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.

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).

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 2025 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.

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.

To keep eligibility for the employer contribution toward PEBB benefits, an employee must have at least eight hours of pay status in each month. Typically, one full day of work or a full day of paid leave (vacation or sick leave) covers this requirement.

However, if the employee cannot maintain at least eight hours of pay status in a PEBB benefits-eligible position, then their insurance coverage (and insurance coverage for any enrolled dependents) will end on the last day of the month in which they are in pay status for at least eight hours.

If their coverage ends, the employee would be eligible to continue any combination of medical, dental, vision, life insurance, and accidental death and dismemberment (AD&D) insurance under PEBB Continuation Coverage (Unpaid Leave) for up to 29 months, as described in WAC 182-12-133. The employee would be responsible to self-pay the full monthly premium and applicable premium surcharges. The PEBB Program will mail the employee a booklet that describes this option and includes the enrollment form. Learn more about PEBB Continuation Coverage (Unpaid Leave).

If the affected employee has a spouse or state-registered domestic partner who is eligible for benefits with their employer (including PEBB or SEBB), they may enroll as a dependent under their account through a special open enrollment. 

No, missed HSA contribution amounts will not be deducted from future paychecks. The employee will not receive their employee contribution if they do not have a paycheck to get the contribution from. Keep in mind, the employee may also revise their election amount by submitting an Employee Authorization for Payroll Deduction to Health Savings Account form to their payroll or benefits office upon returning to work.

Each of these coverages will be handled a little differently:

• Supplemental life insurance: Coverage will continue as long as the employee is in pay status for at least eight hours before the end of the month. The payroll or benefits office will account for any missed payroll deductions when they return to work.
• Employee-paid long‐term disability insurance: Coverage will continue as long as the employee is in pay status for at least eight hours before the end of the month. The payroll or benefits office will account for any missed payroll deductions when they return to work.
• Auto/home insurance: The employee should contact Liberty Mutual at 1‐800‐706‐5525 to ask about alternate payment options to continue their coverage.

The employee who is not affected by the federal government shutdown may enroll their affected spouse under their PEBB (or SEBB) insurance coverage as a dependent if the employee who is affected by the federal government shutdown doesn’t have at least eight hours of pay status. The employee who is adding their spouse as a dependent may do so under a special open enrollment event.

Example: Bill and Jackie are both PEBB benefits‐eligible state employees. Bill works at the Health Care Authority and is being affected by the federal government shutdown. His wife Jackie works at the Department of Transportation (DOT) and is not affected by the federal government shutdown. Jackie may submit her changes and a copy of Bill’s layoff notice (proof of the event) in Benefits 24/7 or to DOT’s payroll or benefits office no later than 60 days after the event to enroll Bill (and any children currently enrolled under Bill’s coverage).

To keep eligibility for the employer contribution toward PEBB benefits, an employee must have at least eight hours of pay status in each month (WAC 182‐12‐131). WAC 182‐12‐109 defines pay status as “all hours for which an employee receives pay.” Typically, one full day of work or a full day of paid leave (vacation or sick leave) covers this requirement. If an employee is not able to work or submit leave for at least eight hours in a month, they will lose eligibility for the employer contribution toward their PEBB benefits; coverage will end on the last day of that month for the employee and any enrolled dependents.

If this happens, the affected employee and their dependents may continue any combination of medical, dental, or vision and may also continue life insurance and accidental death and dismemberment (AD&D) insurance by self-paying the premiums and applicable premium surcharges on a post-tax basis. This is called PEBB Continuation Coverage. Employers make no contribution toward the premiums.

When coverage ends, the PEBB Program will mail a PEBB Continuation Coverage Election Notice booklet to the employee. This booklet describes  available options continuing PEBB insurance coverage.

The PEBB Program offers two types of continuation coverage: PEBB Continuation Coverage (COBRA) and PEBB Continuation Coverage (Unpaid Leave). If an employee loses coverage due to a government shutdown, it would likely be to their advantage to elect PEBB Continuation Coverage (Unpaid Leave) because:

• This coverage also includes the option to continue life insurance. COBRA offers portability or conversion options for life insurance.
• This coverage lasts up to 29 months for a layoff. COBRA generally lasts up to 18 months for a termination or a reduction in hours.

Neither option allows the employee to continue either employer-paid long‐term disability insurance or employee-paid LTD insurance due to a layoff or a reduction of hours.

When enrolling in PEBB Continuation Coverage (COBRA or Unpaid Leave), the employee must pay the full monthly premium and any applicable surcharges. The premiums for both options are the same. Premiums can be found in the PEBB Continuation Coverage Election Notice and on the PEBB Program webpage under "Explore costs."

To enroll in PEBB Continuation Coverage (COBRA or Unpaid Leave), the PEBB Program must receive the affected employee's request in Benefits 24/7 or forms and supporting documentation no later than 60 days after their PEBB health plan coverage ends or from the postmark date on the PEBB Continuation Coverage Election Notice, whichever is later.

If the affected employee has a medical procedure during the shutdown, will it be covered?

If the PEBB Program receives the completed enrollment, monthly premium(s), and any applicable surcharge(s) within the timelines stated in the notice, the employee will continue to receive health plan coverage for any covered services they receive during the shutdown. Their PEBB Continuation Coverage (COBRA or Unpaid Leave) will automatically end when they regain eligibility for the employer contribution toward PEBB benefits.