Change your coverage

Learn the requirements to make changes to your PEBB coverage.

Before you make a change

Before you make a change, it is important to:

How to make changes

You must submit the appropriate form(s) to your personnel, payroll, or benefits office during the PEBB Program's annual open enrollment or when a special open enrollment event occurs, within the PEBB Program’s timelines.

To make a change during the PEBB Program’s annual open enrollment:
Your personnel, payroll, or benefits office must receive the appropriate Employee Enrollment/Change form between November 1-30. You may also make some changes using My Account.

To make a change when a special open enrollment event occurs:
Your personnel, payroll, or benefits office must receive the appropriate Employee Enrollment/Change form no later than 60 days after the event that created the special open enrollment. However, if adding a newborn or newly adopted child, and adding the child increases your premium, your employer must receive this form no later than 12 months after the birth or adoption.

Changes you can make any time

You can make some changes during the year without a special open enrollment event.

Plan change requirements

  • You can only change medical or dental plans during the PEBB Program's annual open enrollment (November 1–30) or if you have a special open enrollment event.
  • All eligible family members must enroll in the same health plan. (Family members can have different providers.)
  • If you have a provider you want to stay with, contact your plan or check the plan’s provider directory to make sure your provider is in the plan’s network.
  • You cannot be enrolled on two PEBB accounts at the same time. If you and your spouse or registered domestic partner are both eligible subscribers, you need to choose which of you will cover yourselves and your eligible children (including adult children who are also eligible for PEBB coverage as an employee). Enrolled family members will be listed on one account, not both.

Special open enrollment

Certain events let you make account changes (like changing a health plan or enrolling a dependent) outside of annual open enrollment. We call these special open enrollment events.

You must provide proof of the event that created the special open enrollment (for example, a marriage or birth certificate).

These changes may be allowed as a special open enrollment:

If this event happens... Add dependent Remove dependent Change PEBB medical and/or dental plan Waive PEBB medical coverage Enroll after waiving PEBB medical coverage
Marriage, registering a domestic partner, as defined by Washington Administrative Code 182-12-260(2), birth, adoption, or assuming a legal obligation for total or partial support in anticipation of adoption. Yes1 Yes2 Yes Yes Yes
Child becomes eligible as an extended dependent through legal custody or legal guardianship. Yes No Yes No Yes
Child becomes eligible as a dependent with a disability. Yes No Yes No Yes
Employee or dependent loses eligibility for other coverage under a group health plan or through health insurance, as defined by the Health Insurance Portability and Accountability Act (HIPAA). Yes No Yes No Yes
Employee has a change in employment status that affects the employee's eligibility for his or her employer contribution toward his or her employer-based group health plan. Yes Yes Yes Yes Yes
Employee's dependent has a change in his or her own employment status that affects his or her eligibility for the employer contribution under his or her employer-based group health plan. Yes Yes Yes Yes Yes
Employee or dependent has a change in enrollment under another employer-based group health plan during its annual open enrollment that does not align with the PEBB Program’s annual open enrollment. Yes Yes No Yes Yes
Employee's dependent moves from outside the United States to live within the United States, or from within the United States to live outside of the United States. Yes Yes No Yes Yes
Employee or dependent has a change in residence that affects health plan availability. No No Yes No No
A court order or National Medical Support Notice requires the employee or any other individual to provide a health plan for an eligible child of the employee. Yes Yes Yes No Yes
Employee or dependent becomes entitled to or loses eligibility for Medicaid or a state Children’s Health Insurance Program (CHIP). Yes Yes Yes Yes Yes
Employee or a dependent becomes eligible for a state premium assistance subsidy for PEBB health plan from Medicaid or a state CHIP. Yes No Yes No Yes
Employee or dependent becomes entitled to Medicare or loses eligibility under Medicare, or enrolls in or terminates enrollment in a Medicare Part D plan. No No Yes Yes No
Employee's or dependent’s current health plan becomes unavailable because the employee or dependent is no longer eligible for a health savings account (HSA). No No Yes No No
Employee or dependent experiences a disruption of care that could function as a reduction in benefits for the employee or his or her dependent for a specific condition or ongoing course of treatment (requires approval by the PEBB Program). No No Yes No No
Employee or dependent becomes eligible and enrolls in TRICARE, or loses eligibility for TRICARE. No No No Yes Yes
Employee becomes eligible and enrolls in Medicare, or loses eligibility for Medicare. No No No Yes Yes

1Subscriber may add only the new spouse, registered domestic partner, or child(ren) of the spouse or partner. Existing dependents may not be added.

2Subscriber may only remove a dependent from PEBB coverage if the dependent enrolls in the new spouse’s or registered domestic partner’s plan.

For more details, see PEBB Program Policy 45-2A and refer to Washington Administrative Code (WAC):

The PEBB Program's annual open enrollment

From November 1–30 each year, you can make changes to your PEBB account that will take effect January 1 of the following year.

During open enrollment you can:

  • Change medical or dental plans.
  • Enroll or remove eligible dependents.
  • Enroll in a medical plan, if you previously waived PEBB medical for other employer-based group medical insurance coverage, TRICARE, or Medicare.
  • Waive enrollment in PEBB medical if you have or are enrolling in other employer-based group medical insurance, TRICARE, or Medicare effective January 1. (Coverage through the Health Benefit Exchange is not group coverage.)
  • Enroll or re-enroll in a Medical Flexible Spending Arrangement (PEBB benefits-eligible state agency and higher-education employees only).
  • Enroll or re-enroll in the Dependent Care Assistance Program (PEBB benefits-eligible state agency and higher-education employees only).
  • Change your election under the state’s premium payment plan.

Changes you can make online

During open enrollment you can make changes online using My Account. You can:

  • Change your medical and/or dental plan(s).
  • Waive medical coverage if you are enrolled in other employer-based group medical insurance coverage, TRICARE, or Medicare (coverage through the Health Benefit Exchange is not group coverage).
  • Remove family members from your coverage.

Please print or save your confirmation page when you’ve completed your changes. Check back in two business days to verify the coverage you selected and your spousal or state-registered domestic partner coverage attestation is correct.

When you submit an online plan change, please wait two business days to make any additional online plan changes.