How to enroll

Before you enroll

1. Compare medical plans.
2. Compare dental plans.
3. See the monthly cost for non-Medicare or Medicare PEBB medical.
4. Explore the additional benefits available to you as a PEBB subscriber.
5. Find out if premium surcharges apply to you.

Limited time to enroll

You have 60 days after your employment or COBRA coverage ends to notify the PEBB Program that you want to enroll in or defer PEBB retiree coverage. You may defer retiree coverage if you maintain continuous enrollment in other employer-based group medical.

If you don't complete your application in time, you could lose rights to enroll in PEBB retiree coverage unless you regain eligibility. To regain eligibility, you would have to return to work in a PEBB Program or Washington State school district or educational service district benefits-eligible position and, at the time of termination, meet the enrollment and eligibility requirements of WAC 182-12-171.

Three-step timeline to enroll

1. Contact the Social Security Administration
   About 90 days before your active employment or COBRA ends, contact the Social Security Administration to enroll in Medicare Part A and Part B if you or any family members you wish to cover are entitled to Medicare.
2. Request a retiree enrollment packet
   Sixty days before your active employment or COBRA ends request a retiree enrollment packet. Call 1-800-200-1004 or 360-725-0440 in the Olympia area. We'll send you a Retiree Enrollment Guide, which includes applications and information.
3. Return your completed retiree application
   Within 60 days after your active employment or COBRA coverage ends return your completed retiree application and any applicable forms to the PEBB Program.

Required forms

Complete the Retiree Coverage Election/Change (Form A) and any other documents and mail or hand deliver it to us as instructed on the form. We must receive your form no later than 60 days after your active employment or COBRA coverage ends. You must submit Form A even if you decide to defer (postpone) your enrollment.

If you or any covered dependents are entitled to Medicare, you must enroll in Part A and Part B and remain enrolled to keep your PEBB coverage. Please include a copy of the Medicare card with your enrollment form(s).

For more help see Completing the retiree forms.

Enrolling family members

If you enroll family members on your PEBB coverage, you must provide proof of their eligibility within the enrollment timelines listed above or the family members will not be enrolled. See Dependent verification. You will need these forms:

• Declaration of Tax Status - To enroll a state-registered domestic partner or a state-registered domestic partner's child
• Certification of Dependent With a Disability - To enroll a dependent child with a disability (over age 26)
• Extended Dependent Certification - To enroll an extended (legal) dependent child

What to expect after submitting your enrollment form

If you are retiring as a state employee or a higher-education institution employee, your PEBB retiree coverage will begin on the first day of the month after your employer-paid coverage, COBRA coverage, or continuation coverage ends.

These are the steps that will occur:

1. In most cases, your employer’s payroll office will cancel your employee coverage when they process your final paycheck. The PEBB Program cannot enroll you in retiree coverage until this occurs.
2. The health plan(s) that covered you as an employee will send you a cancellation letter after your payroll office cancels your employee coverage. Federal rules require us to send you a PEBB Continuation of Coverage Election Notice booklet; keep it for future reference.
3. If your application is incomplete, we will send you a letter requesting more information.
4. Once your payroll office cancels your employee coverage and we receive your complete information, we will enroll you in PEBB retiree coverage In most cases, your retiree coverage begins immediately after your current coverage ends.
5. After your enrollment begins, your health plan(s) will send you a welcome packet.

If you are a Washington State school district or educational service district retiree and meet PEBB eligibility and enrollment requirements, your coverage begins the first of the month after your school district or COBRA coverage ends.

You cannot enroll on two PEBB accounts

An enrolled family member may be enrolled in only one medical or dental plan. If you and your spouse or state-registered domestic partner are both independently eligible for PEBB coverage, you need to decide which of you will cover yourselves and any eligible children on your medical or dental plans. For example, you could defer PEBB retiree medical for yourself and enroll as a dependent on your spouse’s or state-registered domestic partner’s medical coverage.