FAQs for PEBB benefits administrators

No. Employees must notify their benefits administrator of address changes. They can update their email and phone number in Benefits 24/7. Benefit administrators update addresses using Benefits 24/7.

Neither PEBB nor SEBB plans are governed by ERISA. Although there are a lot of ERISA rules we follow because the authorities we are subject to mirror those rules in their own guidance, ERISA does not cover plans established or maintained by governmental entities.

The Marketplace offers private health insurance options. In Washington State, private health insurance plans can be accessed through the Washington Health Benefit Exchange. Employees can find out if they're eligible for a tax credit that lowers their monthly premiums and out-of-pocket costs for deductibles, coinsurance, and copays. They'll also learn if they qualify for free or low-cost coverage from Medicaid (called Apple Health in Washington State), the Children’s Health Insurance Program (CHIP), or Cascade Care plans.

Coverage through the Washington Health Benefit Exchange may cost less than PEBB Continuation Coverage. Being offered PEBB Continuation Coverage won’t limit one's eligibility for coverage or for a tax credit through the Marketplace. Find out more about plans offered under the Washington Health Benefit Exchange at Washington Healthplanfinder.

No, an employee cannot waive enrollment in medical to be on someone else’s COBRA medical coverage. An employee may waive enrollment in medical if they are enrolled in other employer-based group medical, a TRICARE plan, or Medicare Part A and B.  "Employer-based group medical" is defined as group medical related to a current employment relationship and does not include COBRA coverage.

Employers need to determine eligibility for PEBB benefits without considering whether an employee will or will not take leave that is protected under state and/or federal laws. Working hours that contribute to the minimum necessary for eligibility are not “reduced” by anticipated OR taken PFML or FMLA time. If an employee is already determined to be benefits eligible when they go on PFML or FMLA, those benefits must be maintained during PFML or FMLA.

As the ERB Outreach & Training team administers benefits and provides Open Enrollment training for more than 700 organizations in the PEBB and SEBB programs, we are unable to attend individual organizations’ Open Enrollment events due to resource limitations. Instead, we focus on providing annual HCA-sponsored Open Enrollment fairs and training for the PEBB benefits administrator community.

If you wish to invite benefits carrier representatives to your event, we have compiled a list of vendor contacts for your convenience. To ensure fairness and impartiality, please invite all PEBB vendors that offer benefits in your area.

Yes. When an employee is approved for Family and Medical Leave Act (FMLA) or Paid Family Medical Leave (PFML), they remain eligible for the employer contribution and continue their benefits.

Additional guidance can be found in the C-1 and C-2 eligibility worksheets and on the Going on or returning from leave webpage for:

• State agencies and higher ed
• Employer groups

Employees who want to waive medical coverage can do so in Benefits 24/7 or with paper forms. If they waive medical coverage within the PEBB Program timelines, they will not be automatically enrolled into a medical plan. If they do not waive medical coverage and they do not enroll in a medical plan within the PEBB Program's timelines, they will be automatically enrolled in UMP Classic and will be charged the $25 tobacco use premium surcharge. For employers offering the PEBB full benefits package, employees will also be enrolled in the Uniform Dental plan, MetLife Vision plan, MetLife basic life insurance, MetLife basic accidental death and dismemberment insurance, and The Standard employer-paid and employee-paid long-term disability insurance.

Yes, Benefits 24/7 follows the Americans with Disabilities Rehabilitation Act (ADA) Website Content Accessibility Guidelines (WCAG) 2.0. This includes making the system friendly for screen readers to read textual information.

Yes. If employees who are enrolling in a PEBB medical plan do not attest to the tobacco use premium surcharge during enrollment or if they attest that they or their enrolled dependents use tobacco, they will be charged a monthly $25-per-account premium surcharge in addition to their monthly medical premium.