New retiree enrollment

About to retire? There is a limited time to enroll.

If you are about to retire, in most cases, you have 60 days after your current coverage ends to submit an enrollment form to the PEBB Program showing that you want to enroll in PEBB retiree insurance coverage.

"Current coverage" includes your own:

• Employer-paid coverage (for example, a state agency or public school district)
• COBRA coverage
• Continuation coverage

Understand the deadlines

The deadlines listed on this page indicate when the PEBB Program must receive all required forms and supporting documentation. This is not a postmark date. If we do not receive your materials by the required deadline, you may lose your opportunity to enroll.

Enrollment deadlines

Forms and documents must be submitted online or received by the PEBB Program no later than 60 days after your own employer-paid, COBRA, or continuation coverage ends. For elected or full-time appointed officials, the timeline is no later than 60 days after you leave public office.

If you are an employee determined eligible for a disability retirement, please call the PEBB Program at 1-800-200-1004 for more information.

If you choose a Medicare Advantage with Part D plan or UMP Classic Medicare with Part D (PDP) enrollment cannot be retroactive. 

We encourage you to submit the Retiree Election Form (form A) (or use Benefits 24/7) so we receive it no later than the last day of the month in which your own employer-paid, COBRA, or continuation coverage ends (or for elected or full-time appointed officials: before you leave office and no later than the last day of the month in which your PEBB insurance coverage ends). Otherwise, you and your dependents will be enrolled in another medical plan during the gap months between when your other coverage ends and the selected Medicare plan begins.

Steps to enroll

Follow these three steps to enroll in PEBB retiree insurance coverage.

Step one: Enroll yourself and dependents

Submit your enrollment request through Benefits 24/7 or return the Retiree Election Form (form A) to the PEBB Program. (Submit your materials.)

If you are enrolling in Premera Medicare Supplement Plan G, also submit Premera Group Medicare Supplement Enrollment Application (form B).

If you are enrolling dependents, you may need to prove their eligibility by submitting documents. Visit Dependents.

Step two: Make your first payment

In most cases, you must make your first payment for PEBB retiree insurance coverage, including applicable premium surcharges, before we can enroll you.

Send your first payment to HCA no later than 45 days after your 60-day election period ends. You will not be enrolled until we receive payment.

• Premiums
• Paying for benefits
• Premium surcharges

Step three: Enroll in Medicare, if eligible

If you or a dependent are eligible for Medicare, the eligible person must enroll (and stay enrolled) in Medicare Part A and Part B.

You’ll need to submit proof of Medicare enrollment. Submit copies of Medicare cards or benefit verification letters for you or any covered dependents. Write your full name and the last four digits of your Social Security number on the copy.

Visit Social Security's website to enroll in Medicare.

Note: Social Security is currently experiencing longer than usual processing times for Medicare enrollment requests. We strongly encourage applying to Social Security for Medicare enrollment three months before your Medicare start date.

Enrolling after deferring

You may enroll in a PEBB retiree health plan. In most cases, you must have been continuously enrolled in one or more qualifying medical coverages during your deferral. 

You can enroll in a PEBB retiree health plan after you defer: 

• During the PEBB Program's open enrollment. The online enrollment or PEBB retiree Open Enrollment Election/Change Form (form A-OE) must be received by the PEBB Program no later than the last day of open enrollment. 
• When other qualified medical coverage ends. The online enrollment or Retiree Election Form (form A) must be received by the PEBB Program no later than 60 days after the date the other qualifying medical coverage ends. 
• When you permanently move back to the United States. The online enrollment or Retiree Election Form (form A) must be received by the PEBB Program no later than 60 days after the date of the permanent move or the date notification of such move is provided, whichever is later. 

If you are enrolling in a Medicare Advantage with Part D plan or UMP Classic Medicare with Part D (PDP), enrollment cannot be retroactive.

We encourage you to submit Form A (or use Benefits 24/7) so we receive it no later than the last day of the month before the date PEBB retiree insurance coverage is to begin. Otherwise, you and your dependents will be enrolled in another medical plan during the gap months prior to when the selected Medicare plan begins. 

Proof of continuation coverage

When you apply for enrollment after your deferral, you must provide proof that you were continuously enrolled in one or more qualifying medical coverages, including the start date and in most cases the end dates for each coverage. You will need proof of coverage for each qualified coverage while you are in a deferred status.

You can have a gap of 31 days or less

• Between the date you defer enrollment in your PEBB retiree insurance coverage and the start date of qualified coverage, and
• Between each period of enrollment in qualified coverages during the deferral period.

If you defer enrollment while enrolled in Medicare and permanently living outside of the United States, and you permanently move back to the United States, you must provide proof of enrollment in Medicare Parts A and B to return to a PEBB retiree health plan after deferral. Evidence of continuous enrollment in a qualified coverage is waived while you live outside of the United States.

Submit your materials

Reminder: The PEBB Program must receive your forms, documentation, and payment by the enrollment period deadlines.

Where do I submit my materials?

Forms and documentation

You can use Benefits 24/7 to enroll and submit your documents. If you use forms, submit your forms and documentation using one of the following methods.

Online

Submit your forms through HCA Support. Attach them to a secure message. Be sure to sign them (typed signatures are not allowed).

To keep your personal information secure, you will need to register for a SecureAccess Washington (SAW) 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

First payment and premium surcharges

If you're sending payment with your forms, enclose your check or money order payable to Health Care Authority and mail to:

Washington State Health Care Authority
PO Box 42691
Olympia, WA 98504-2691

How do I pay my premiums?

You have three options to pay for coverage, which are described on Form A:

• Pension deduction
• Monthly invoice
• Electronic Debit Service (EDS)

For details on payment options, visit Paying for benefits.

What happens after I submit?

After you submit your enrollment materials, we will process them and send you a letter notifying you of next steps.

Your employer is responsible for cancelling your employee coverage. In some cases, we cannot enroll you in PEBB retiree insurance coverage until this occurs.

When does coverage begin?

• Retiring employees: Your coverage will start on the first day of the month after your own employer-paid, COBRA, or continuation coverage ends.
• Elected or full-time appointed officials: Your coverage will start on the first day of the month after you leave public office.
• Enrolling after deferring: Your coverage will start as follows:
  • If you enroll during the PEBB Program's open enrollment, your coverage will start on January 1 of the next year. 
  • If you enroll no later than 60 days after other qualifying medical coverage ends, your coverage will start on the first day of the month after the other coverage ends.
  • If you enroll no later than 60 days after the date of your permanent move back to the United States or the date you provide notification of such move, your coverage will start on the first day of the month after the permanent move or the date you provide notification of such move, whichever is later.  

Related laws and rules

Washington Administrative Codes (WACs) are the official rules used for PEBB Program eligibility and enrollment.

For retiring employees

• WAC 182-12-171: When is a retiring employee or a retiring school employee eligible to enroll in public employees benefits board (PEBB) retiree insurance coverage?
• WAC 182-12-211: May an employee or a school employee who is determined to be retroactively eligible for disability retirement enroll or defer enrollment in public employees benefits board (PEBB) retiree insurance coverage?

For elected or full-time appointed officials

• WAC 182-12-180: When is an elected and full-time appointed official of the legislative and executive branch of state government, or their survivor eligible to continue enrollment in public employees benefits board (PEBB) retiree insurance coverage?

Deferral related

• WAC 182-12-200: May a retiring employee, a retiring school employee, or a retiree enrolled as a dependent in a health plan sponsored by public employees benefits board (PEBB) or school employees benefits board (SEBB) defer enrollment under PEBB retiree insurance coverage?
• WAC 182-12-205: May a retiree or a survivor defer enrollment or voluntarily terminate enrollment under public employees benefits board (PEBB) retiree insurance coverage?