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Change my coverage
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Our annual open enrollment is held in the fall. To make any of the changes below, we must receive the required forms no later than the last day of open enrollment. The change will become effective January 1 of the next year.
- Change medical or dental plans.
- Add dental coverage.
- Enroll or remove eligible dependents.
- Defer your PEBB retiree insurance coverage.
- End your PEBB retiree insurance coverage.
- Enroll if you deferred in the past.
You must provide proof of continuous enrollment in one or more qualifying medical coverages to return to a PEBB retiree health plan after a deferral. You can have a gap of 31 days or less between the date you defer your PEBB coverage and the start date of a qualified coverage, and between each qualified coverage. We encourage you to collect proof of coverage annually and keep a file to provide to the PEBB Program in the event you want to return in the future.
- Change your or a dependent's tobacco use premium surcharge attestation. Use the PEBB Premium Surcharge Attestation Change form or log in to PEBB My Account.
- Cancel or defer (postpone) your PEBB retiree insurance coverage.
- Remove a dependent from your PEBB retiree insurance coverage.
- Change your retiree term life insurance beneficiary information. Use the MetLife Beneficiary Designation form, or call MetLife at 1-866-548-7139.
- Apply for, cancel, or change auto and home insurance coverage.
- Manage your health savings account contribution or change your HCA beneficiary information. UMP members, call 1-844-351-6853 (TRS: 711). Kaiser Permanente members, call 1-877-873-8823 (TRS: 711).
There are several ways to notify us of your address change:
- Send us a secure message. You need to set up an account to protect your privacy and sensitive health information. By using our secure messaging system we can ensure that your data is safeguarded.
- Use the Retiree Change Form (form E).
- Fax to 360-725-0771.
- Mail us a written request with your new name or address.
- Call us at 1-800-200-1004 (TRS: 711).
In most cases, the change will occur the first day of the month after the date of the event or the date we receive your forms, whichever is later. If that day is the first of the month, the enrollment change begins on that day.
- Medicare Advantage plans. Start the first of the month after we receive your forms, per federal rules.
- Arrival of a child (a newborn, adopted child, or a child you are legally required to support ahead of adoption). PEBB benefits will start or end as follows:
- A newborn child, PEBB health plan coverage will start on the date of birth.
- A newly adopted child, PEBB health plan coverage will start on the date of placement or the date you assume legal responsibility for their support ahead of adoption, whichever is earlier.
- Enrolling a spouse or SRDP because of a birth or adoption, PEBB health plan coverage will start the first day of the month in which the event occurs.
- If the special open enrollment is due to a child becoming eligible as an extended dependent or a dependent child with a disability, PEBB health plan coverage will start the first day of the month following either the event date or the date we confirm their eligibility, whichever is later.
The PEBB Program
Send us a secure message. You need to set up an account to protect your privacy and sensitive health information. By using our secure messaging system we can ensure that your data is safeguarded.