FAQs for PEBB benefits administrators

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.

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. 

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.

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).

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.