Washington Administrative Code › Title 182 - Health Care Authority › PUBLIC EMPLOYEES BENEFITS BOARD (PEBB) PROGRAM › Chapter 182-12 - Eligible and noneligible employees › Section 182-12-114 - How do employees establish eligibility for public employees benefits board (PEBB) benefits?

Current through Register Vol. 24-14, July 15, 2024
Eligibility for an employee whose work circumstances are
				  described by more than one of the eligibility categories in subsections (1)
				  through (5) of this section shall be determined solely by the criteria of the
				  category that most closely describes the employee's work circumstances.
Hours that are excluded in determining eligibility include
				  standby hours and any temporary increases in work hours, of six months or less,
				  caused by training or emergencies (except governor-declared emergencies) that
				  have not been or are not anticipated to be part of the employee's regular work
				  schedule or pattern. Any hours worked in direct response to a governor-declared
				  emergency are not excludable and must be included in determining eligibility.
				  In order to include excluded hours in determining eligibility, employing
				  agencies must request and receive the public employees benefits board (PEBB)
				  program's approval.
For how the employer contribution toward PEBB benefits is
				  maintained after eligibility is established under this section, see WAC
				  182-12-131.
(1) Employees are eligible for PEBB benefits
				as follows, except as described in subsections (2) through (5) of this section:
(a)
Eligibility.
An employee is
				eligible if they are anticipated to work an average of at least 80 hours per
				month and are anticipated to work for at least eight hours in each month for
				more than six consecutive months.
(b)
Determining eligibility.
(i)
Upon employment:
An employee
				is eligible from the date of employment if the employing agency anticipates the
				employee will work according to the criteria in (a) of this
				subsection.
(ii)
Upon
				revision of anticipated work pattern:
If an employing agency revises an
				employee's anticipated work hours or anticipated duration of employment such
				that the employee meets the eligibility criteria in (a) of this subsection, the
				employee becomes eligible when the revision is made.
(iii)
Based on work pattern:
An
				employee who is determined to be ineligible, but later meets the eligibility
				criteria in (a) of this subsection, becomes eligible the first of the month
				following the six-month averaging period.
(c)
Stacking of hours.
As long
				as the work is within one state agency, employees may "stack" or combine hours
				worked in more than one position or job to establish eligibility and maintain
				the employer contribution toward PEBB benefits. Employees become eligible
				through stacking when they meet the requirements described in (a) of this
				subsection. They must notify their employing agency if they believe they are
				eligible through stacking. Stacking includes work situations in which:
(i) The employee works two or more positions
				or jobs at the same time (concurrent stacking);
(ii) The employee moves from one position or
				job to another (consecutive stacking); or
(iii) The employee combines hours from a
				seasonal position with hours from a nonseasonal position or job. An employee
				who establishes eligibility by stacking hours from a seasonal position or job
				with hours from a nonseasonal position or job shall maintain the employer
				contribution toward PEBB benefits as described in WAC
				182-12-131(1).
(d)
When PEBB benefits
				begin.
Medical, dental, basic life insurance, basic accidental death and
				dismemberment (AD&D) insurance, employer-paid long-term disability (LTD)
				insurance, employee-paid LTD insurance (unless the employee declines the
				employee-paid LTD insurance as described in WAC
				182-08-197(1))
				, and if eligible, benefits under the salary reduction plan begin on the first
				day of the month following the date an employee becomes eligible. If the
				employee becomes eligible on the first working day of a month, then coverage
				begins on that date. Supplemental life insurance and supplemental AD&D
				insurance begin on the first day of the month following the date the contracted
				vendor receives the required form or approves the enrollment.