Washington Administrative Code › Title 182 - Health Care Authority › PUBLIC EMPLOYEES BENEFITS BOARD (PEBB) PROGRAM › Chapter 182-12 - Eligible and noneligible employees › Section 182-12-200 - May a retiring employee, a retiring school employee, or a retiree enrolled as a dependent in a health plan sponsored by public employees benefits board (PEBB) or school employees benefits board (SEBB) defer enrollment under PEBB retiree insurance coverage?

Current through Register Vol. 24-14, July 15, 2024
(1) A retiring
				employee or a retiring school employee may defer enrollment in public employees
				benefits board (PEBB) retiree insurance coverage at retirement if they meet
				substantive eligibility requirements as described in WAC
				182-12-171(2) or
				as described in WAC
				182-12-180(1).
				An enrolled retiree may defer enrollment after enrolling in PEBB retiree
				insurance coverage. Enrollment in PEBB retiree insurance coverage may be
				deferred when they are enrolled as a dependent in a health plan sponsored by
				PEBB or school employees benefits board (SEBB), including such coverage under
				the Consolidated Omnibus Budget Reconciliation Act (COBRA) or continuation
				coverage.
(2) A retiring employee,
				a retiring school employee, or a retiree who defers enrollment in PEBB retiree
				insurance coverage defers enrollment in PEBB medical and PEBB dental. A retiree
				must be enrolled in PEBB medical to enroll in PEBB dental. A retiree who defers
				enrollment also defers enrollment for all eligible dependents. A retiree may
				only defer enrollment in PEBB retiree term life insurance as described in WAC
				182-12-209(3)(b).
(3) A retiring employee, a retiring school
				employee, or a retiree who defers enrollment as described in this section may
				later enroll themselves and their dependents in a PEBB health plan by
				submitting the required forms as described below and evidence of continuous
				enrollment in a health plan sponsored by PEBB or SEBB. Evidence of continuous
				enrollment in a health plan sponsored by a Washington state educational service
				district may be required if a retiring employee, a retiring school employee, or
				a retiree deferred enrollment under this section prior to January 1, 2024. A
				gap of 31 days or less is allowed between the date PEBB retiree insurance
				coverage is deferred and the start date of enrollment in a health plan
				sponsored by PEBB, a Washington state educational service district, or SEBB,
				and between each period of enrollment in qualifying coverages as described in
				WAC 182-12-205(3)(a) through
				(e) during the deferral period:
(a) During the PEBB annual open enrollment
				period. The required form must be received by the PEBB program no later than
				the last day of the open enrollment period. PEBB health plan coverage begins
				January 1st of the following year; or
(b) When enrollment in a health plan
				sponsored by PEBB, a Washington state educational service district, or SEBB
				ends, or such coverage under COBRA or continuation coverage ends. The required
				forms to enroll must be received by the PEBB program no later than 60 days
				after coverage ends. PEBB health plan coverage begins the first day of the
				month following the date the other coverage ends. To continue in a deferred
				status, the retiree must defer enrollment as described in WAC
				182-12-205.
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.
(c)
				If a retiree elects to enroll a dependent in PEBB health plan coverage as
				described in this subsection, the dependent must be enrolled in the same PEBB
				medical or PEBB dental plan as the retiree.
Exception:
If a retiree selects a medicare supplement plan or
							 MA-PD plan, nonmedicare enrollees will be enrolled in the UMP Classic. If a
							 retiree selects any other medicare plan, they must also select a nonmedicare
							 plan with the same contracted vendor available to nonmedicare enrollees.