How do I enroll?

What coverage can I continue?

You may continue the PEBB medical and/or dental coverage you were enrolled in on the day before your qualifying event. In some cases, you may continue life and accidental death and dismemberment (AD&D) insurance, long-term disability insurance (LTD), and your flexible spending arrangement (FSA). Visit Am I eligible? for more information about your coverage options.

What forms do I need?

We will not enroll you until you submit forms to continue your PEBB coverage and make the first premium payment, including applicable premium surcharges, within the timelines provided.

Medical and dental coverage

Depending on the coverage you are eligible for, submit either:

• PEBB Continuation Coverage (COBRA) Election/Change form
• PEBB Continuation Coverage (Unpaid Leave) Election/Change form

Life insurance and AD&D insurance

Life and AD&D insurance are available to continue for PEBB Continuation Coverage (Unpaid Leave) subscribers. Make your election to continue life and AD&D insurance on the PEBB Continuation Coverage (Unpaid Leave) Election/Change) form. If you do not continue your life and AD&D insurance while on leave, you must reapply for supplemental life and AD&D insurance when you regain eligibility.

If you are a PEBB Continuation Coverage (COBRA) subscriber and wish to continue your life insurance under portability or conversion, submit the form sent to you by MetLife. MetLife must receive your form no later than 60 days after your PEBB employee life insurance ends.

Learn more about life and AD&D insurance.

Long-term disability (LTD) insurance

PEBB Continuation Coverage (Unpaid Leave) subscribers may self-pay for LTD insurance when you are on approved educational leave or called to active duty under the uniformed services as defined under USERRA. Make your election to continue LTD insurance on the PEBB Continuation Coverage (Unpaid Leave) Election/Change form.

If you are eligible to continue employee-paid LTD insurance but choose not to, you will have to provide evidence of insurability when you regain eligibility.

You will receive the same coverage of LTD insurance before leave on the first day of the month you regain eligibility. You do not need to submit forms.

Learn more about LTD insurance.

Flexible spending arrangements (FSAs)

Both COBRA and Unpaid Leave subscribers can continue FSAs.

If you are eligible to continue your FSA, Navia Benefit Solutions will mail a COBRA election notice to you. Navia must receive your election no later than 60 days from the date PEBB health plan coverage ended or the postmark date on Navia’s COBRA election notice, whichever is later.

Learn more about FSAs.

Can I enroll later?

You can enroll in coverage as long as the PEBB Program receives your forms no later than 60 days from the date your PEBB health plan coverage ended, or the postmark date on the PEBB Continuation Coverage Election Notice, whichever is later. After this date, you will lose your opportunity to enroll.