MetLife PEBB employee Certificate of Coverage (COC) Washington residents 2020

This is the MetLife life insurance and accidental death and dismemberment certificate of coverage for PEBB employees who live in Washington.

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MetLife PEBB employee life insurance Certificate of Coverage (COC) non-Washington residents 2020

This is the MetLife PEBB employee life and accidental death and dismemberment insurance certificate of coverage for employees who do not reside in Washington.

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MetLife PEBB employees Certificate of Coverage (COC) non-Washington residents 2019

MetLife PEBB employee Certificate of Coverage (COC) Washington residents 2019.

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MetLife PEBB employees Certificate of Coverage (COC) Washington residents 2019

MetLife PEBB employee Certificate of Coverage (COC) Washington residents 2019.

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MetLife PEBB life insurance beneficiary designation

Use this form to name the persons or entities you want to receive your life insurance proceeds after your death. Return this form to MetLife.

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Paying for your premiums with pretax dollars

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This is a FAQ document about pretax deductions for your PEBB medical plan. If you are an eligible state agency or higher-education institution employee enrolling in a PEBB medical plan, your employer may deduct your medical premium from your paycheck before calculating federal withholding, Social Security, and Medicare taxes.

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PEBB Certification of a child with disability 2019

50-142-2019

After turning 26, your dependent may be eligible for enrollment under your PEBB coverage. Use this form to certify your dependent's disability and enroll them on your PEBB coverage.

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PEBB dental benefits comparison 2019

This chart briefly compares the per-visit costs of some in-network benefits for PEBB plans. Some copays and coinsurance do not apply until after you have paid your annual deductible. For information on specific benefits and exclusions, refer to the dental plan’s certificate of coverage or contact the plan directly.

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PEBB dental benefits comparison 2020

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This chart briefly compares the per-visit costs of some in-network benefits for PEBB plans. Some copays and coinsurance do not apply until after you have paid your annual deductible. For information on specific benefits and exclusions, refer to the dental plan’s certificate of coverage or contact the plan directly.

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PEBB Employee authorization for payroll deduction to health savings account (HSA) 2019

50-098-2019

Use this form to have your employer withhold money from your paychecks and deposit it into your health savings account (HSA) on a pretax basis. Check with your payroll department before submitting this form; not all employers can arrange for payroll deductions. You must be enrolled in a consumer-directed health plan (CDHP) with an HSA before you can start a payroll deduction.

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