Spousal coverage surcharge

How to respond

Respond to the surcharge in Benefits 24/7 or on your enrollment/change form when you enroll your spouse or SRDP. Note: Pierce County, Washington State University (WSU), and University of Washington (UW) employees must respond through Workday.

Step one: Find out if the surcharge applies

Answer the six questions on your enrollment/change form (or in Workday) to find out if the surcharge applies. You may also need to use the Spousal Plan Calculator (interactive tool) or (pdf).

If you answer NO to ANY of the questions, the surcharge does not apply.

Answer YES to ALL six questions you will need to:

1. Ask your spouse or state-registered domestic partner (SRDP) for a Summary of Benefits and Coverage (SBC) for all medical plans that serve their county of residence, and have a monthly employee premium of less than $126.36 (2025) or $137.76 (2026).
2. Use the SBC information to answer the questions in the Spousal Plan Calculator (interactive tool) or (pdf) to find out if the surcharge applies.

Download the calculator and Enable content

If you use the interactive version of the Spousal Plan Calculator, you must download and save the calculator. Be sure to click Enable Content for the calculator to work. Do not print or submit the interactive tool.

Step two: Complete your attestation

Check the corresponding boxes in Benefits 24/7 or on your enrollment/change form.

Note: Pierce County, WSU, and UW employees use Workday.

Do I need to respond every year?

If you will cover your spouse or SRDP on your medical coverage for the next plan year, you may need to attest to the surcharge during open enrollment. You will get a letter from the PEBB Program if you need to attest.

You are required to respond during open enrollment if you currently pay the $50 monthly premium surcharge or are not paying the surcharge because you attested your spouse or SRDP's employer-based medical coverage was not comparable to UMP Classic.

When can I report a change?

You can only report a change to this surcharge:

• During open enrollment
• Within 60 days of a change in your spouse's or SRDP's employer-based group medical insurance

To change your response, use Benefits 24/7 or the PEBB Premium Surcharge Attestation Change form. Pierce County, WSU, and UW employees use Workday.

When changes take effect

If you submit a change that results in paying the premium surcharge, the change is effective the first day of the month after the date of the status change. If that occurs on the first of the month, the change begins that day.

If the change results in removal of the premium surcharge, the change is effective the first day of the month after your attestation is received. If that occurs on the first of the month, the change begins that day.

Exception: If attesting during annual open enrollment, any change is effective January 1 of the following year.