Due to COVID-19, HCA’s lobby is closed until further notice. Learn more about your virtual customer service options.

How to determine eligibility

Find out if you are eligible for PEBB retiree insurance coverage.

On April 2, 2020, the Public Employees Benefits Board (PEB Board) held a special telephonic meeting to approve policy resolutions that extend retiree eligibility and enrollment timelines during the Governor’s state of emergency due to COVID-19. Learn more about the approved emergency resolution.

Who is eligible for PEBB retiree insurance coverage?

You may be eligible to enroll in PEBB retiree insurance coverage if you are a retiring or separating employee of a:

  • State agency.
  • State higher-education institution.
  • PEBB-participating employer group.
  • Washington school district, educational service district, or charter school.

You may also be eligible to enroll in PEBB retiree insurance coverage if you are:

What are the eligibility requirements?

To be eligible to enroll in PEBB retiree insurance coverage, you must meet both the procedural (enrollment) requirements and all eligibility requirements of WAC 182-12-171, 182-12-180, 182-12-211, 182-12-250, or 182-12-265.

Enrollment requirements

  1. If you are a retiring employee we must receive your Retiree Election Form (form A) no later than 60 days after your employer-paid coverage, COBRA coverage, or continuation coverage ends.

    If you are an elected or full-time appointed official described in WAC 182-12-180(1), we must receive your Retiree Election Form (form A) no later than 60 days after you leave public office. If you select a Medicare Advantage plan, we must receive Form A and Form C before you leave public office, or no later than the last day of the month before the month your PEBB coverage ends. Otherwise, you may not select these plans until a special open enrollment. 

    If you are a dependent becoming eligible as a survivor, please see Survivors.

  2. If you or a dependent are eligible for Medicare, you must enroll (and stay enrolled) in Medicare Part A and Part B to be eligible and remain eligible for a PEBB retiree health plan.
  3. If you do not enroll in PEBB retiree insurance coverage at retirement, when you become eligible and separate from service, when leaving public office as an eligible official, or when you become a surviving dependent, you are only eligible to enroll at a later date if you defer (postpone) enrollment and maintain continuous enrollment in other qualifying medical coverage as described in WAC 182-12-200 and 182-12-205See deferring coverage.

Eligibility requirements 

  1. You must be a vested member of, and eligible to retire from a Washington State-sponsored retirement plan when your employer coverage, COBRA coverage, or continuation coverage ends (unless you are an elected or full-time appointed official as described in WAC 182-12-180). 
  2. Washington State-sponsored retirement plans include:
    1. Public Employees’ Retirement System (PERS) 1, 2, or 3
    2. Public Safety Employees’ Retirement System (PSERS) 2
    3. Teachers Retirement System (TRS) 1, 2, or 3
    4. Washington Higher Education Retirement Plan (HERP) (for example, TIAA-CREF)
    5. School Employees’ Retirement System (SERS) 2 and 3
    6. Law Enforcement Officers’ and Fire Fighters’ Retirement System (LEOFF) 1 or 2
    7. Washington State Patrol Retirement System (WSPRS) 1 or 2
    8. State Judges/Judicial Retirement System
    9. Civil Service Retirement System and Federal Employees’ Retirement System (for Washington State University Extension employees covered under PEBB benefits at the time of retirement).
  3. You must also immediately begin to receive a monthly retirement plan payment, unless one of the following exceptions apply: 

    1. If you receive a lump sum payment, you are only eligible for PEBB retiree insurance coverage if DRS offered you the choice between a lump sum actuarially equivalent payment and an ongoing payment. 

    2. If you are an employee retiring or separating under PERS Plan 3, TRS Plan 3, or SERS Plan 3, and you meet the plan’s eligibility criteria.
    3. If you are an employee retiring under a Washington State Higher Education Retirement Plan (such as TIAA-CREF)and meet your plan’s retirement eligibility criteria or you are at least age 55 with 10 year of state service. 
    4. If you are a retiring employee from a PEBB employer group who is eligible to retire under a retirement plan sponsored by an employer group or tribal government, and your employer  does not participate in a Washington State-sponsored retirement plan. However, you must meet the same age and years of service requirements as if they had been employed as a member of PERS Plan 1, if your date of hire with your employer group was before October 1, 1977, or Plan 2, if your date of hire was on or after October 1, 1977.
    5. If you are an elected or a full-time appointed official of the legislative or executive branch of state government, you do not have to meet the age and years of service requirements or receive a monthly retirement plan payment from a Washington State-sponsored retirement plan.
    6. If you are an elected or full-time appointed official of the executive branch, or a surviving dependent of such an official as described in WAC 182-12-180.
    7. If you are a survivor of an emergency service person killed in the line of duty as described in WAC 182-12-250, or a surviving dependent who loses eligibility because of the death of an eligible retiree as described in WAC 182-12-265.

Are my dependents eligible?

You may enroll the following dependents (see WAC 182-12 260):

  • Your legal spouse
  • Your state-registered domestic partner, (see WAC 182-12-109 and RCW 26.60.020(1)). This includes substantially equivalent legal unions from other jurisdictions (see RCW 26.60.090). Strict requirements apply to these partnerships including that one partner is age 62 or older and you live in the same residence.
  • Your children through the last day of the month in which they turn age 26, except for children with a disability (who may be covered past the age of 26 if they qualify).

The PEBB Program verifies the eligibility of all dependents and will request proof of a dependent’s eligibility. We will not enroll a dependent if we cannot verify the dependent’s eligibility. See Dependent verification.

Learn more about dependent eligibility.

Contact

The PEBB Program
Phone: 1-800-200-1004 
(TRS: 711)
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.