Washington Administrative Code › Title 182 - Health Care Authority › PUBLIC EMPLOYEES BENEFITS BOARD (PEBB) PROGRAM › Chapter 182-08 - Procedures › Section 182-08-185 - What are the requirements regarding premium surcharges?

Current through Register Vol. 24-14, July 15, 2024
(1) A subscriber's account will incur a
				premium surcharge in addition to the subscriber's monthly medical premium, when
				any enrollee, thirteen years and older, engages in tobacco use.
(a) A subscriber must attest to whether any
				enrollee, thirteen years and older, enrolled in their public employees benefits
				board (PEBB) medical engages in tobacco use. The subscriber must attest as
				described in (a)(i) through (vii) of this subsection:
(i) An employee who is newly eligible or
				regains eligibility for the employer contribution toward PEBB benefits must
				complete the required form to enroll in PEBB medical as described in WAC
				182-08-197(1)
				or (3). The employee must include their
				attestation on that form. The employee must submit the form to their employing
				agency. If the employee's attestation results in a premium surcharge, it will
				take effect the same date as PEBB medical begins.
(ii) If there is a change in the tobacco use
				status of any enrollee, thirteen years and older on the subscriber's PEBB
				medical, the subscriber must update their attestation on the required form. An
				employee must submit the form to their employing agency. Any other subscriber
				must submit their form to the PEBB program. The attestation change will apply
				as follows:
* A change that results in a premium surcharge will begin the
				  first day of the month following the status change. If that day is the first of
				  the month, the change to the surcharge begins on that day.
* A change that results in removing the premium surcharge
				  will begin the first day of the month following receipt of the attestation. If
				  that day is the first of the month, the change to the surcharge begins on that
				  day.
(iii) If a subscriber
				submits the required form to enroll a dependent, thirteen years and older, in
				PEBB medical as described in WAC
				182-12-262,
				the subscriber must attest for their dependent on the required form. An
				employee must submit the form to their employing agency. Any other subscriber
				must submit their form to the PEBB program. A change that results in a premium
				surcharge will take effect the same date as PEBB medical begins.
(iv) An enrollee, thirteen years and older,
				who elects to continue medical coverage as described in WAC
				182-12-133,
				182-12-141,
				182-12-142,
				182-12-146,
				182-12-148,
				or 18212-270, must provide an attestation on the required form if they have not
				previously attested as described in (a) of this subsection. The enrollee must
				submit their form to the PEBB program. An attestation that results in a premium
				surcharge will take effect the same date as PEBB medical begins.
(v) An employee or retiree who enrolls in
				PEBB medical as described in WAC
				182-12-171(1)(a),
				182-12-180(3)(a),
				182-12-200(3)(a)
				or (b),
				182-12-205(6)
				or (7), or 182-12-21 1, must provide an
				attestation on the required form if they have not previously attested as
				described in (a) of this subsection. The employee or retiree must submit their
				form to the PEBB program. An attestation that results in a premium surcharge
				will take effect the same date as PEBB medical begins.
(vi) A surviving spouse, state registered
				domestic partner, or dependent child, thirteen years and older, who enrolls in
				PEBB medical as described in WAC
				182-12-180(3)(a),
				182-12-250(5)
				or
				182-12-265,
				must provide an attestation on the required form to the PEBB program if they
				have not previously attested as described in (a) of this subsection. An
				attestation that results in a premium surcharge will take effect the same date
				as PEBB medical begins.
(vii) An
				employee who previously waived PEBB medical must complete the required form to
				enroll in PEBB medical as described in WAC
				182-12-128(3).
				The employee must include their attestation on that form. An employee must
				submit the form to their employing agency. An attestation that results in a
				premium surcharge will take effect the same date as PEBB medical begins.
Exceptions:
(1) A subscriber enrolled in both medicare Parts A
							 and B and in the medicare risk pool as described in
							 RCW
							 41.05.080(3) is not required
							 to provide an attestation and no premium surcharge will be imposed on the
							 subscriber's account.
(2) An employee who waives PEBB medical as described
							 in WAC
							 182-12-128
							 is not required to provide an attestation and no premium surcharge will be
							 applied to their account as long as the employee remains in waived
							 status.