For newly eligible employees

What forms do I use?

Note: Pierce County, Washington State University, and University of Washington employees must enroll through Workday.

For medical and dental benefits

Submit one of the following forms, depending on your situation:

• If your employer offers the full benefits package: Employee Enrollment/Change form
• If your employer offers PEBB medical coverage only: Employee Enrollment/Change for Medical Only Groups form

Where and when do I submit these forms?

To your payroll or benefits office no later than 31 days after you become eligible for benefits.

For life and AD&D insurance

Basic life and AD&D insurance

If your employer offers this coverage, we enroll you when your PEBB benefits begin. Your employer pays for these benefits. 

Name your beneficiaries so your benefit goes where you expect. 

Supplemental life and supplemental AD&D insurance

To enroll, you must use your MetLife MyBenefits account. Don't have an account? Learn how to create one. 

For questions about enrollment in life or AD&D insurance, call MetLife at 1-866-548-7139. Evidence of insurability is not required within the 31-day window for the guaranteed issued coverage amounts.

Where and when do I need to enroll? 

Through the MetLife MyBenefits account, no later than 31 days after you become eligible for PEBB benefits. 

Note: You may choose to enroll in supplemental life insurance and accidental death and dismemberment (AD&D) insurance at any time during the calendar year. If you apply after your 31-day eligibility period or outside of a special open enrollment event, MetLife must approve your request and evidence of insurability may be required.

For long-term disability (LTD) insurance

Employer-paid LTD insurance

If your employer offers this coverage, we enroll you when your PEBB benefits begin. Your employer pays for these benefits.

Employee-paid LTD insurance

All employees are automatically enrolled in an employee-paid LTD plan that covers 60 percent of your insured income (up to $16,667) with a 90-day benefit waiting period.

Exception: Employee paid LTD insurance is not available to Port commissioners or seasonal employees who work a recurring, annual season that is less than nine months. 

Can I change this?

Yes. Submit the Long-Term Disability Enrollment/Change form to reduce to a lower-cost 50-percent coverage level or decline the coverage.

Where and when do I submit this form?

Submit the Long-Term Disability Enrollment/Change form at any time to your payroll or benefits office. Note: Pierce County, UW, and WSU employees use Workday to reduce or decline coverage.

If you later decide to enroll in or increase coverage, you will have to provide evidence of insurability and be approved by the insurer. Visit Long-term disability insurance for more information.

For other PEBB-sponsored benefits

State agency and higher-education employees only may enroll in a Flexible Spending Arrangement (FSA) or Dependent Care Assistance Program (DCAP).

Where and when do I enroll?

Submit the Midyear Enrollment Form to your payroll or benefits office no later than 31 days after you become eligible for PEBB benefits. 

UW and WSU employees use Workday.

Am I required to enroll?

If your employer determines that you are eligible, yes, you are required to enroll. However, you may waive your enrollment in medical coverage if you are enrolled in other employer-based group medical, a TRICARE plan, or Medicare.

What happens if I waive coverage?

• Your dependents will not be enrolled.
• You will still be enrolled in PEBB dental, basic life insurance, basic accidental death and dismemberment insurance, employer-paid long-term disability (LTD) insurance, and employee-paid LTD insurance (unless you decline it) if your employer offers these coverages.

Exceptions: You may waive enrollment in PEBB medical to enroll in School Employees Benefits Board (SEBB) medical only if you are also enrolled in SEBB dental and vision. By doing so, you waive enrollment in PEBB dental. Visit Waive my coverage.

If you waive enrollment in PEBB medical when you are enrolled in other employer-based group medical, a TRICARE plan, or Medicare, and you are not enrolled in SEBB medical, you may waive enrollment in PEBB dental only if you are enrolled in both SEBB dental and SEBB vision as an eligible dependent in the SEBB Program. 

Visit waive my coverage. 

What if I don't submit my forms?

If you do not submit forms to enroll or waive enrollment, you will be enrolled as a single subscriber (no dependents) in the following benefits:

• Uniform Medical Plan (UMP) Classic
• Uniform Dental Plan (UDP)
• Basic life insurance and basic AD&D insurance
• Employer-paid long-term disability (LTD) insurance
• Employee-paid LTD insurance

The following also apply:

• You will be charged a monthly premium for medical coverage and the tobacco use premium surcharge.
• You cannot change plans or enroll eligible dependents until the next open enrollment, unless you have life event that creates a special open enrollment that allows the change.

How do I enroll my dependents?

If you enroll dependents on your PEBB coverage, you must provide proof of their eligibility within the required enrollment timelines or they will not be enrolled. Visit Verify and enroll dependents.

What if I'm enrolled in Medicare?

If you or any of your dependents are enrolled in Medicare, or may soon be, learn more about how Medicare and PEBB benefits work together while you're employed.

FAQs

When does coverage begin?

If you're newly eligible

Medical, dental, basic life, basic AD&D insurance, employer-paid LTD, and employee-paid LTD insurance coverage begins on the first day of the month following the date you become eligible for PEBB benefits (generally the first day of employment). If you become eligible on the first working day of the month, coverage begins on that day.

If you're a faculty member hired on a quarter/semester to quarter/semester basis

Medical, dental, basic life, basic AD&D insurance, employer-paid LTD, and employee-paid LTD insurance coverage begins on the first of the month following the beginning of the second consecutive quarter/semester of half-time or more employment (or anticipated half-time or more employment). If the first day of the second consecutive quarter/semester is the first working day of the month, coverage begins on that day.

How do I get my plan ID cards?

After you enroll, your health plans will send you an identification (ID) card to show providers when you receive care. If you have questions about your ID card, contact your plan.

The Uniform Dental Plan does not mail ID cards, but you may download one from the Delta Dental website.