Federal government shutdown FAQs for PEBB subscribers

I’m an employee enrolled in PEBB benefits. If the federal government shuts down and that impacts my job, what will happen to my PEBB benefits? If I have a medical procedure during the shutdown, will it be covered?

To keep eligibility for the employer contribution toward your PEBB benefits, you must have at least eight hours of pay status in each month (WAC 182-12-131). WAC 182-12-109 defines pay status as “all hours for which an employee receives pay.” Typically, one full day of work or a full day of paid leave (vacation or sick leave) covers this requirement. If you are not able to work or submit leave for at least eight hours in a month, you will lose eligibility for the employer contribution toward your PEBB benefits and coverage will end on the last day of that month for you and any enrolled dependents.

If this happens, you and your dependents may continue any combination of medical, dental, or vision and may also continue life insurance and accidental death and dismemberment (AD&D) insurance by self-paying the premiums and applicable premium surcharges on a post-tax basis. This is called PEBB Continuation Coverage. Your employer will make no contribution toward the premiums.

When your coverage ends, the PEBB Program will mail a PEBB Continuation Coverage Election Notice to you. This booklet describes your options to continue your PEBB insurance coverage.

The PEBB Program offers two types of continuation coverage: PEBB Continuation Coverage (COBRA) and PEBB Continuation Coverage (Unpaid Leave). If you lose coverage due to a government shutdown, it would likely be to your advantage to elect PEBB Continuation Coverage (Unpaid Leave) because:

• This coverage also includes the option to continue life insurance. COBRA offers portability or conversion options for life insurance.
• This coverage lasts up to 29 months for a layoff. COBRA generally lasts up to 18 months for a termination or a reduction in hours.

Neither option allows you to continue either employer-paid long-term disability insurance or employee-paid LTD insurance due to a layoff or a reduction of hours.

When enrolling in PEBB Continuation Coverage (COBRA or Unpaid Leave), you must pay the full monthly premium and any applicable surcharges. The premiums for both options are the same. You can find the premiums in the PEBB Continuation Coverage Election Notice and PEBB Continuation Coverage Monthly Premiums.

To enroll in PEBB Continuation Coverage (COBRA or Unpaid Leave), the PEBB Program must receive your request in Benefits 24/7 or forms and supporting documentation no later than 60 days after your PEBB health plan coverage ends or from the postmark date on the PEBB Continuation Coverage Election Notice, whichever is later.

If the PEBB Program receives your completed enrollment, monthly premiums, and any applicable surcharges within the timelines stated in the notice, you will continue to receive health plan coverage for any covered services you receive during the shutdown. Your PEBB Continuation Coverage (COBRA or Unpaid Leave) will automatically end when you regain eligibility for the employer contribution toward PEBB benefits.

What actions may a PEBB benefits-eligible employee take if they are affected by the federal government shutdown, and their spouse is also an employee who is eligible for PEBB (or SEBB) benefits is not affected by the federal government shutdown?

The employee who is not affected by the federal government shutdown may enroll their affected spouse under their PEBB (or SEBB) insurance coverage as a dependent if the employee who is affected by the federal government shutdown doesn’t have at least eight hours of pay status. The employee who is adding their spouse as a dependent may do so under a special open enrollment event.

Example

Bill and Jackie are both PEBB benefits-eligible state employees. Bill works at the Health Care Authority and is being affected by the federal government shutdown. His wife Jackie works at the Department of Transportation (DOT) and is not affected by the federal government shutdown. Jackie may submit her changes and a copy of Bill’s layoff notice (proof of the event) in Benefits 24/7 or to DOT’s payroll or benefits office no later than 60 days after the event to enroll Bill (and any children currently enrolled under Bill’s coverage).

I’m an employee who has Flexible Spending Arrangement (FSA) or Dependent Care Assistance Program (DCAP) contributions deducted from each paycheck. If I’m not paid because of a federal government shutdown, what happens to my FSA and/or DCAP contribution?

Your payroll office will work with Navia Benefit Solutions to recalculate the deduction for each missed pay period. Your contribution amount will be recalculated on future paychecks to make up for any missed payroll deductions when you return to work. If you are a higher-education employee, your employer will make the adjustments in payroll.

I’m an employee who has health savings account (HSA) contributions deducted from each paycheck. If I’m not paid because of a federal government shutdown, will my HSA contribution amounts be deducted from future paychecks?

No, missed HSA contribution amounts will not be deducted from future paychecks. You will not receive your employee contribution if you do not have a paycheck to get the contribution from. Keep in mind, you may also revise your election amount by submitting an Employee Authorization for Payroll Deduction to Health Savings Account form to your payroll or benefits office upon returning to work.