Forms & publications

The 2026 PEBB Employee Enrollment/Change form. Use this form to enroll in benefits or make changes to your benefits.

The 2026 PEBB Employee Enrollment/Change form for Medical Only groups. Use this form to enroll in benefits or make changes to your benefits.

These are the PEBB employee premiums for medical plans offered for 2025. 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.

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.

This publication lists the monthly medical premiums for school employees in 2025.

The monthly medical premiums for school employees in 2026.

Fact sheet about the PEBB and SEBB Programs for the Legislature.

Submit this form with your enrollment form if you are enrolling an extended (legal) dependent child.

Submit this form with your enrollment form if you are enrolling an extended (legal) dependent child.

This benefits book describes what is covered as a PEBB member under EyeMed Vision, including vision services and specific services not covered by the plan. Finding preferred providers and how much you’ll pay, including deductibles, coinsurance, and copays.