Frequently asked questions (FAQs)
On this page
- Retiree eligibility and enrollment
- Plan information
- Becoming eligible for Medicare
- Voluntary Employees' Beneficiary Association (VEBA)
- Retiree term life insurance (MetLife)
- Open enrollment, special open enrollment, and changes that can be made any time during the year
- How do I file an appeal?
Where do I find the most commonly used forms?
Am I eligible for PEBB Retiree coverage?
To be eligible to enroll in PEBB retiree insurance, you must meet both the procedural requirements and all eligibility requirements of WAC 182-12-171. PEBB will confirm your eligibility upon receipt of your application. For help determining eligibility, visit determine eligibility.
What coverage can I enroll in?
As an eligible retiree, you can choose to continue your medical and dental coverage, or medical coverage only, through the PEBB Program for yourself and your eligible family members.
If you select retiree dental coverage for yourself, you must keep dental coverage for yourself and any enrolled dependents for at least two years unless you defer or cancel enrollment in PEBB coverage as allowed under PEBB Program rules. However, you may change retiree dental plans within those two years during the PEBB Program's annual open enrollment or due to a special open enrollment event. You cannot enroll in dental only coverage.
You may also enroll in retiree term life insurance if you were enrolled in PEBB employee life insurance while working.
If you are enrolled in Medicare Part A and Part B, you may also have other medical plan options available to you. See Medicare and PEBB Program benefits.
Can I enroll my family members?
You may enroll the following family members (dependents) as described in WAC 182-12 260:
- Your lawful spouse
- Your state-registered domestic partner.
- Your children up to the last day of the month in which they become age 26, except for children with a disability.
The PEBB Program verifies the eligibility of all dependents and will request proof of a dependent’s eligibility. We will not enroll a dependent if we cannot verify the dependent’s eligibility. See dependent verification.
When should I enroll?
It’s important for the PEBB Program to receive your forms within the required timelines. The PEBB Program must receive your Retiree Coverage Election/Change form (Form A) indicating your decision to enroll or defer no later than 60 days after your employer-paid coverage, COBRA coverage, or continuation coverage ends. Additional forms and documentation may be required for enrollment. If the PEBB Program does not receive your completed required forms within the required timeline, you could lose your right to enroll. Find out how to enroll.
Can I enroll later?
If you meet the eligibility requirements for PEBB retiree coverage (WAC 182-12-171) and you meet requirements in WAC 182-12-200 or 182-12-205, you can defer (postpone) PEBB retiree insurance and enroll in the future. To defer your enrollment, the PEBB Program must receive your Retiree Coverage Election/Change form (Form A) requesting deferment no later than 60 days after your employer-paid coverage, COBRA coverage, or continuation coverage ends. See deferring coverage.
What plans are available to PEBB retirees?
For a listing of plans available to retirees, visit medical plans and benefits.
How can I compare the plans available through PEBB?
You can compare the plans available through PEBB by using the Medical Benefit Comparison tool.
Note: the comparison tool does not include information for Medicare Supplement Plan F, administered by Premera Blue Cross.
What happens once I (or my covered dependents) enroll in Medicare Part A and Part B?
Once you or your covered dependent(s) enroll in Medicare Part A and Part B, you must send a copy of either the Medicare card or a letter from the Social Security Administration as soon as you receive it but no later than 60 days after enrolling in Medicare that shows the effective date of Medicare Part A and Part B coverage.
Mail a photocopy of the Medicare card or letter to:
PEBB Program Health Care Authority
P.O. Box 42684
Olympia, WA 98504-2684
We will reduce your premium to the lower Medicare rate, if applicable, and notify your health plan of your Medicare enrollment.
Visit Medicare and PEBB Program benefits for more information.
How much does PEBB Retiree coverage cost?
Rates vary depending on your plan and if you're enrolled in Medicare. Generally, rates change every January 1. See plan costs.
Where can I compare premium costs?
You can compare PEBB premiums by visiting plan costs.
How do I pay the premiums?
The following are options for paying for your medical and dental premiums:
- DRS pension deduction.
- Automatic bank account withdrawal (Electronic Debit Service).
- A personal check or money order.
See paying for benefits for more details.
If you are eligible for and electing Retiree Term Life Insurance coverage, premium payment will be made directly to MetLife. See how will I pay for my Retiree term life insurance premiums.
What happens if I miss a payment?
You must pay the premiums and any applicable surcharges for your PEBB coverage when due. The monthly premium will be considered unpaid if there is one of the following occurs:
- No payment of premium or premium surcharge is paid and the monthly premium remains unpaid for 30 days; or
- A premium payment or premium surcharge is underpaid by an amount greater than what would be considered an insignificant shortfall (described in WAC 182-08-015) and the monthly premium remains underpaid for 30 days past the date the monthly premium was due.
If either of the events listed above occur, the PEBB Program will terminate your PEBB insurance coverage retroactive to the last day of the month for which the monthly premium and any premium surcharge was paid. If your PEBB retiree insurance coverage is terminated, any enrolled dependents’ coverage will be terminated as well. You cannot enroll again later unless you regain eligibility for PEBB coverage (for example, by returning to employment in a PEBB, Washington State school district, educational service district, or charter school benefits-eligible position.
For more information visit paying for benefits.
What is a VEBA?
A voluntary employees’ beneficiary association (VEBA) is a tax-exempt trust under Section 501(c)(9) of the Internal Revenue Code. VEBA trusts hold assets for the purpose of providing employee benefits. Hundreds of state and local governmental agencies and employers in Washington have adopted VEBA programs that provide health reimbursement arrangements (HRAs) to eligible employees and retirees.
What is an HRA?
A health reimbursement arrangement or HRA is an account you can use to reimburse your out-of-pocket medical care expenses and premiums. HRAs are often called VEBA accounts.
For more information on VEBA, call the VEBA MEP customer care center at 1-888-828-4953. You may also contact your agency personnel, payroll or benefits office or employer agency to see if your agency or employer participates in VEBA.
Can I use my VEBA account to pay my premiums?
Yes, and you can set up a monthly “automatic premium reimbursement.” Supporting documentation, such as a Statement of Insurance, is required. For information on how to reimburse your premiums by using a VEBA account, visit paying for benefits.
Other types of common qualified expenses include co-pays, deductibles, prescription drugs, dental, vision, etc.
How do I get a Statement of Insurance for reimbursement from VEBA?
Once you are enrolled, a Statement of Insurance can be downloaded by logging in to My Account. My Account will not be available until your retiree coverage is effective.
Can I use my VEBA account to pay my premiums?
For information on how to pay your premiums by using a VEBA account, visit paying for benefits.
How do I get a Statement of Insurance for reimbursement from VEBA?
A Statement of Insurance can be printed or downloaded by logging in to My Account on the PEB website.
Am I eligible for Retiree Term Life insurance?
The PEBB Program provides retiree term life insurance through Metropolitan Life Insurance Company (MetLife). Coverage is available if you:
- Meet PEBB retiree eligibility requirements,
- Are enrolled in PEBB Program life insurance as an active employee,
- Are not on a waiver of premium due to disability.
Your dependents are not eligible for retiree term life insurance.
If you enroll in COBRA between the time you had PEBB employee coverage and the time you become eligible or PEBB retiree coverage, you cannot enroll in retiree term life insurance. The PEBB Program does not offer life insurance to COBRA enrollees and you cannot have a break in life insurance coverage.
How do I enroll in Retiree Term Life Insurance?
The PEBB Program must receive these forms no later than 60 days after your employer-paid coverage ends. If you enroll when eligible and pay premiums on time, insurance becomes effective on your retirement date.
How much is Retiree Term Life insurance?
Premiums for Retiree Term Life insurance are located under life insurance premiums.
How do I pay for Retiree Term Life insurance?
Your retiree term life insurance premiums are not included with your PEBB medical plan premiums. Visit how will I pay for my retiree term life insurance premiums for information on how to pay for retiree term life insurance.
How do I cancel my Retiree Term Life Insurance?
To cancel your Retiree Term life insurance through MetLife, follow the instructions for cancelling retiree term life insurance. If you cancel Retiree Term Life Insurance, you may not reapply in the future unless you regain eligibility.
Additional retiree life insurance resources:
When is PEBB’s annual open enrollment?
PEBB’s annual open enrollment is November 1 through November 30. PEBB’s annual open enrollment is your chance to make changes to your PEBB health plan coverage without having a Special Open Enrollment event. Changes made will take effect January 1 of the following year.
What changes can I make during PEBB's annual open enrollment?
During open enrollment (November 1 – 30), you can make changes online using My Account. You can:
- Change your medical and/or dental plan.
- Add an eligible family member to your coverage.
- Attest to the tobacco use premium surcharge and spousal coverage premium surcharge (if applicable).
- Remove a family member from your coverage.
- Defer your retiree coverage.
- Enroll in a health plan if you previously deferred retiree coverage for other coverage.
Some changes can be made online using My Account.
What is a Special Open Enrollment (SOE)?
The PEBB Program allows changes outside of the PEBB Program’s annual open enrollment when certain events create a special open enrollment. The change must be on account of and correspond to the event that affects eligibility for coverage. You must provide proof of the event that created the special open enrollment (for example, a marriage or birth certificate). Please visit the change your coverage page for a list of events that may qualify as a Special Open Enrollment.
Which events may qualify as a Special Open Enrollment (SOE)?
Please visit change your coverage for a list of events that may qualify as a Special Open Enrollment.
When will my Special Open Enrollment (SOE) become effective?
In most cases, changes will occur the first day of the month after the date of the event or the date the PEBB Program receives your required, completed enrollment form(s) and documents(s), whichever is later. If that day is the first of the month, coverage begins on that day.
What changes can I make any time during the year?
There are some changes you can make any time during the year without a special open enrollment event, including:
- Change your name and/or address.
- Remove an eligible dependent from insurance coverage.
- Change your life insurance beneficiary information.
- Apply for, cancel, or change auto or home insurance coverage.
- Start, stop, or change your contribution to your health savings account (HSA).
- Change your HSA beneficiary information.
Please visit the change your coverage page for more information.
How do I make an address change?
Retirees can call 1-800-200-1004 or submit a signed request to update their address. If you are moving out of your medical plan’s service area, you will be required to submit the Retiree Coverage Election Change (Form A) with your new plan(s) selection. Additional forms may be required based upon your new plan(s) selection.
See completing the retiree forms for more information.
How do I cancel PEBB retiree coverage?
To cancel your PEBB retiree coverage, you must submit your request in writing to:
Health Care Authority
P.O. Box 42684
Olympia, WA 98504-2684
Or fax to 360-725-0711
Your insurance coverage will end on the last day of the month in which the PEBB Program receives your written notice. If your written notice is received on the first day of the month, coverage will end on the last day of the previous month.
Exception: If you or an enrolled dependent are enrolled in a Medicare Advantage plan, you must also send the PEBB Program a completed PEBB Medicare Advantage Plan Disenrollment form (Form D). PEBB insurance coverage will end on the last day of the month when the Medicare Advantage Form is received.
Note: If you cancel your PEBB retiree coverage, you cannot enroll again later unless you regain eligibility for PEBB coverage, for example, by returning to employment in a PEBB, Washington State School district, educational service district, or charter school benefits-eligible position. If you cancel coverage, any enrolled dependents’ coverage will be terminated as well.
How do I defer my PEBB retiree coverage after enrollment?
If you are a retiree enrolled in PEBB retiree insurance coverage, the PEBB Program must receive your election/change form and any other forms before you defer coverage. Enrollment will be deferred effective the first of the month following the date the PEBB Program receives your form. Exception: if the form is received on the first day of the month, coverage will end on the last day of the previous month. If you or an enrolled dependent are enrolled in a Medicare Advantage plan, you must also send the PEBB Program a completed PEBB Medicare Advantage Plan Disenrollment form (Form D). PEBB insurance coverage will end on the last day of the month when the Medicare Advantage Form is received.
For additional information, see deferring coverage.
How do I re-enroll after deferring PEBB coverage?
Please see how to enroll after deferring coverage.
Submit the Retiree/COBRA/PEBB Continuation Coverage Notice of Appeal form to the PEBB Appeals Manager as instructed on the form. More information on how to file an appeal is located on the file an appeal page.