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Separating employment: Plan 3 members

DRS Plan 3 members not retiring, but meet DRS requirements.

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Enroll in or defer PEBB retiree insurance coverage
When you are ready to retire

Enroll in or defer PEBB retiree insurance coverage

If you are enrolling in or deferring PEBB retiree insurance coverage:

Timeframe	Action to take if you are enrolling in coverage:	Action to take if you are deferring coverage:
3 months prior to retirement	Request a Retiree Enrollment Guide.	Request a Retiree Enrollment Guide.
3 months prior to your 65^th birthday or terminating employment at age 65 or older	Contact the Social Security Administration (SSA) to enroll in Medicare Part A and Part B if you or any dependents you wish to cover are eligible for Medicare, due to either age or disability. Make sure you understand the Initial Enrollment Period (IEP) and Special Enrollment Period (SEP) for Medicare and how these timelines affect the start date of Medicare.
30-60 days prior to retirement	Send the PEBB Program: Retiree Election Form (form A) and any other required forms. A copy of your Medicare ID card showing enrollment in Medicare Part A and Part B (if eligible). Write your full name and the last four digits of your Social Security number on the copy of your card. If you wish to enroll dependents who are enrolled in Medicare, include a copy of their Medicare ID card. Payment for your first month’s health plan premium and applicable premium surcharges (if not using pension deduction). The PEBB Program must receive the form no later than 60 days after employer-paid coverage, COBRA coverage or continuation coverage ends. If enrolling in a Medicare plan, the PEBB Program should receive the forms prior to the month the retiree coverage begins. You may want to keep a copy of your forms for your files.	Send your Retiree Election Form (form A) to the PEBB Program. The form must be received by the PEBB Program no later than 60 days after your employer-paid coverage, COBRA coverage or continuation coverage ends. You may want to keep a copy of your form for your files. You must be enrolled in other qualified insurance to reenroll in the future.

When you are ready to retire

Timeframe	Action to take:
6 months prior to retirement	Contact DRS to request a retirement estimate.
30-60 days prior to retirement	Submit your retirement application to DRS.

Contact

The PEBB Program

Department of Retirement Systems (DRS)
Online
360-664-7000
Toll-free: 1-800-547-6657