Rules and policies

The PEBB Program follows the rules in Washington Administrative Code (WAC). Our administrative policies describe how we implement a law or rule affecting participation in PEBB Program benefits.

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PEBB Program law

You can find the PEBB Program's existing law in chapter 41.05 of the Revised Code of Washington (RCW).

PEBB Program rules

The PEBB Program follows the rules in Washington Administrative Code (WAC) chapters:

Below are links to the detailed rules for circumstances most common to employees, retirees and dependents:

To find a specific WAC section look under chapters 182-08, 182-12, or 182-16.

PEBB Program policies

The PEBB Program's administrative policies describe how we implement a law or rule affecting participation in PEBB Program benefits. The statements made in these documents reflect our interpretations of the eligibility and enrollment rules.

Employee eligibility and enrollment

Number Title Effective Date
11-1 Providing notifications to employees and employers 6/1/2010
11-3

Correcting employing agency enrollment errors

1/1/2017
15-1 Determining eligibility for seasonal employees and maintenance of employer contribution through the off-season 1/1/2017
17-1 Determining faculty eligibility for summer/short class sessions 1/1/2017
17-2 Determining faculty eligibility after a layoff 1/1/2017
17-3 Determining faculty eligibility for off-quarter/semester or for decreases in workload 1/1/2017
19-1 Termination due to loss of eligibility 1/1/2017
19-1A Addendum - Termination due to loss of eligibility: Employee 1/1/2017
19-1B Addendum - Termination due to loss of eligibility: Self-pay subscriber 1/1/2017

Retiree eligibility and enrollment

Number Title Effective Date
21-1 Exemption from retiree deferral form 1/1/2017
26-1 Administering PEBB insurance in coordination with Medicare Part D 1/1/2017

Dependent eligibility and enrollment

Number Title Effective Date
31-1 Verifying dependent eligibility before enrollment 1/1/2017
31-2 Use of premium surcharge help sheet and spousal plan calculator tools 1/1/2016
33-1 Verifying legal union's residency status 4/26/2014
36-1 Certifying eligibility for dependent children with disabilities who are age 26 and older 1/1/2015
37-1 Certifying eligibility for an extended dependent child 1/1/2016

Open enrollment

Number Title Effective Date
45-2 Special Open Enrollment (SOE) 1/1/2017
45-2A Addendum - Special open enrollment (SOE) matrix: Summary of permitted election changes 1/1/2017

Administrative - Permanent

Number Title Effective Date
90-1 Allowable mid-year employer group terminations 1/1/2017
91-1 Requesting a reasonable alternative for completing wellness incentive program requirements or avoiding the tobacco use premium surcharge 1/1/2017
91-2 Tobacco as it relates to religious or ceremonial 4/26/2014
93-2 PEBB Program payment plans 1/1/2017

Proposed policies

There are no proposed policies at this time.

Rescinded or superseded policies

The policies listed below are rescinded as of January 1, 2017. To request policies that have been rescinded, contact the PEBB Policy and Rules team at the address at the bottom of this page.

Number Title Effective Date
11-3

Correcting employing agency enrollment errors

1/1/2016
15-1 Determining eligibility for seasonal employees and maintenance of employer contribution through the off-season 1/1/2016
17-1 Determining faculty eligibility for summer/short class sessions 1/1/2010
17-2 Determining faculty eligibility after a layoff 1/1/2014
17-3 Determining faculty eligibility for off-quarter/semester or for decreases in workload 1/1/2014
19-1 Termination due to loss of eligibility 1/1/2016
19-1A Addendum - Termination due to loss of eligibility: Employee 1/1/2016
19-1B Addendum - Termination due to loss of eligibility: Self-pay subscriber 1/1/2016
21-1 Retiree deferral form exemption 1/1/2016
26-1 Administering PEBB insurance in coordination with Medicare Part D 1/1/2015
31-1 Verifying dependent eligibility before enrollment 1/1/2016
45-2 Special Open Enrollment (SOE) 1/1/2016
45-2A Addendum - Special open enrollment (SOE) matrix: Summary of permitted election changes 1/1/2016
90-1 Allowable mid-year employer group terminations 1/1/2014
91-1 Requesting a reasonable alternative for completing wellness incentive program requirements or avoiding the tobacco use premium surcharge 1/1/2016

Contact

Mail:

Washington State Health Care Authority
PEBB Policy and Rules
P.O. Box 42684
Olympia, WA 98504-2684