Partial federal government shutdown
HCA does not anticipate any immediate impacts to our services or disruption to provider payments at this time. We will continue to monitor the situation and share updates if anything changes.
HCA does not anticipate any immediate impacts to our services or disruption to provider payments at this time. We will continue to monitor the situation and share updates if anything changes.
Find information on the open enrollment page that’s right for you: PEBB retirees, PEBB employees and PEBB continuation coverage subscribers, and SEBB employees and SEBB continuation coverage subscribers.
Choosing a medical plan is an important decision.
When selecting a medical plan, in most cases, your options are based on eligibility and where you live. If you cover dependents, everyone must enroll in the same medical, dental, and vision plans.
Get a side-by-side comparison of common medical benefits and costs for service.
All medical plans cover the same basic health care services but vary in other ways, such as provider networks and premiums. Use the tools below to compare plan benefits.
When choosing a plan, here are some things to consider:
A premium is the monthly amount the employee or employer pays to the plan to cover the cost of insurance. The premium does not cover copays, coinsurance, or deductibles. Premium amounts vary by medical plan. A higher premium doesn't necessarily mean higher quality of care or better benefits; each plan has the same basic level of benefits.
View plan costs for school employees or SEBB Continuation Coverage subscribers.
If you have a long-term relationship with your doctor or health care provider, you should verify whether they are in the plan's network. See Find a provider.
If you are currently receiving care, are on a treatment plan, have an upcoming surgery or are taking prescription medications, some things you will want to consider for you and your dependents are:
The amount you should expect to pay out of pocket before a plan begins to pay their portion. Plans have deductible exemptions for certain types of care. For instance, certain preventive care is covered before meeting your deductible. Your plan will cover costs for qualifying care before you meet the deductible.
A copay is a fixed fee you pay when you receive care.
Coinsurance is a percentage of the allowed amount charged by the provider that you pay.
The annual out-of-pocket limit is the most you pay in a calendar year for covered benefits. Some plans have a separate out-of-pocket limit for prescription drugs. Once you have reached the out-of-pocket limit, the plan pays 100 percent of allowed charges for most covered benefits for the rest of the calendar year. Certain charges (such as your annual deductible, copays, and coinsurance) may count toward your out-of-pocket limit. Others, such as your monthly premiums, do not count toward your out-of-pocket limit.
Some plans allow you to self-refer to network providers for specialty care. Others require you to have a referral from your primary care provider. After you join a medical plan, you may change your provider, although the rules vary by plan.
All health carriers in Washington State are required to maintain provider networks that provide members reasonable access to covered services. Check the plan's provider directories to see how many providers are accepting new patients and what the average wait time is for an appointment. For more information, see Behavioral services by plan and Brennen's Law (RCW 48.43.765).
All SEBB medical plans coordinate benefit payments with other group plans, Medicaid, and Medicare. This is called coordination of benefits. It ensures the highest level of reimbursement for services when a person is covered by more than one plan. Payment will not exceed the benefit amount. If you are also covered by another health plan, call the medical plans directly to ask how they will coordinate benefits. This is especially important for those coordinating benefits between the SEBB and PEBB programs, and those also enrolled in Medicaid.
The SEBB Program offers three types of medical plans: