Washington Administrative Code › Title 182 - Health Care Authority › PUBLIC EMPLOYEES BENEFITS BOARD (PEBB) PROGRAM › Chapter 182-12 - Eligible and noneligible employees › Section 182-12-270 - What options for continuation coverage are available to dependents who cease to meet the eligibility criteria as described in WAC 182-12-260?

Current through Register Vol. 24-14, July 15, 2024
If eligible, dependents may continue health plan enrollment
				  under one of the continuation coverage options in subsection (1) or (2) of this
				  section by self-paying the premiums and applicable premium surcharges set by
				  the health care authority (HCA), with no contribution from the employer,
				  following their loss of eligibility under the subscriber's health plan
				  coverage. The dependent's first premium payment and applicable premium
				  surcharges are due no later than forty-five days after the election period ends
				  as described in WAC
				  182-12-146,
				  182-12-180,
				  182-12-250,
				  or
				  182-12-265,
				  whichever applies. Premiums and applicable premium surcharges associated with
				  continuing PEBB medical, must be made to the HCA as well as premiums associated
				  with continuing PEBB dental insurance coverage. Following the dependent's first
				  premium payment, the dependent must pay premium and applicable premium
				  surcharges as they become due. If the monthly premium or applicable premium
				  surcharges remain unpaid for sixty days from the original due date, PEBB
				  insurance coverage will be terminated retroactive to the last day of the month
				  for which the monthly premium and applicable premium surcharges were paid as
				  described in WAC
				  182-08-180(1)(c).
				  The PEBB program must receive the required forms as outlined in the
PEBB Initial Notice of COBRA and Continuation Coverage Rights
.
				  Options for continuing health plan enrollment are based on the reason that
				  eligibility was lost.
(1) Spouses,
				state registered domestic partners, or children who lose eligibility due to the
				death of an employee or retiree may be eligible to continue health plan
				enrollment as described in WAC
				182-12-180,
				182-12-250,
				or
				182-12-265;
				or
(2) Dependents who lose
				eligibility because they no longer meet the eligibility criteria as described
				in WAC
				182-12-260
				are eligible to continue PEBB medical, dental, or both under provisions of the
				federal Consolidated Omnibus Budget Reconciliation Act (COBRA). See WAC
				182-12-146
				for more information on COBRA.
(3)
				A subscriber's state registered domestic partner and the state registered
				domestic partner's children may continue PEBB medical, dental, or both on the
				same terms and conditions as spouses and other eligible dependents under COBRA
				as described under
				RCW
				26.60.015.
(4) No continuation coverage will be offered
				unless the PEBB program is notified through hand-delivery or United States
				Postal Service mail of the qualifying event as outlined in the
PEBB
				Initial Notice of COBRA and Continuation Coverage Rights
.
Statutory Authority:
					 RCW
					 41.05.160. 12-20-022 (Order 2012-01), §
											182-12-270, filed 9/25/12,
					 effective 11/1/12; 09-23-102 (Order 09-02), §
											182-12-270, filed 11/17/09,
					 effective 1/1/10; 08-20-128 (Order 08-03), §
											182-12-270, filed 10/1/08,
					 effective 1/1/09; 07-20-129 (Order 07-01), §
											182-12-270, filed 10/3/07,
					 effective 11/3/07. Statutory Authority:
					 RCW
					 41.05.160,
					 41.05.350, and
					 41.05.165. 05-16-046 (Order
					 05-01), §
											182-12-270, filed 7/27/05,
					 effective 8/27/05. Statutory Authority:
					 RCW
					 41.05.160 and
					 41.05.165. 04-18-039, §
											182-12-270, filed 8/26/04,
					 effective 1/1/05.