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PEBB employee authorization for payroll deduction to health savings account (HSA) 2020
50-098Use 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.
FormPEBB Employee Enrollment Guide 2020
50-100This guide explains everything about PEBB benefits for public employees.
PublicationPEBB employee monthly premiums 2019
These are the Public Employee Benefits Board (PEBB) Program medical plans offered for 2019. These premiums apply to employees in state agencies, higher-education institutions, and community and technical colleges. These premiums do not include the monthly premium surcharges, if applicable to your account.
PublicationPEBB employee monthly premiums 2020
50-626These are the Public Employee Benefits Board (PEBB) Program medical plans offered for 2020. These premiums apply to employees in state agencies, higher-education institutions, and community and technical colleges. These premiums do not include the monthly premium surcharges, if applicable to your account.
PublicationPEBB employee request for review/notice of appeal
Use this form if you are requesting an appeal of a decision.
FormPEBB Kaiser Permanente NW Classic Summary of Benefits and Coverage (SBC) 2020
A summary of what the PEBB Kaiser Permanente NW Classic plan covers and what it costs.
PublicationPEBB Kaiser Permanente NW Consumer Directed Health Plan (CDHP) Summary of Benefits and Coverage (SBC) 2020
A summary of what the PEBB Kaiser Permanente NW Consumer Directed Health Plan (CDHP) plan covers and what it costs.
PublicationPEBB medical 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.
PublicationPEBB medical benefits comparison 2020
50-683This 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.
PublicationPEBB Medicare benefits comparison 2020
51-604This 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. Call the plans directly for more information on specific benefits, including preauthorization requirements and exclusions. Kaiser Permanente NW and Kaiser Permanente WA offer Medicare Advantage plans, but not in all areas.
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