Washington Administrative Code › Title 182 - Health Care Authority › PUBLIC EMPLOYEES BENEFITS BOARD (PEBB) PROGRAM › Chapter 182-12 - Eligible and noneligible employees › Section 182-12-265 - What options for continuing health plan enrollment are available to a surviving spouse, state registered domestic partner, or child, if an employee, a school employee, or a retiree dies?

Current through Register Vol. 24-14, July 15, 2024
The survivor of an eligible employee, an eligible school
				  employee, or a retiree who meets the eligibility criteria and submits the
				  required forms as described in subsection (1), (2), or (3) of this section is
				  eligible to enroll or defer enrollment as a survivor under public employees
				  benefits board (PEBB) retiree insurance coverage. If enrolling in PEBB retiree
				  insurance coverage, the survivor's first premium payment 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 subsection (1), (2), or (3) of
				  this section. Following the survivor's first premium payment, premiums and
				  applicable premium surcharges must be paid as described in WAC
				  182-08-180(1)(c).
(1) An employee's spouse, state registered
				domestic partner, or child who loses eligibility due to the death of an
				eligible employee may enroll or defer enrollment as a survivor under PEBB
				retiree insurance coverage provided they immediately begin receiving a monthly
				retirement benefit from any state of Washington sponsored retirement system. To
				satisfy the requirement to immediately receive a monthly retirement benefit
				they must begin receiving monthly benefit payments no later than 120 days from
				the date of death of the employee. The required forms to enroll or defer
				enrollment must be received by the PEBB program no later than 60 days after the
				later of the date of the employee's death or the date the survivor's PEBB
				insurance 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 the 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.
(a) The
				employee's spouse or state registered domestic partner may continue health plan
				enrollment until death.
(b) The
				employee's children may continue health plan enrollment until they lose
				eligibility as described in WAC
				182-12-260.
Notes:
If a spouse, state registered domestic partner, or
							 child of an eligible employee is not eligible for a monthly retirement benefit,
							 they are not eligible to enroll as a survivor under PEBB retiree insurance
							 coverage. However, they may continue health plan enrollment as described in WAC
							 182-12-146.
Eligibility for the surviving spouse, surviving state
							 registered domestic partner, or surviving child of an employee of a
							 participating employer group will cease at the end of the month in which the
							 group's contract with the authority ends.
Eligibility for the surviving spouse, surviving state
							 registered domestic partner, or surviving child of an elected and full-time
							 appointed official of the legislative and executive branches of state
							 government is described in WAC
							 182-12-180.