Welcome to PEBB
The information here will help you:
- Choose which plans are right for you and your family.
- Know how and when to enroll.
This is only a brief summary. For details, see our Employee Enrollment Guide (see amendment to this guide).
See the 2014 medical and dental premiums for PEBB medical coverage.
You 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 to make a decision about your benefit options.
Give all enrollment forms and documents to your personnel, payroll, or benefits office unless directed otherwise.
You must submit your forms no later than 31 days after you become eligible for benefits (generally, eligibility begins on your first day of employment), or you will 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
Uniform Medical Plan (UMP),
administered by Regence BlueShield
- Choose one plan.
(If you have other comprehensive group medical coverage, you can waive PEBB medical coverage in section 1 of the enrollment form.)
- Fill out an Employee Enrollment/Change form. List which family members you want to enroll* in sections 1-3, and select a medical plan in section 4. (Or opt to waive PEBB medical coverage in section one.)
- Submit the form to your personnel, payroll, or benefits office no later than 31 days after you become eligible.
If you don't select a plan or don't submit your forms on time, you'll be enrolled in UMP Classic as a single subscriber.
* 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
Step 3 | Determine if premium surcharges apply to you
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.
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 PEBB 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 started July 1, 2014.
Do the premium surcharges apply to me?
Use these resources to decide:
Step 4 | Consider a flexible spending account and/or Dependent Care Assistance Program (optional)
Step 5 | Consider supplemental life insurance (optional)
Life insurance policies through ReliaStar Life Insurance Company.
You automatically receive $25,000 basic life insurance and $5,000 accidental death and dismemberment (AD&D) insurance at no cost to you.
You can build on your basic coverage with supplemental plans that add coverage for you and your family members.
You automatically receive basic employee life insurance and basic 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:
- Fill out a Life and AD&D Insurance Enrollment/ Change Form.
- Submit the form to your personnel, payroll, or benefits office no later than 60 days after you become eligible for benefits.
If you do need evidence of insurability:
- Fill out a Life and AD&D Insurance Enrollment/Change Form.
- Submit the form to your personnel, payroll, or benefits office.
- Ask your personnel, payroll, or benefits office to fill out their portion of a Life Insurance Evidence of Insurability Form.
- Once your employer completes their portion, fill out your portion and submit the form to ReliaStar Life Insurance Company (to the address on the form).
Step 6 | Consider long-term disability coverage (optional)
Long-term disability (LTD) plans through Standard Insurance Company.
You automatically receive basic LTD insurance at no cost to you.
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.
To enroll in the Optional LTD Plan:
- Fill out a Long Term Disability (LTD) Enrollment/Change Form.
- Submit the form to your employer’s personnel, payroll, or benefits office no later than 31 days after you become eligible for benefits.
Step 7 | Consider the SmartHealth wellness incentive (optional)
Step 8 | Consider PEBB auto and home insurance (optional)
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: