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Paying for benefits

Find out how to pay for your PEBB retiree benefits.

The Health Care Authority collects premiums and applicable premium surcharges for the full month, and will not prorate them for any reason, including when a member dies or terminates coverage during a month. You cannot have a gap in coverage. Premiums are due back to the first month after your employer-paid coverage, COBRA coverage, or continuation coverage ends.  

How do I pay for coverage?

You have three options to pay for PEBB retiree insurance coverage. In most cases, you must make your first payment by 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.

Making your first payment

Send your first payment to HCA no later than 45 days after your 60-day election period ends. 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. Make checks payable to Health Care Authority and send to: 
Health Care Authority
PO Box 42691
Olympia, WA 98504-2691

Payment options

Your payments are taken from your end-of-the month pension through the Department of Retirement Systems (DRS). For example, if your coverage takes effect January 1, your January 31 pension will show your deductions for January.

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. We will send you an invoice if a first payment is needed. If you receive an invoice, your payment is due by the deadline listed on it.

You can pay through automatic bank withdrawals. To choose this option, you must submit the PEBB Electronic Debit Service Agreement. You cannot make your first payment through EDS because approval takes six to eight weeks. In the meantime, please make payments as invoiced until you receive a letter from us with your EDS start date. Send your first payment to HCA no later than 45 days after your 60-day election period ends. Your coverage will not start until your first payment has been received.

We will send you a monthly invoice. Payments are due on the 15th of each month for that month of coverage. Send your payment to the address listed on the invoice.

How does a surviving dependent pay for coverage?

When you become eligible as a surviving dependent, you will move from being a dependent to having your own subscriber account. You cannot have a gap in coverage between these accounts. As a result, you may receive two invoices and must pay both: 

  • The invoice for the month the subscriber passed away (when you were their dependent).
  • The invoice for your first month under your own PEBB account.

If  premiums and  applicable premium surcharges were deducted from the subscriber's pension through the Department of Retirement Systems (DRS), this will stop. You may be eligible for a survivor’s pension from DRS. To find out, call DRS at 1-800-547-6657.

If  the first invoice listed above remains unpaid, your PEBB retiree health plan coverage will be terminated back to the last day of the month in which the premium and applicable surcharge were paid. This may cause a gap in coverage, which means that any claims paid from the month the subscriber passed to the current month would be your financial responsibility. If you were enrolled in a Medicare Advantage plan, termination will occur at the end of the month your termination notice was sent. If your coverage is terminated, you may not be able to enroll again unless you regain eligibility in the future.

Can I use a VEBA account to pay my premiums?

If have a Voluntary Employees’ Beneficiary Association Medical Expense Plan (VEBA MEP) account, you can set up automatic reimbursement of your qualified insurance premiums. It is important that you notify the VEBA MEP when your premium changes.

Qualified insurance premiums include medical, dental, vision, Medicare Supplement, Medicare Part B, Medicare Part D, and tax-qualified long-term care insurance (subject to annual IRS limits). Retiree term life insurance premiums are not eligible for reimbursement from your VEBA MEP account.

Your VEBA MEP account is a health reimbursement arrangement (HRA). Certain limits apply:

  • Retiree rehire limitation: You must notify the VEBA MEP if your employer that set up your account rehires you. Only certain limited or “excepted” qualified medical care expenses and premiums (for example: out-of-pocket expenses for dental, vision, and qualified long-term care) you incur while you are reemployed are eligible for reimbursement.
  • HSA contribution eligibility limitation:  If you want to enroll in a consumer-directed health plan (CDHP) or other qualified high-deductible health plan (HDHP) and want to become eligible for health savings account (HSA) contributions, you must limit your VEBA MEP HRA coverage by submitting a Limited HRA Coverage Election form to VEBA.

More information and forms, including the Automatic Premium Reimbursement form and Limited HRA Coverage Election form, are available after logging in to the VEBA website or by calling the VEBA MEP customer care center at 1-888-828-4953.

What happens if I miss a payment?

You must pay the monthly premium and applicable premium surcharges for your PEBB retiree health plan coverage when due. They will be considered unpaid if one of the following occurs:

  • You make no payment for 30 days past the due date.
  • You make a payment, but it is less than the total due by an amount greater than an insignificant shortfall (described in WAC 182-08-015). The remaining balance stays underpaid for 30 days past the due date.

If either of these events occur and the payment remains unpaid for 60 days from the original due date, the PEBB Program will terminate your coverage back to the last day of the month for which the monthly premium and applicable premium surcharges were paid. If you were enrolled in a Medicare Advantage plan, it will terminate at the end of the month after the month your termination notice was sent. We will also terminate coverage for any enrolled dependents. 

You cannot enroll again unless you regain eligibility. You can do so, for example, by returning to work with a PEBB employing agency or School Employees Benefits Board (SEBB) organization in which you are eligible for PEBB or SEBB benefits.