As of Wednesday, March 18, HCA’s lobby is closed. In-person customer services for Apple Health and the PEBB and SEBB Programs will not be available. Learn more.
How to enroll
Learn how to enroll in PEBB retiree insurance coverage.
On this page
- Compare medical plans. You must enroll in medical to enroll in dental.
- Compare dental plans. If you enroll in retiree dental coverage for yourself, your dependents will also be enrolled in dental.You must keep dental coverage for at least two years, unless you defer or cancel enrollment as allowed under PEBB Program rules.
- See the monthly non-Medicare or Medicare plan premiums for PEBB medical.
- Explore the additional benefits available to you as a PEBB subscriber.
- Find out if premium surcharges apply to you.
Limited time to enroll
You have 60 days after your employer-paid 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 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.
An employee or school employee who is determined to be retroactively eligible for a disability retirement can enroll or defer enrollment in PEBB retiree insurance coverage if they meet the following requirements:
- The PEBB Program receives the required form and a copy of the formal determination letter sent by the Department of Retirement Systems or the appropriate higher education authority no later than 60 days after the date on the determination letter, and
- The employee or school employee immediately begins to receive a monthly pension benefit or monthly supplemental retirement benefit under their higher education retirement plan. Some exceptions to the monthly benefit apply, as described in WAC 182-12-211.
The effective date of the enrollment or deferral may be retroactive to the date of eligibility for retirement, or prospective from the date on the determination letter.
- Contact the Social Security Administration
About 90 days before your employer-paid 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.
- Request a retiree enrollment packet
60 days before your employer-paid 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 applications and information.
- Return your completed 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.
Submit the Retiree Coverage Election Form (form A) and any required forms and mail or hand deliver it to us as instructed on the form. We must receive your form no later than 60 days after your employer-paid coverage or continuation coverage ends. You must submit Form A even if you decide to defer (postpone) your enrollment.
If you or any covered dependents are entitled to Medicare, you or your covered dependent must enroll in and remain enrolled in Medicare Part A and Part B to keep your PEBB retiree health plan coverage. Please include a copy of the Medicare card or Medicare entitlement letter with your enrollment form(s). Write your full name and the last four digits of your Social Security number on the document.
For more help and additional forms required see Completing the retiree forms.
Need help completing the 2019 Retiree Coverage Election Form (form A)? Use the step-by-step tutorial.
The PEBB Program verifies the eligibility of all dependents of subscribers not entitled to Medicare Part A and Part B, and any subscriber enrolling a state-registered domestic partner before they are enrolled under your coverage. If you enroll dependents on your PEBB retiree insurance coverage, 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 will need these forms:
- PEBB Declaration of tax status - To enroll a state-registered domestic partner, a state-registered domestic partner's child, extended dependent, or other nonqualified tax dependent.
- PEBB Certification of a child with a disability - To enroll a dependent child with a disability (age 26 or older)
- PEBB Extended dependent certification - To enroll an extended (legal) dependent child
Your first premium payment and applicable premium surcharges are due to the HCA no later than 45 days after your 60-day election period ends unless you choose to have premiums deducted from your monthly pension from the Department of Retirement Systems (DRS). Due to timing issues with DRS, you may receive an invoice for any premiums and applicable premium surcharges not deducted from your pension when you first enrolled. The PEBB Program will send you an invoice if a first payment is needed..
If we do not receive your first premium payment and applicable premium surcharges by the deadline, you will not be enrolled, and may lose your right to enroll in PEBB retiree insurance coverage. See Paying for benefits for more information.
If you select Electronic Debit Service (EDS) as your payment method, you still need to submit your first premium payment and any applicable premium surcharge(s) to begin your coverage.
If you are a retiring employee of a state agency, employer group, or a higher-education institution, your PEBB retiree insurance coverage will begin on the first day of the month after your employer-paid coverage, COBRA coverage, or continuation coverage ends.
If you are an elected or full-time appointed official leaving public office, your PEBB retiree insurance coverage will begin on the first day of the month after you leave public office.
If you are a retiring school employee of a Washington State school district, educational service district, or charter school, your PEBB retiree insurance coverage will begin on the first day of the month after your employer-paid coverage, COBRA coverage, or continuation coverage ends.
Your employer’s payroll office is responsible for cancelling (terminating) your 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.
Here is what will happen after you submit your PEBB Retiree Coverage Election form:
- When the PEBB Program processes your form, we will send you a letter confirming that we received it and notifying you of next steps.
- The health plan(s) that covered you as an employee or school employee will send you a cancellation letter after your employer’s payroll office cancels your coverage.
- Federal rules require us to send you a Continuation of Coverage Election Notice booklet. Keep it for future reference.
- If your election form is incomplete, we will send you a letter requesting more information.
- If you choose to pay your premiums by invoice or electronic debit service (EDS), we must receive your first premium payment and applicable premium surcharges no later than 45 days after your 60-day election period ends. If we do not receive your payment by the required deadline, you will not be enrolled and you may lose your right to PEBB insurance coverage.
- If you select pension deduct you will be invoiced for any premiums owed prior to the pension deduction being set up. You will be responsible for remitting payment for this amount owed; it will not be deducted from your pension.
- We will enroll you in PEBB retiree insurance coverage once your employer’s payroll office terminates your coverage; we receive your completed election form, all other required documents, and first premium payment (with applicable premium surcharges); and determine you are eligible.
- After your enrollment begins, your health plan(s) will send you a welcome packet.
If we determine you are not eligible, you will receive a denial letter that includes your rights to appeal and a refund of any premiums and applicable premium surcharges received.
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.