Surcharges

About the surcharges

The Legislature requires two premium surcharges that may be added to your medical plan premium each month:

• Tobacco use premium surcharge
  A monthly $25 surcharge per account if you or a dependent (age 13 and older) enrolled on your PEBB medical uses a tobacco product.

• Spouse or state-registered domestic partner coverage premium surcharge
  A monthly $50 surcharge if you have a spouse or state-registered domestic partner enrolled on your PEBB medical, and they have elected not to enroll in their employer-based group medical insurance that is comparable to Uniform Medical Plan (UMP) Classic.

These surcharges apply to PEBB benefits-eligible subscribers who:

• Are enrolled in a PEBB medical plan.

  and

• Do not have Medicare Part A and Part B as their primary coverage.

When you enroll in or add a dependent to your PEBB medical, you must attest (respond) on your enrollment form to whether the tobacco use and spousal coverage premium surcharges apply.