter/semester to quarter/semester basis:

Medical, dental, basic life, and basic LTD insurance begins on the first of the month after the beginning of the second consecutive quarter/semester of halftime or more employment. If the first day of the second consecutive quarter/semester is the first working day of the month, benefits begin on that day.

How do I get my plan ID card(s)?

After you enroll, your plan(s) will send you an identification (ID) card to show providers when you receive care.

If you have questions about your ID card, contact your plan directly. (Uniform Dental Plan does not mail ID cards, but you may download one from the plan’s website.)

What if I want to change my coverage later?

You can change plans or enroll your eligible dependents: