When employees may make changes

Information about how and when employees may make changes to their Public Employees Benefits Board (PEBB) coverage. Most changes can be made during annual open enrollment or during a special open enrollment. 

Annual open enrollment

From November 1-30 each year, employees can make changes to their PEBB benefits that become effective January 1 of the following year.

For most changes, employees must submit the next year’s PEBB Employee Enrollment/Change form to their payroll or benefits office during annual open enrollment. Some changes can be made online using PEBB My Account instead.

The next year’s enrollment forms are available on November 1 each year.
Pierce County, Washington State University, and University of Washington employees must make changes through Workday.

Making changes during annual open enrollment

During open enrollment (November 1-30) employees can:

  • Change medical or dental plans.
  • Add or remove eligible dependents.
    • Dependent verification is required when adding eligible dependents to coverage.
      Visit the Dependents page for more information.
  • Enroll in a medical plan, if previously waived.
  • Waive enrollment in PEBB medical if already enrolled or enrolling in other employer-based group medical insurance, a TRICARE plan, or Medicare effective January 1
    • Employees may waive PEBB medical to enroll in School Employees Benefits Board (SEBB) medical, only if they are also enrolled in SEBB dental and SEBB vision. An employee who waives PEBB medical coverage to enroll in SEBB medical, also waives enrollment in PEBB dental.
    • Employees who waive PEBB medical to enroll in other employer-based group medical insurance, a TRICARE plan, or Medicare, may also waive enrollment in PEBB dental only if enrolled in both SEBB dental and vision coverage as a dependent.
    • Employees may not waive PEBB medical to enroll in coverage through the Health Benefit Exchange.
  • Attest or reattest to the spouse or state-registered domestic partner coverage premium surcharge.
    • Attest or reattest using the next year’s Premium Surcharge Attestation Change form.

The following changes can be made by eligible employees of state agencies and higher-education institutions only:

  • Enroll or reenroll in a Flexible Spending Arrangement or Dependent Care Assistance Program
    • Employees may enroll or reenroll online through Navia’s portal or by completing and submitting Navia’s PEBB Open Enrollment form. Learn more on the FSA and DCAP page.
  • Enroll in or opt out of participation in the premium payment plan for pretax premium deductions.
    • This change can be made using the next year’s Premium Payment Plan Election/Change form.

Making changes online

Some changes can be made online during open enrollment using PEBB My Account:

  • Change medical and/or dental plans.
  • Waive medical coverage.
  • Remove dependents from coverage.
  • Reattest to the spousal or state-registered domestic partner premium surcharge, if applicable.

After completing changes online, employees should:

  • Print or save their confirmation page.
  • Wait two business days to review changes in PEBB My Account and verify coverage is correct.
  • Wait two business days before making additional changes.

Pierce County, Washington State University, and University of Washington employees must make changes through Workday.

Special open enrollment

Certain life events allow employees to make changes outside of annual open enrollment. These events and the time frame employees have to make changes are called a special open enrollment (SOE). Changes must be allowable, correspond to, and be consistent with the event that creates the SOE and employees must provide proof of the event (e.g. marriage or birth certificate).

Refer to the SOE matrix: Addendum 45-2A whenever an employee is requesting to make changes outside of annual open enrollment. The matrix provides a summary of permitted election changes, which includes:

  • A list of qualifying SOE events.
  • Valid documents required to verify proof of the event.
  • What changes are or not allowed, according to the event.
  • Required time frames for making a change.
  • When changes are effective.

To make a change, employees must complete and submit the appropriate form(s) and proof of the qualifying event to their payroll or benefits office within the required time frames. For most events, the employer must receive the forms and proof of the event no later than 60 days after the date of the event.

Learn more about special open enrollment on the Public employees website.

Changes that can be made at any time

There are several changes that employees can make at any time of the year.

  • Change of employee’s or dependent’s name and/or address.
    • A form is not required to report a name or address change.
      • Instructions for updating employee names and addresses are located on the Pay1 insurance system page.
      • If Outreach & Training keys for you, send a secure message to report an employee's name change or change of address.
  • Employees are required to remove dependents from coverage when they lose eligibility.
    • In most cases, employees must complete and submit the current year's PEBB Employee Enrollment/Change form to their payroll or benefits office no later than 60 days after the last day of the month the dependent lost eligibility. Proof of the event may be required.
    • Exception: A form is not required to remove a dependent child who loses eligibility due to turning age 26.
      Learn more on the Dependents page.
  • Life and accidental death and dismemberment (AD&D) insurance:
    • Change life and AD&D insurance beneficiary information.
    • Apply for, cancel, or change coverage amounts for supplemental life and AD&D insurance. Evidence of insurability may be required.
      Learn more on the Life and AD&D insurance page.
  • Long-term disability (LTD) insurance:
    • Reduce, decline, enroll in, or increase employee-paid LTD insurance. Evidence of insurability may be required.
      Learn more on the Long-term disability page.
  • Health savings accounts (HSA):
    • Start, stop, or change the employee contribution to a health savings account (HSA) using the current year's Employee Authorization for Payroll Deduction to Health Savings Account form.
    • Change HSA beneficiary information using the Health Savings Account Beneficiary Designation form.
  • Make changes to the tobacco use premium surcharge attestation online through PEBB My Account or by using the Premium Surcharge Attestation Change form.

For instructions on keying changes, visit the Pay1 insurance system age. If Outreach & Training keys for you, send required forms and documentation for processing through HCA Support.

Related rules

  • WAC 182-08-198: When may a subscriber change health plans?
  • WAC 182-08-199: When may an employee enroll in or change their election under the premium payment plan, Flexible spending arrangement (FSA), or dependent care assistance program (DCAP)?
  • WAC 182-12-123: Is dual enrollment in public employees benefits board (PEBB) and school employees benefits board (SEBB) prohibited?
  • WAC 182-12-128: Waiving enrollment and reenrolling in PEBB medical
  • WAC 182-12-262: When may subscribers enroll or remove eligible dependents?

Contact

Outreach and Training
Benefits administrators contact O&T for eligibility, enrollment, or billing related questions.
Phone: 1-800-700-1555
Secure messaging: HCA Support