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.
See the updates on Benefits 24/7 stabilization efforts.
Find information about paying for Public Employees Benefits Board (PEBB) Program benefits.
The employee contribution is the portion of the total monthly premium paid by an employee.
The employer contribution is the portion of the total monthly premium (or rate) paid by the employer, for each eligible employee.
Monthly premiums pay for a full calendar month of coverage and cannot be prorated for any reason.
The employee contribution may include the following premiums and/or surcharges, as applicable:
See medical premiums for employees of state agencies and higher-education institutions on the Public employees website. Employer groups determine the employee premium.
PEBB participating employer groups determine how much of the total premium eligible employees are required to pay for medical coverage (and dental or vision coverage, if applicable) (section 5(c) of the Interlocal Agreement).
See the supplemental life and AD&D rates on the public employees website.
See the employee-paid LTD rates on the public employees website.
The employer contribution and rates vary based on employer type:
State agencies and higher-education institutions | PEBB Participating employer groups |
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State agencies and higher-education institutions pay a monthly employer contribution for (WAC 182-08-120):
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Employer groups determine how much of the total monthly premium they pay (employer contribution) and how much their eligible employees pay (employee contribution) for medical coverage (and dental or vision coverage, if applicable) (section 5(c) of the Interlocal Agreement).
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View the monthly PEBB program rates for your employer type.
For faculty eligible for PEBB benefits at more than one institution, each institution will pay a percentage of the faculty's total work at all institutions (WAC 182-08-200):
The institution with the greatest percentage coordinates the collection of payment from the other institutions and is responsible for sending the total premium payment to the Health Care Authority's (HCA) PEBB Program.
Eligible employees pay premiums and applicable premium surcharges to their employer or the contracted vendor (for supplemental benefits).
Employers are responsible for collecting the employee contributions and any applicable surcharges from their eligible employees. Each month, employers must pay the full premium payment (total monthly billed amount) to the PEBB Program for each eligible employee, even for those who waive medical coverage.
If an employee enrolls in supplemental coverage or is enrolled in employee-paid coverage, the employee is responsible for payment of premiums from the month that coverage begins.
View the accounting manual for your employer type to learn more.
Eligible state agency and higher education institution employees may pay for coverage with pretax dollars from their paycheck under the state's premium payment plan, which is part of the Salary Reduction Plan under IRC Section 125. Learn more about paying for premiums with pretax dollars.
PEBB participating employer groups may offer their own pretax deduction benefit and must have and implement a cafeteria plan per IRC 125 (section 5(a) in the interlocal agreement).
Under federal law, employer contributions for health insurance do not need to be included as gross income for federal income tax. However, if an employee's enrolled PEBB dependent does not qualify as a tax dependent for tax purposes under Internal Revenue Code (IRC) Section 152, as modified by IRC Section 105(b), employers must report the fair market value of the dependent's health insurance as gross income.
Employees adding a dependent who does not qualify as a dependent for tax purposes (e.g., state-registered domestic partner (SRDP), SRDP's child(ren), extended dependent) to their employer-sponsored insurance must identify their family tax status for the upcoming calendar year by completing and submitting the Declaration of Tax Status form to their benefits administrator.
Learn about tax issues related to nontax qualified dependents.
Situations may occur where employers are unable to deduct the employee contribution from an employee's paycheck. Examples include the following scenarios:
Employers should make arrangements with their employees to pay the employee contribution through other methods while payroll deduction is not available.
Examples include:
Pay-as-you-go
If you are unable to collect the employee contribution due to the employee not responding to the employer's requests for payment of premiums, the employer must pay for PEBB insurance coverage billed by the PEBB Program regardless of an employee's underpayment or nonpayment.
Employee benefits may not be terminated due to nonpayment of the employee contribution. Benefits may only be terminated when eligibility for the employer contribution toward PEBB benefits ends as outlined in WAC 182-12-131(7) and PEBB Policy Addendum 19-1A.
See below for general guidance on how you can address employee failure to make premium payments and speak with your HR and legal advisers as you deem necessary:
Pay-as-you-go: Negotiate timely payments by the employee on the same schedule as if payroll deductions were occurring.
PEBB insurance premiums and applicable premium surcharges will be refunded using the following methods: