Washington Administrative Code › Title 182 - Health Care Authority › PUBLIC EMPLOYEES BENEFITS BOARD (PEBB) PROGRAM › Chapter 182-12 - Eligible and noneligible employees › Section 182-12-171 - When is a retiring employee or a retiring school employee eligible to enroll in public employees benefits board (PEBB) retiree insurance coverage?

Current through Register Vol. 24-14, July 15, 2024
A retiring employee or a retiring school employee is eligible
				  to continue enrollment or defer enrollment in public employees benefits board
				  (PEBB) insurance coverage as a retiree if they meet procedural and substantive
				  eligibility requirements as described in subsections (1), (2), and (3) of this
				  section. An elected and full-time appointed official of the legislative and
				  executive branch of state government is eligible as described in WAC
				  182-12-180.
(1)
Procedural requirements.
A
				retiring employee or a retiring school employee must enroll or defer enrollment
				in PEBB retiree insurance coverage as described in (a) through (d) of this
				subsection:
(a) To enroll in PEBB retiree
				insurance coverage, the required form must be received by the PEBB program no
				later than 60 days after the employee's or the school employee's own
				employer-paid coverage, Consolidated Omnibus Budget Reconciliation Act (COBRA)
				coverage, or continuation coverage ends. The effective date of PEBB retiree
				insurance coverage is the first day of the month after the employee's or the
				school employee's employer-paid coverage, COBRA coverage, or continuation
				coverage ends;
Note:
Enrollment in the PEBB program's medicare advantage
							 (MA) or medicare advantage-prescription drug (MA-PD) plan may not be
							 retroactive. If a subscriber elects to enroll in a MA plan, and the required
							 forms are received by the PEBB program after the date the PEBB retiree
							 insurance coverage is to begin, the subscriber and their enrolled dependents
							 will be enrolled in a plan with the same contracted vendor during the gap
							 month(s) prior to when MA coverage begins. If a subscriber elects to enroll in
							 a MA-PD plan, and the required forms are received by the PEBB program after the
							 date the PEBB retiree insurance coverage is to begin, the subscriber and their
							 enrolled dependents will be enrolled in Uniform Medical Plan (UMP) Classic
							 during the gap month(s) prior to when the MA-PD coverage begins.
(b)
				The employee's or the school employee's first premium payment for PEBB retiree
				insurance coverage and applicable premium surcharges are due to the health care
				authority (HCA) no later than 45 days after the election period ends as
				described in (a) of this subsection. Following the employee's or the school
				employee's first premium payment, premiums and applicable premium surcharges
				must be paid as described in WAC
				182-08-180(1)(c);
				and
(c) If a retiring employee or a
				retiring school employee elects to enroll a dependent in PEBB health plan
				coverage, the dependent must be enrolled in the same PEBB medical and PEBB
				dental plan as the retiring employee or the retiring school employee;
Exception:
If a retiring employee or a retiring school employee
							 selects a medicare supplement plan or MA-PD plan, nonmedicare enrollees will be
							 enrolled in the UMP Classic. If a retiring employee or a retiring school
							 employee selects any other medicare plan, they must also select a nonmedicare
							 plan with the same contracted vendor available to nonmedicare enrollees.
(d)
				To defer enrollment in PEBB retiree insurance coverage, the employee or the
				school employee must meet substantive eligibility requirements in subsection
				(2) of this section and defer enrollment as described in WAC
				182-12-200 or
				182-12-205.