New retiree enrollment

Whether you’re newly eligible or enrolling after deferring coverage, the most important thing you need to do is use Benefits 24/7 or submit the Retiree Election Form (form A) — along with any other required forms and documents based on your situation — by the required deadline. Once you have submitted your enrollment materials we will notify you of next steps.

Ready to enroll?

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

Enroll or defer now to protect your eligibility

If you do not enroll in PEBB retiree insurance coverage when you first become eligible, you are only eligible to enroll at a later date if you deferred enrollment when you were first eligible due to a qualifying reason. In most cases, you must have maintained continuous enrollment in other qualified medical 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.

Incomplete applications will be accepted

If you can't complete your application in time, it is better to submit an incomplete application than to miss your 60-day window to enroll or defer. If you submit an incomplete application by the deadline, we will send you a letter asking for the missing information and giving you a deadline to respond.

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.

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.

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.

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?

Contact

The PEBB Program
Phone: 1-800-200-1004
TRS: 711
Hours: 8 a.m. to 4:30 p.m., Monday through Friday

HCA Support (secure, login with your personal account)
Send us a secure message or submit your forms