School districts

Information to help school districts compare PEBB Program eligibility, benefits, and costs, as well as view the requirements to apply to join the PEBB Program.

Eligibility

K-12 school districts, educational service districts (ESDs), and charter schools are eligible to purchase employee healthcare benefits through the Public Employees Benefits Board (PEBB) Program per RCW 41.05 and WAC 182-12.

PEBB Program group coverage is available to your entire group, groups of bargaining unit employees, or all non-represented employees. Additional information regarding group eligibility is in WAC 182-12-111.

Eligibility criteria for employees are defined in WAC 182-12-114 and for dependents in WAC 182-12-260. The PEBB Program may negotiate different eligibility criteria for K-12 school districts, ESDs and charter schools under RCW 41.05.065(4). Requests must be submitted in writing and approved by the PEBB Program.

Benefits

The PEBB Program provides a comprehensive insurance package that includes:

Optional coverage is available for auto and home insurance.

Your employees can select any PEBB Program health plan available in their county of residence.

Your group must purchase the full package of medical/vision, dental, basic life and AD&D, and basic long-term disability insurance.

Costs

View the school district monthly premiums for the first eight months of 2017. PEBB Program rates change twice a year, in January and again in September.

Applicants may use the 2017 projected monthly cost tool to tabulate PEBB Program rates based on subscriber enrollment selections.

When districts or schools join the PEBB Program, they are assessed a start-up fee based on the number of employees who will receive benefits. The following table outlines these start-up fees.

Group size
(includes employees)
Fee
Less than 100 potential enrollees $10 per person
100 - 500 potential enrollees $1,500
501 - 700 potential enrollees $2,000
701 - 1,000 potential enrollees $2,500
More than 1,000 potential enrollees $4,000

How to apply

To apply, submit the documents and information described below:

  1. A letter of application that includes:
    1. A reference to your district's authorizing statute.
    2. A description of the district's organizational structure and a description of the employee bargaining unit(s) or group of non-represented employees for which the district is applying.
    3. Employer tax ID number (TIN).
    4. An estimate of the number of employees and dependents to be enrolled.
  2. A resolution from the district's governing body authorizing the purchase of PEBB Program benefits. You may use this sample resolution.
  3. A signed attestation affirming that the employees of your district substantially perform governmental functions.

All application requirements are outlined in WAC 182-08-235(1) through (3).

The required information and documents for application must be submitted to the PEBB Program at least 60 days before the requested coverage dates.

Send your application to

Amy Corrigan
PEBB Outreach and Training
Health Care Authority
P.O. Box 42684
Olympia, WA 98504-2684
amy.corrigan@hca.wa.gov

Review process

The PEBB Program will review your application for compliance with HCA terms and conditions of participation. We will respond within 30 days and process your group’s enrollment or request additional information.

If the PEBB Program receives an incomplete application, we will work with you to complete the application. If 60 days pass from the initial submission date with no action from you, then you must resubmit your request for participation and all documentation to the PEBB Program. The PEBB Program may approve a 30-day extension due to unusual circumstances. However, an extension may delay the effective date of coverage for employees.

If you have questions or need help, please contact PEBB Outreach and Training at 1-800-700-1555.

What you must do when your application is accepted

When your application is accepted and your group chooses to join the PEBB Program, you must sign a contract/interlocal agreement and a memorandum of understanding. All participation requirements are listed in WAC 182-08-245.

The PEBB Program bills employers on a monthly basis. You will get an invoice around the 25th of each month before the month of coverage. Payment in-full is due by the 20th of the month of coverage. For example, around May 25 an invoice will be sent for June coverage. Payment in-full for June coverage is due by June 20.

You are expected to provide your own PEBB Program account maintenance. Groups with more than 75 employees must manage entering account information into the PEBB Program insurance system (PAY1). The PEBB Program provides training.

Cancelling participation with the PEBB Program

Once enrolled, your group must participate in PEBB Program insurance coverage for at least one full calendar year, and may end participation only at the end of the year, which the PEBB Program has defined as the end of October for school districts and charter schools.

Employers that cancel their participation with the PEBB Program assume responsibility for the continued insurance of any employees on COBRA or continuation of coverage.

Contact

Phone: 1-800-700-1555