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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-19Learn 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:

  • A surviving dependent (see WAC 182-12-180, 182-12-250, or 182-12-265) eligible to continue enrollment in PEBB retiree insurance coverage.
  • An elected or full-time appointed official of the legislative or executive branch of state government who leaves public office (see WAC 182-12-180).

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

Eligibility requirements

Certain eligibility and procedural requirements must be met to receive PEBB retiree insurance coverage.

Procedural requirements

  1. If you are a retiring employee or retiring school employee, you must submit the required forms to enroll  or defer enrollment in PEBB retiree insurance coverage. The PEBB Program must receive your forms 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), the PEBB Program must receive your forms no later than 60 days after you leave public office.  If you are a dependent becoming eligible as a survivor, see If I die, are my dependents eligible or Eligibility for survivors of emergency service employees. If you do not submit an application to enroll or defer enrollment within the required timeline, you lose all rights to enroll in PEBB retiree insurance coverage in the future.
  2. If you or a dependent are eligible for Medicare and your retirement date is after July 1, 1991, 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 eligible and separating from service, when leaving public office as an eligible official, or upon becoming 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 182-12-205.  See deferring coverage.

In general, the eligibility requirements state 

  1. You must be a vested member and meet the eligibility criteria 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 are considered a Washington State-sponsored retirement system for Washington State University Extension employees covered under PEBB benefits at the time of retirement.
  3. Plan 1 and 2 members under a Washington State-sponsored retirement plan with the Department of Retirement Systems (DRS) must immediately receive a monthly retirement plan payment or lump sum payment as allowed by the plan.

    Plan 3 members under a Washington State-sponsored retirement plan with DRS are not required to receive a retirement plan payment or lump sum payment, but must meet the retirement plan’s eligibility criteria.

    Washington State higher-education retirement plan members, must meet their plan’s retirement eligibility criteria, or immediately begin receiving a monthly retirement plan payment, or be a least age 55 with 10 year of state service. 

    Employees retiring from a PEBB participating employer group that does not participate in a Washington State-sponsored retirement plan, do not have to receive a monthly retirement plan payment.  However, 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 with your employer group was on or after October 1, 1977.

    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.

Are my dependents eligible?

You may enroll the following dependents as described in WAC 182-12 260:

  • Your legal spouse
  • Your state-registered domestic partner, as defined in WAC 182-12-109 and RCW 26.60.020(1). This includes substantially equivalent legal unions from other jurisdictions as defined in 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.