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PEBB - Tobacco Use Premium Surcharge

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For premium surcharge questions:

What is this?

A monthly $25 surcharge is required in addition to your medical plan premium if you or a family member enrolled on your PEBB medical coverage uses a tobacco product. You do not have to pay this surcharge if you respond that all tobacco users ages 18 and older are enrolled in your PEBB medical plan’s tobacco cessation program. Tobacco users ages 13-17 are considered enrolled in a tobacco cessation program if they access information and resources in Smokefree Teen. Enrolled family members ages 12 and younger are automatically defaulted as non-tobacco-users.

Note: As long as any family member covered under your PEBB medical plan uses a tobacco product, you will pay the tobacco use surcharge.

What is tobacco use?

Any use of a tobacco product within the past two months. It does not include the religious or ceremonial use of tobacco.

What are tobacco products?

Any product made with or derived from tobacco that is intended for human consumption, including any component, part, or accessory of a tobacco product. This includes, but is not limited to, cigars, cigarettes, chewing tobacco, snuff, and other tobacco products.

For more details, see the 2015 Premium Surcharge Help Sheet.

Who needs to attest (respond)?

You need to attest to this surcharge if you are one of the following PEBB medical plan subscribers:

  • Employee
  • Retiree not enrolled in Medicare Part A and Part B
  • COBRA not enrolled in Medicare Part A and Part B
  • Leave Without Pay (LWOP)

You do not need to attest if you are not one of these subscribers. The surcharge will not apply to your account.

What happens if I do not attest (respond)?

You will pay a monthly $25 surcharge in addition to your medical plan premium.

How do I attest or re-attest (report a change)?

Attest

Complete and submit the appropriate 2015 enrollment form as directed on the form if you are a subscriber enrolling in PEBB medical coverage. Use the 2015 Premium Surcharge Help Sheet to fill out the premium surcharge sections of the form.

Note: If you add a family member to your PEBB medical coverage, you need to re-attest to the tobacco use surcharge within PEBB’s timelines by completing and submitting the correct enrollment form.

Re-attest

Use one of the following options to report a change to your previous attestation:

When can I report a change?

Whenever you or a family member enrolled on your PEBB medical coverage has a change in tobacco use as noted below.

What is a change to tobacco use?

You can report a change if any family members who you reported using tobacco products have done ANY of the following:

  • Stopped using tobacco products for two months.
  • Enrolled in your PEBB medical plan’s tobacco cessation program (for ages 18 and older).
  • Accessed the information and resources in Smokefree Teen (for ages 13-17).

You must also report a change if a family member starts using a tobacco product, or ceases enrollment in your PEBB medical plan’s tobacco cessation program.

When do my attestations or changes take effect?

Generally, attestation changes will affect surcharges starting the first of the month after the changes were received. If attestation changes are received on the first day of the month, the change begins that day.