PEBB Continuation Coverage (COBRA) Election/Change 2025
Use this form to enroll in or change your enrollment options for COBRA coverage.
Forms & publications
PEBB Continuation Coverage (COBRA/Employer Group Ended Participation) Election/Change 2026
The 2026 PEBB Continuation Coverage (COBRA/Employer Group Ended Participation) Election/Change form. Use this form to enroll in or change your enrollment options for COBRA or Employer Group Ended Participation coverage.