The ProviderOne system will be unavailable from 5:00 a.m. Saturday, December 20 until 7 a.m. Sunday, December 21 (26 hours) due to scheduled maintenance.
This outage does not affect the Pharmacy POS
Pharmacies will still be able to submit claims for processing and faxes can be sent during the outage. Faxes will be processed after the outage is complete.
Please report any issues to: mmishelp@hca.wa.gov.
Thank you.
When the client does not have the Eligibility for EED and the Eligibility exists from AED, the utmost review date process is checking the eligibility for EED to enroll the clients and not AED; this is causing MC enrollment transactions to reject.
Due to the observance of Christmas and New Years holidays, ProviderOne claims submission deadlines have been moved up to ensure that providers are able to receive payment and Remittance Advices (RA’s and HIPAA 835 files) on Friday of each impacted week. The following table details the updated claims submission deadlines for both ProviderOne and the Pharmacy POS systems.
ProviderOne Claims Submission Deadline Changes – Christmas and New Years
| Week of December 22, 2025 | Claims Submission Deadline Change due to the observance of Christmas |
|---|---|
| Payment | No Change: Friday, December 26, 2025 |
| Remittance Advice (RAs)/835 | No Change: Friday, December 26, 2025 |
| Claims submission deadline - ProviderOne | Changed to 5 p.m. Monday, December 22, 2025 |
| Claims submission deadline – Pharmacy POS | Changed to 5 p.m. Sunday, December 21, 2025 |
| Week of December 29, 2025 | Claims Submission Deadline Change due to the observance of New Years |
|---|---|
| Payment | No Change: Friday, January 2, 2026 |
| Remittance Advice (RAs)/835 | No Change: Friday, January 2, 2026 |
| Claims submission deadline - ProviderOne | Changed to 5 p.m. Monday, December 29, 2025 |
| Claims submission deadline – Pharmacy POS | Changed to 5 p.m. Sunday, December 28, 2025 |
Please report any issues to: mmishelp@hca.wa.gov.
- Are there health insurance options outside of the PEBB Program?
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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.
- What happens to an employee's health savings account (HSA) during a layoff?
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The HSA still belongs to the employee; however, the employer no longer contributes to it when employment ends.
If eligible, the employee can elect to continue enrollment in their Consumer-Directed Health Plan (CDHP) through PEBB Continuation Coverage (Unpaid Leave) and use their HSA dollars to pay for health insurance premiums and health care expenses. They can also continue to use their HSA for health care expenses even if they do not have other coverage.
Note: HealthEquity may charge the employee a monthly fee if they maintain their HSA without being enrolled in a PEBB CDHP. Employees can learn more in The Complete HSA Guidebook, or by contacting HealthEquity, the HSA administrator, toll-free at 1-877-873-8823 (for Kaiser members) or 1-844-351-6853 (for UMP members).
- What happens to an employee's Flexible Spending Arrangement (FSA) and Dependent Care Assistance Program (DCAP) after a layoff?
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Employees are no longer allowed to contribute pre-tax funds to FSA and DCAP when their PEBB coverage ends, but they can still submit claims to spend down their remaining funds.
FSAs: Employees are able to claim expenses that happened while they were employed. They may be able to continue participating in their FSA by electing PEBB Continuation Coverage (COBRA) and making post-tax contributions directly to Navia Benefit Solutions for the rest of the year. If they are eligible for this option, Navia Benefit Solutions will mail a COBRA election notice to the employee. More information can be found on the how FSAs work through PEBB Continuation Coverage webpage and in the 2026 FSA Enrollment Guide.
DCAP: Employees may continue to submit claims for eligible expenses through March 31 of the following year, as long as the expenses allow them to attend school full-time, look for work, or work full-time. Claims may be submitted up to their account balance. They cannot incur expenses after December 31. There are no continuation coverage rights for DCAP.
- What happens to an employee's life insurance, AD&D insurance, long‐term disability (LTD) insurance, or auto or home insurance during a layoff?
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Each of these coverages will be handled a little differently:
- Life and AD&D insurance: Life insurance and AD&D insurance may be continued on a self-pay basis under PEBB Continuation Coverage (Unpaid Leave). If the employee does not elect to continue enrollment in PEBB Continuation Coverage (Unpaid Leave), they can elect to continue life insurance through MetLife under portability or conversion. MetLife will send information to the employee, which will include instructions on how to continue coverage.
- LTD insurance: LTD insurance will end the last day of the month in which the employee was in pay status for at least eight hours. They may not continue employer-paid or employee-paid LTD insurance under PEBB Continuation Coverage.
- Auto/home insurance: The employee should contact Liberty Mutual at 1‐800‐706‐5525 or email libertymutual.service@libertymutual.com to ask about alternate payment options to continue coverage.