PEB Board approves two resolutions

On April 13, 2023, the Public Employees Benefits Board (PEB Board) met. Members attended in person at the Health Care Authority building in Olympia and remotely. The meeting was open to the public both in person and via Zoom.

Meeting recap

Highlights are listed below. See the briefing book for all presentation materials.

The Board approved the following resolutions:

  • PEBB 2023-01 — When a subscriber has a change in residence that affects medical plan availability: After a change in residence, the subscriber must elect a new medical plan if a subscriber’s current medical plan is no longer available based on residence. If they do not elect a new medical plan within the time period allowed by special open enrollment rules, the subscriber will be enrolled in a PEBB medical plan as designated by the director or designee.
  • PEBB 2023-02 — When a subscriber is involuntarily terminated by a MA or MAPD plan: When a subscriber or their dependent must be disenrolled by a Medicare Advantage (MA) plan or Medicare Advantage-Prescription Drug (MAPD) plan as required by federal law, the subscriber and their enrolled dependents will be enrolled in a PEBB medical plan as designated by the director or designee. The new medical plan coverage will begin the first day of the month following the date the MA or MAPD plan is terminated.

HCA staff provided presentations on the following:

  • Follow up on a question asked at the March board meeting about measuring customer satisfaction with Uniform Medical Plan (UMP) pharmacy services
  • The legislative proposals for the next biennial PEBB Program budget
  • The 2023 legislative session and several bills that passed fully, including the following already signed by the Governor:
    • SB 5421, which creates a public records act exemption for all enrollment information collected by the Public Employees Benefits Board (PEBB) and School Employees Benefits Board (SEBB) programs
    • SB 5490, which allows certain retirees to have a second chance to apply for PEBB retiree coverage if they were denied and appealed their application for enrollment by December 31, 2022
    • SSB 5275, which allows certain employer groups to join the SEBB Program
    • SB 5729, which creates an insulin cost-sharing cap
  • Update on the annual rulemaking process
  • Over-the-counter hearing instruments
  • Washington Wellness program and SmartHealth participation
  • The procurement process, including a completed procurement for a flexible spending arrangement (FSA) and Dependent Care Assistance Program (DCAP) vendor for 2024, as well as progress on contracting with WebMD as the likely future SmartHealth vendor starting in 2024
  • Insights on Medicare issues, including information about a Centers for Medicare and Medicaid Services (CMS) surcharge that sometimes applies, called “Income Related Monthly Adjustment Amount” (IRMAA)
  • An analysis of UMP Classic Medicare pharmacy benefits, which examined potential plan savings under frequently suggested alternative pharmacy benefit designs: changing pharmacy cost shares from coinsurance to copayment, increasing the maximum pharmacy out-of-pocket limit, and creating a higher cost sharing tier for specialty drugs. These changes are often perceived as having potential cost savings to retirees, but the analysis showed that any premium savings are shifted to members' out-of-pocket spending at the pharmacy. There was not any overall net change in the annual costs for the vast majority (more than 95 percent) of retirees.

Next meeting

The next public meeting of the PEB Board is scheduled for May 11, 2023, from 9 a.m. to 1:30 p.m. Board members and the public may attend in person (masks are recommended) or virtually via Zoom. A link or call-in number for virtual attendance will be noted on the meeting agenda and posted on the PEB Board Meetings and materials webpage.