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Waiving medical coverage

You can waive your enrollment in PEBB medical coverage if you are enrolled in another employer-based group medical insurance, a TRICARE plan, or Medicare.

If you waive enrollment in medical coverage, you must still enroll in dental, basic life, basic accidental death and dismemberment (AD&D), and employer-paid long-term disability (LTD) insurance.  If you do not enroll in these coverages, you will be automatically enrolledYou will also be enrolled in employee-paid LTD insurance, unless you decline this coverage.

How do I waive coverage?

Submit the PEBB Employee Enrollment/Change form to your payroll or benefits office:

  • Newly eligible: No later than 31 days after the date you become eligible for PEBB benefits.
  • Annual open enrollment: No later than the last day of annual open enrollment.
  • Special open enrollment: No later than 60 days after the event

What happens if I waive enrollment?

  • If your employer offers PEBB dental, basic life insurance, basic accidental death and dismemberment (AD&D) insurance, and employer-paid long-term disability (LTD) insurance, you must enroll in these coverages for yourself, regardless of whether you waive PEBB medical.
  • You will be enrolled in employee-paid LTD insurance, unless you decline this coverage.
  • You cannot enroll your eligible dependents in PEBB medical coverage, but you can enroll them in PEBB dental coverage if your employer offers it.
  • You cannot change plans or enroll your dependents until the next annual open enrollment, unless you have a special open enrollment that allows the change.
  • The premium surcharges will not apply to you.
  • You will be eligible to participate in the SmartHealth wellness program, but you will not qualify for the wellness incentive.
  • You can enroll in supplemental life insurance, supplemental AD&D insurance, the Medical Flexible Spending Arrangement (FSA), Limited Purpose FSA, and Dependent Care Assistance Program (DCAP), if your employer offers them.

What happens if I don't enroll or waive?

If you are eligible for PEBB benefits, but do not enroll or waive your enrollment during the PEBB Program's enrollment timelines:

  • You will be automatically enrolled as a single subscriber in Uniform Medical Plan (UMP) Classic, Uniform Dental Plan, basic life insurance, basic accidental death and dismemberment (AD&D) insurance, employer-paid long-term disability (LTD) insurance (if your employer offers these coverages).
  • You will be charged a monthly premium for medical coverage as well as a $25 tobacco use premium surcharge.
  • You will be enrolled in employee-paid LTD insurance (if your employer offers this coverage), unless you decline coverage.
  • You cannot change plans or enroll your eligible dependents until the next annual open enrollment, unless you have a special open enrollment event that allows the change.
  • You will be eligible to participate in the SmartHealth wellness program and qualify for the wellness incentive.
  • If you are enrolled on your spouse's, state-registered domestic partner's, or your parent's PEBB coverage, you will be removed from that coverage.

What if I’m already enrolled in PEBB health plan coverage?

You cannot be enrolled in two PEBB accounts. If you are a newly eligible employee who is already enrolled in PEBB coverage as a dependent under your spouse’s, state-registered domestic partner’s, or parent’s account, you may choose one of these options:

  • Waive PEBB medical, and stay enrolled in medical under your spouse’s, state-registered domestic partner’s, or parent’s account.
    You must still enroll in PEBB dental, basic life insurance, basic AD&D insurance, and employer-paid long-term disability insurance (if your employer offers them) under your own account. You will also be automatically enrolled in employee-paid LTD insurance if your employer offers it, unless you decline the coverage. In addition, your spouse, state-registered domestic partner, or parent, must also submit the appropriate PEBB Employee Enrollment/Change form to remove you from their dental coverage to prevent two enrollments in PEBB coverage.

    OR

  • Enroll in PEBB medical under your own account. You must also enroll in PEBB dental, basic life insurance, basic AD&D insurance, and employer-paid LTD insurance under your own account. You will also be enrolled in employee-paid LTD insurance, if your employer offers it, unless you decline the coverage. You must be removed from your spouse's, state-registered domestic partner's or parent's medical and dental accounts.

How do I enroll after waiving coverage?

Once you waive enrollment in PEBB medical coverage, you may enroll during annual open enrollment or if you have an event that creates a special open enrollment event. Your payroll or benefits office must receive the appropriate PEBB Employee Enrollment/Change form before the end of the annual open enrollment or no later than 60 days after a special open enrollment event.

What if I’m enrolled in Medicare?

For employees and their enrolled dependents age 65 and older, enrollment in Medicare is not required. If you are enrolled in Medicare Part A or Part B, you cannot enroll in a CDHP with an HSA. If employees and their enrolled dependents are enrolled in Medicare coverage (Part A or Part B, or both) and a PEBB medical plan, in most cases, the PEBB medical plans provide primary coverage, and Medicare coverage is ordinarily secondary. There are circumstances where Medicare would be the primary payer even when you or a covered dependent are enrolled in employer-sponsored benefits. Contact your PEBB medical plan for more information. You may choose to waive your enrollment in PEBB medical and have Medicare as your primary coverage. You will need to remain enrolled in PEBB dental, basic life, basic AD&D, and long-term disability insurance. See how Medicare works with your PEBB benefits while you're employed.