Gender identity information

The Health Care Authority (HCA) is adding gender identity options for the people we serve. Washington Apple Health is exploring what those options will be. The Public Employees Benefits Board (PEBB) Program and School Employees Benefits Board (SEBB) Program added gender identity options, including gender X, to their paper forms and in SEBB My Account for the 2021 plan year. Gender identity options will also be added to the PEBB and SEBB program’s online enrollment system, Benefits 24/7 in 2024. “X” means a gender that is not exclusively male nor female. Some examples include nonbinary, agender, or gender nonconforming.

Why add gender identity?

We are aligning with the Department of Health (DOH) and the Department of Licensing (DOL). As of 2018, DOH allows a person born in Washington State to change their sex designation on their birth certificate from male or female to the new designation of "X” to reflect their gender identity. In late 2019, DOL began allowing Washington drivers to change their gender designation on their driver’s licenses to “X”.

This “X” option helps to ensure that all Washington residents have consistent identity documents where possible. Consistent documents help residents of all genders access the public services they need, and it may reduce the risk of violence, discrimination, and harassment. We are extending the same options to our members’ health coverage.

Why do the PEBB and SEBB programs ask for “Sex assigned at birth”?

The gender identity field is optional on the enrollment forms, in SEBB My Account, and will continue to be optional in the PEBB and SEBB program’s new online enrollment system, Benefits 24/7 — you may choose not to complete it.

However, the “Sex assigned at birth” field is mandatory. This information is required for federal reporting, to meet health plan vendor requirements, and ensure coordination of benefits and efficient medical claims processing. The data also ensures that enrollees are getting the type of health services they need. For example, uterine cancer screenings are only covered by medical plans for those who were assigned female at birth, and prostate exams are only covered for those who were assigned male at birth.  

What happens if I don’t respond to the gender identity field for the PEBB or SEBB programs?

If you do not complete the gender identity field, our system of record will populate this field with the same answer you provided for the “Sex assigned at birth” field.

How can I change my gender identity on my account?

Apple Health clients

Visit the Transhealth program webpage.

PEBB and SEBB employees

Contact your payroll or benefits office.

All other PEBB or SEBB subscribers

Fax your gender identity change to 360-725-0771, or write to the PEBB or SEBB Program at:

Health Care Authority
PEBB or SEBB Program
PO Box 42684
Olympia, WA 98504-2684

Write the last four digits of the subscriber’s Social Security number on your letter so that we can identify your account.

Will you keep this information private?

We will keep this information confidential to the extent allowable by law. Learn more by visiting the Health Care Authority’s notice of privacy practices webpage. You can also read the Public Records Act, described in Revised Code of Washington 42.56, at the Washington State Legislature’s website.