Changes to PEBB benefits for 2027

The Public Employees Benefits Board (PEB Board) has authorized the following changes effective January 1, 2027. The PEBB Program will provide more information about these and other changes in October before annual open enrollment.

Annual open enrollment is October 26 through November 23, 2026.

If you are a retiree or Medicare COBRA subscriber, visit Changes to PEBB retiree benefits for 2027.

Note: Information on this page may change. If changes are needed, we will update the information.

Changes to all PEBB medical plans

• Deductible for consumer-directed health plans (CDHPs) will increase to $1,750 for single subscribers and $3,500 for families, per IRS requirements.
• Health savings accounts (HSAs): The annual maximum contribution will increase to $4,500 for single subscribers and $9,000 for families per IRS requirements.
• HIV prevention and treatment: Senate Bill 6183 requires coverage of all FDA-approved antiviral drugs for the prevention and treatment of HIV without prior authorization or step therapy. If there is a therapeutically equivalent, generic antiviral drug available, plans do not need to cover the brand name version.

Medical plan changes

Kaiser Permanente Northwest (KPNW)

• Non-emergency medical transportation by wheelchair and gurney vans will be available at $0 copay (with prior authorization) to specific locations such as a hospital, skilled nursing facility, or hospital home. CDHP members must first meet the deductible.
• Birth doula benefit: KPNW-contracted doulas will be covered for up to four visits total during pregnancy and for up to 12 months after birth. Members also have doula coverage for delivery. CDHP members must first meet the deductible.

Kaiser Permanente Washington (KPWA)

• Provider network name change from Core to SoundChoice for Classic, CDHP, and Value plans. There will be no changes to providers due to the name change. Members will receive a new ID card.
• Non-emergency medical transportation by wheelchair and gurney vans will be available at $0 copay (with prior authorization) to specific locations such as a hospital, skilled nursing facility, or hospital home. CDHP members must first meet the deductible.
• Birth doula benefit: Doulas from an established, licensed provider will be covered up to four visits total during pregnancy and for up to 12 months after birth. Members also have coverage for delivery. There is a $1,000 coverage limit per pregnancy. CDHP members must first meet the deductible.
• Post-mastectomy bras will no longer be limited to two every six months.
• Urine drug screening is subject to member cost-sharing.

Uniform Medical Plan (UMP)

• Birth doula benefit: Members may file claims for reimbursement of up to $1,000 per calendar year. Services must be provided in Washington state by a Washington Department of Health (DOH)-certified birth doula. CDHP members must first meet the deductible.
• Centers of Excellence program for total joint replacement and spine surgery will end December 31, 2026. Surgeries must be completed by December 31, 2026 to qualify for this program.

Flexible spending arrangements

Available to state agency and higher-education employees.

• The annual maximum contribution for the FSA and Limited Purpose FSA will increase to $3,400.
  If the IRS announces an additional increase to the maximum contribution before the end of open enrollment, the PEBB Program will adopt it for 2027.
• The maximum carryover limit is increasing to $680 for balances eligible to carry over from 2026 to 2027.

Long-term disability (LTD) premiums

Premiums for employee-paid LTD coverage may decrease by 23% to 26% in 2027.

SmartHealth

SmartHealth will no longer be available after December 31, 2027. Eligible subscribers who qualify for the wellness incentive by the deadline in 2027 will receive it in January 2028.

2027 monthly premiums: Employees

The PEB Board has authorized the following monthly premiums for 2027 at the July 9, 2026 meeting.

• View the 2026 monthly employee premiums.

State agency and higher-education employees

Employees who work for a city, tribal government, county, port, hospital, etc., must contact their payroll or benefits office to get their monthly premiums.

Notes

• SRDP is state-registered domestic partner.
• Subscribers may also have to pay the following monthly premium surcharges:
  • $25 Tobacco use premium surcharge if you or any enrolled dependent use tobacco products.
  • $50 Spouse or state-registered domestic partner coverage premium surcharge if you enroll your spouse or SRDP and they choose not to enroll in another employer-based group medical plan that is comparable to PEBB's UMP Classic.