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How do I defer?

If you are a retiree eligible to defer, this page will help you understand the criteria you must meet and what you need to do, by when, to defer PEBB retiree insurance coverage.

You must be eligible to enroll in PEBB retiree insurance coverage to defer your enrollment. You must also be continuously enrolled in qualified medical coverage and submit the required form to defer by the deadline. If we do not receive the form by the deadline, it may affect your ability to enroll in PEBB retiree insurance coverage in the future.

You must stay enrolled in qualified coverage

Deferring is a formal process that allows you to pause or postpone enrollment in PEBB retiree insurance coverage but lets you stay eligible to enroll in the future. The process involves checking that you are eligible to defer, then submitting forms and documents within a given timeframe.

If you defer, in most cases, you also defer enrollment for your dependents.

To be eligible to enroll later, you must provide proof of continuous enrollment in qualifying medical coverage while you are deferred.

Note: A gap in coverage of 31 days or less is allowed between the date you defer PEBB retiree insurance 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.

Things you must do and their deadlines

These are the things you must do — and when you must do them — to be eligible to defer PEBB retiree insurance coverage for yourself and your dependents.

If you want to defer, you must submit the required forms to the PEBB Program. After that, what you do depends on your situation.

Understand the deadlines: Deadlines indicate the last date all required documents must be received by the PEBB Program. This is not a postmark date. If we do not receive your materials by the deadline, you may lose your opportunity to defer.

What do I do?

To defer enrollment, you must:

To enroll in the future, you must provide proof of continuous enrollment in qualifying medical coverage while you are deferred.

Note: A gap in coverage of 31 days or less is allowed between the date you defer PEBB retiree insurance 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.

By when?

The PEBB Program must receive your form no later than 60 days after your employer-paid, COBRA, or continuation coverage ends.

When does the deferral take effect?

If you are eligible to defer and submit your documents by the deadline, we will defer your enrollment the first of the month after the date your employer-paid, COBRA, or continuation coverage ends.

What do I do?

To defer enrollment, you must:

To enroll in the future, you must provide proof of continuous enrollment in qualifying medical coverage while you are deferred.

Note: A gap in coverage of 31 days or less is allowed between the date you defer PEBB retiree insurance 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.

By when?

The PEBB Program must receive your form no later than 60 days after you leave public office.

When does the deferral take effect?

If you are eligible to defer and submit your form by the deadline, we will defer your enrollment the first of the month after the date you leave public office.

If you are a survivor or a dependent becoming eligible as a survivor and are ready to defer, visit Defer as a survivor.

If you have questions about eligibility, visit Are my survivors eligible?

What do I do?

To defer enrollment, you must:

  • Be approved by the Department of Retirement Systems (DRS) or the appropriate higher-education authority for disability retirement.
  • Submit a copy of the formal determination letter from DRS (or the appropriate higher-education authority) approving the disability retirement.
  • Submit the Retiree Election Form (form A) to the PEBB Program by the required deadline.
  • Submit any other required forms or documents, based on your situation.

To enroll in the future, you must provide proof of continuous enrollment in qualifying medical coverage while you are deferred.

Note: A gap in coverage of 31 days or less is allowed between the date you defer PEBB retiree insurance 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.

By when?

Your form and formal determination letter must be received by the PEBB Program no later than 60 days after the date on the formal determination letter approving the disability retirement.

When does the deferral take effect?

If you are eligible to defer and submit your form and documents by the deadline, we will defer your enrollment as you request on the form. Either:

  • Your disability retirement date, or
  • The first day of the month after the date the letter was written.

as of the retirement date on the determination letter or the first day of the month after the date the letter was written

If you are already enrolled in PEBB retiree insurance coverage, you may want to defer enrollment because you have other qualifying medical coverage.

What do I do?

To defer enrollment, you must:

  • Submit the Retiree Change Form (form E) to the PEBB Program.
  • Submit any other required forms or documents, based on your situation.
  • If you become eligible for the employer contribution toward PEBB benefits, PEBB retiree insurance coverage will be automatically deferred when you become eligible for the employer contribution toward PEBB benefits. You will be exempt from the deferral form requirement.

To reenroll in the future, you must be continuously enrolled in qualified medical coverage while you are deferred.

By when?

Before your other qualified medical coverage starts.

When does the deferral take effect?

If you are eligible and submit your forms by the deadline, we will defer your enrollment the first of the month after the date we receive all the required forms. If we receive the forms on the first day of the month, the deferral will be effective that day.

If you are enrolled in a Medicare Advantage Plan, enrollment will be deferred effective the first of the month after the date we receive the Medicare Advantage Plan Disenrollment Form (form D).

Criteria you must meet

This is the criteria you must meet to be eligible to defer enrollment in PEBB retiree insurance coverage.

Be eligible

You must be eligible to enroll or are already enrolled in PEBB retiree insurance coverage to be eligible to defer. (Refer to Related laws and rules at the bottom of the page for details.)

If you have lost your eligibility to enroll, you cannot defer.

Real-world example

You retired in 2019 and enrolled as a dependent on your spouse’s employee medical coverage, so you didn’t need PEBB retiree insurance coverage. Maybe you didn’t realize you should defer or forgot when you retired. But six years later, when your spouse is ready to retire, you may think about enrolling in PEBB retiree insurance coverage.

Unfortunately, since you did not defer PEBB retiree insurance coverage when you first became eligible in 2019, you lost your eligibility and cannot enroll.

Have other qualified medical coverage

  • This includes COBRA or continuation coverage.
  • This does not include an employer's retiree coverage.

(Beginning January 1, 2001)

  • PEBB-sponsored medical plan
  • SEBB-sponsored medical plan
  • Washington State educational service district-sponsored medical plan

This includes COBRA or continuation coverage.

  • A TRICARE plan
  • The Federal Employees Health Benefits Program

You will have a one-time opportunity to enroll in a PEBB retiree health plan.

(Beginning January 1, 2001)

To be considered creditable coverage, your Medicaid coverage must include coverage for medical and hospital benefits.

Any dependents who are not eligible for creditable coverage under Medicaid may stay enrolled in a PEBB retiree health plan.

(Beginning January 1, 2006)

This does not include Medicaid coverage, known as Apple Health in Washington State.

You will have a one-time opportunity to enroll or reenroll in a PEBB retiree health plan.

(Beginning January 1, 2014)

You will have a one-time opportunity to enroll in a PEBB retiree health plan.

(Beginning July 17, 2018)

Find your forms

The forms are labeled with letters in the upper right corner to help you identify them.

The only form you have to submit is the Retiree Election Form (form A). No other forms or documents are required.

Select the forms you need to submit based on the medical plan you or your dependents are currently enrolled in.

I need Form E only…

For the following medical plans, you only need the Retiree Change Form (form E).

  • Kaiser Permanente NW: Classic or CDHP
  • Kaiser Permanente WA: Classic, CDHP, Original Medicare, SoundChoice, or Value
  • Uniform Medical Plan (UMP): Classic, Select, or CDHP
  • Premera Blue Cross Medicare Supplement Plan G
  • UMP Plus—Puget Sound High Value Network (PSHVN), or UMP Plus—UW Accountable Care Network (ACN)

I need both Forms E and D

For the following medical plans, you need both the Retiree Change Form (form E) and Medicare Advantage Plan Disenrollment Form (form D).

  • Kaiser Permanente NW Senior Advantage
  • Kaiser Permanente WA Medicare Advantage
  • UnitedHealthcare: PEBB Balance or PEBB Complete

Submit your materials

Reminder: The PEBB Program must receive your materails by the enrollment period deadline.

Submit your forms and documentation using one of the following methods.

Electronically

Send a secure online message to PEBB Customer Service. Sign and date any forms you attach to a secure message. A typed signature is not acceptable. This is separate from PEBB My Account.

To keep your personal information secure, you will need to register for an account (if you don’t already have one) to submit your materials using this method.

By mail

Washington State Health Care Authority
PEBB Program
PO Box 42684
Olympia, WA 98504-2684

By fax

360-725-0771

Supporting information

Qualified medical coverage is enrollment in other insurance, for example, through your spouse or state-registered domestic partner, or military affiliation. This may include:

  • Enrollment as a dependent in a Washington State educational service district-sponsored, PEBB-sponsored, or SEBB-sponsored health plan
  • Employer-based group medical
  • Federal retiree medical plan such as a TRICARE plan or Federal Employees Health Benefits Program
  • Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA)
  • Medicare Part A and Part B and a Medicaid program that provides creditable coverage
  • Enrollment in health benefit exchange coverage that is not Medicaid – for retirees not enrolled in Medicare Part A and Part B

Related laws and rules

Contact

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