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How to enroll

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

If you select a Medicare Advantage plan, we must receive Form A and the Medicare Advantage Plan Election Form (form C) no later than the last day of the month before the month your employer-paid coverage, COBRA coverage, or continuation coverage ends.

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.

Before you enroll

  1. Compare medical plans. You must enroll in medical to enroll in dental.
  2. Compare dental plans. If you enroll in retiree dental coverage for yourself, your dependents will also be enrolled in dental. 
  3. See the monthly non-Medicare or Medicare plan premiums for PEBB medical.
  4. Explore the additional benefits.
  5. Find out if premium surcharges apply to you.

How do I enroll?

Limited time to enroll

You have 60 days after your employer-paid coverage, COBRA coverage, or continuation coverage ends to notify the PEBB Program that you want to enroll or defer enrollment in PEBB retiree insurance coverage. You may defer enrollment in PEBB retiree insurance coverage if you are eligible for it, and you enrolled in other qualified medical coverage. 

If we don’t receive your application in time, you could lose rights to enroll in PEBB retiree insurance coverage unless you regain eligibility for PEBB insurance coverage, for example, by returning to employment in a PEBB or SEBB benefits-eligible position and at the time of termination, meet the enrollment and eligibility requirements of WAC 182-12-171.

Three steps to enroll

  1. Contact the Social Security Administration
    About 90 days before your employer-paid coverage, COBRA coverage, or continuation coverage ends, contact the Social Security Administration to enroll in Medicare Part A and Part B if you or any dependents you wish to cover are entitled to Medicare.
  2. Request a retiree enrollment packet
    60 days before your employer-paid coverage, COBRA coverage, or continuation coverage ends request a retiree enrollment packet. Call 1-800-200-1004. We will send you a Retiree Enrollment Guide, which includes forms and information.
  3. Return your retiree application
    Within 60 days after your employer-paid coverage or continuation coverage ends return your completed retiree application and any other applicable forms to the PEBB Program. If you select a Medicare Advantage plan, we must receive Form A and the Medicare Advantage Plan Election Form (form C) no later than the last day of the month before the month your employer-paid coverage, COBRA coverage, or continuation coverage ends. Otherwise, you may not select these plans unless you have a special open enrollment.

What forms do I need?

Submit the Retiree Election Form (form A) may direct you to submit other forms as well. We must receive your form no later than 60 days after your employer-paid coverage, COBRA coverage, or continuation coverage ends.

If you select a Medicare Advantage plan, we must receive Form A an the Medicare Advantage Plan Election Form (form C) no later than the last day of the month before the month your employer-paid coverage, COBRA coverage, or continuation coverage ends. Otherwise, you may not select these plans unless you have a special open enrollment.

You must submit Form A even if you decide to defer (postpone) your enrollment.

For more help and additional forms you may need see Completing the retiree forms.

Need help completing the Retiree Election Form (form A)? Use the step-by-step tutorial.

When do I send payment?

You must make your first premium payment no later than 45 days after your 60-day election period ends. In most cases, you must make your first payment y check before we can enroll you.

When you enroll, you must pay premiums and applicable premium surcharges back to the date your other coverage ended. You cannot have a gap in coverage. For example, if your other coverage ends in December, but you don’t submit your enrollment form until February, you must pay premiums and applicable premium surcharges for January and February to enroll in PEBB retiree insurance coverage.

If we do not receive your first payment by the deadline, you will not be enrolled, and you may lose your right to enroll in PEBB retiree insurance coverage.

You have three options to pay for coverage: pension deduction, monthly invoice, or Electronic Debit Service. To learn about these payment options, see Paying for benefits.

What can I expect after I submit my election form?

After you submit your form, we will process it 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. If you chose to defer your coverage, see Deferring coverage.

FAQs

If you are an eligible retiring employee, your PEBB retiree insurance coverage will start on the first day of the month after your employer-paid coverage, COBRA coverage, or continuation coverage ends.

If you are an eligible elected or appointed official, your coverage will start on the first day of the month after you leave public office.

For subscribers who are not eligible for Medicare Part A and Part B, the PEBB Program verifies the eligibility of all dependents before enrolling them. We will also verify the eligibility of any subscriber enrolling a state-registered domestic partner. If you enroll dependents, you must provide proof of their eligibility within the PEBB Program’s enrollment timelines or the dependents will not be enrolled. The PEBB Program reserves the right to review a dependent’s eligibility at any time (except for children with a disability, who are reviewed separately). See Dependent verification. You may also need to submit these forms:

Under some circumstances, yes. If you feel this situation may apply to you, visit Disability retirement.

You cannot enroll in medical or dental coverage under two PEBB accounts. An enrolled dependent may be enrolled in only one PEBB medical or dental plan. If you and your spouse or state-registered domestic partner are both independently eligible for PEBB insurance coverage, you need to decide which of you will cover yourselves and any eligible children on your PEBB medical or dental plans. For example, you could defer PEBB retiree medical for yourself and enroll as a dependent on your spouse’s or state-registered domestic partner’s PEBB medical coverage.

Contact

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