Kaiser Permanente WA Classic, Kaiser Permanente WA Value, and the Kaiser Permanente WA Consumer Directed Health Plan (CDHP) with a Health Savings Account (HSA) are available to residents in all counties we serve. Visa or passport with date of entry; proof of former and current residence (e.g. What's changing with your PEBB health coverage in 2021. Transportation Account: Use this pretax account to pay for qualified expenses for commuting by bus, ferry, rail, monorail, streetcar, train, subway or vanpool, when the expenses are not deducted by your employer from your pay pre-tax. Log into My Account to view your coverage and premium surcharge information, get your statement of insurance, and make open enrollment changes. Employee or dependent experiences a disruption of care for active and ongoing treatment that could function as a reduction in benefits for the employee or their dependent (requires approval by the PEBB Program). Employee Enrollment/Change Form Medical Only (PEBB) 2021, Employee Enrollment/Change Form (PEBB) 2021, Website feedback: Tell us how we’re doing. UMP plans. Compare medical plans. Help Using PEBB’s My Account We want to help you use My Account. Retirement is an exciting time, but it can also be a challenge. Changes to medical and dental plans, removal of a dependent, and spouse or state registered domestic partner may be made through PEBB My Account until 11:59 pm on Monday, November 30, 2020. (Why do I need a SAW account? Help with register. Enrolling in PEBB benefits. PEBB … However, members can use funds in their health savings account (HSA) to pay for many out-of-pocket costs (including deductibles), or allow HSA savings to grow for future medical expenses. Skip Mega Menu My Accounts My Group Benefits. Employee has a change in employment status that affects their eligibility for their employer contribution toward their employer-based group health plan. We recommend using your personal email address to access your account. Existing dependents may not be added. Questions about PEBB or SEBB retiree benefits? To log in. All valid documents for proof of this event must show the name of the parent who is the subscriber, subscriber’s spouse, or the subscriber’s state-registered domestic partner. Cancellation letter from the health plan; coverage confirmation in a new health plan; Medicare entitlement letter; copy of current tax return claiming you as a dependent, Submit request for a plan change to: Help with PEBB My Account login. PEBB medical. Adding a dependent that is not already listed on the account requires a paper form. You pay less for in-network services, more for out-of-network services. Learn the requirements to make changes to your PEBB coverage. Employee or dependent enrolls in or loses eligibility for Medicare. Notice of privacy practices. Set up and manage direct deposit of your benefit payments from your online retirement account. PEBB Program Use the PEBB Premium Surcharge Attestation Change form or log into PEBB My Account. Online changes: PEBB My Account portal. View your life and long-term disability insurance information. As a PEBB member, you have support to help you achieve your health goals. If you and your spouse or state-registered domestic partner are both eligible subscribers, you need to choose which of you will cover yourselves and your eligible children (including adult children who are also eligible for PEBB coverage as an employee). For more details about the changes you can make during these events, see PEBB Program Administrative Policy Addendum 45-2A and refer to the following Washington Administrative Code (WAC) sections: Copyright © 2020 Washington Health Care Authority, Long-term services and supports (LTSS) and hospice, Autism & Applied Behavioral Analysis (ABA) therapy, Medically Intensive Children's Program (MICP), American Indians and Alaska Natives (AI/AN), Apple Health coverage without managed care, Update my income or address (report a change), Pregnant mother finds comfort during uncertain times, Apple Health client inspired to help others access health coverage, Apple Health supported client while searching for job, Telehealth helps a mother connect with her child during pandemic, Foster parent helps kids get overdue medical care through Apple Health, After accident, hiker gets the care she needs through Apple Health, Apple Health worker helps ease financial worries of new mother, Facing high diabetes treatment costs, Apple Health (Medicaid) saves the day, Access to housing, employment, and health care gives Yakima resident a second chance, Cancer patient lives a quality life thanks to Apple Health, New mother and baby have healthy start thanks to Apple Health, Apple Health covers medically necessary surgery when other insurance wouldn’t, Apple Health leads the way to a better life for autism spectrum disorder (ASD) client, Apple Health for Kids provides relief for new parents, Access to health care allows student to pursue education stress-free, Children’s Health Insurance Program (CHIP) keeps health care affordable for families, Helping Apple Health (Medicaid) clients when they need it most, Apple Health gives life to those with chronic disease, Mother and daughter have a better life because of Apple Health, Apple Health provides otherwise unaffordable, life-saving medication for HIV patient, Apple Health outreach staff help spread the word about free and low-cost health insurance, Apple Health and community partners help improve the health of the Latino population in Washington, Apple Health brings stability to lives of young couple, I can’t begin to explain how much Apple Health has helped me, I wouldn’t be able to afford health insurance otherwise, Apple Health gives me a sense of security, Helping people navigate their way to Washington Apple Health, Apple Health has given her such peace of mind, Contact Washington Apple Health (Medicaid), Child and youth behavioral health services, Wraparound with Intensive Services (WISe), Substance use disorder prevention and mental health promotion, Painful life lessons become strengths for crisis counselor, Integrated approach delivers all care “right here, right now”, General eligibility requirements that apply to all Apple Health programs, Modified Adjusted Gross Income (MAGI) based programs manual, Long-term services and supports (LTSS) manual, Uniform Medical Plan (UMP) administered by Regence BlueShield and WSRxS, Health plans with health savings accounts (HSAs), Medical Flexible Spending Arrangement (FSA), Not participating in a Washington State-sponsored retirement plan, Health plans with health savings accounts (HSAs) (non-Medicare), Long-term disability insurance (unpaid leave only), PEBB Continuation Coverage premiums (non-Medicare), PEBB Continuation Coverage premiums (Medicare), Life insurance premiums (unpaid leave only), Long-term disability insurance premiums (unpaid leave only), SEBB Continuation Coverage spousal plan questionnaire 2020, Public Employees Benefits Board (PEBB) Program, Archived agendas, minutes, & presentations, School Employees Benefits Board (SEBB) Program. The Navia Benefits Card is a debit MasterCard® that allows you to access your FSA funds directly. If you use PEBB My Account, you will be directed to these forms. Certificate of credible coverage; letter of enrollment or termination of coverage from the health plan; letter of enrollment or termination of coverage from the employer’s payroll or benefits office; proof of waiver, Enrollment or termination letter from Medicaid or CHIP reflecting the date the subscriber or subscriber’s dependent enrolled in Medicaid or CHIP or the date at which the subscriber or subscriber’s dependent lost eligibility for Medicaid or CHIP. << < > << Last 4 digits of subscriber SSN: Verify My Information. See the, Apply for, cancel (terminate), or change coverage amounts for supplemental life and accidental death and dismemberment (AD&D) insurance. If there is any conflict between information posted on the site and the FSA Enrollment Guide or DCAP Enrollment Guide, the Enrollment Guide prevails. PEBB/My Account login. select My Account under My PEBB in the left navigation panel. 2021 plan information. Sensitive data will be used to verify account ownership. Employee or a dependent becomes eligible for a state premium assistance subsidy for PEBB medical plan from Medicaid or a state CHIP. Visit HCA’s website at hca.wa.gov/pebb-retirees or call PEBB Customer Service at 1-800-200-1004 (TRS: 711). PEBB does not designate premium contributions, contact your agency benefit office if you have additional questions about your premium contribution. What can I do in PEBB My Account? FSA […] These changes may be allowed as a special open enrollment: Marriage certificate; certificate of state-registered domestic partnership or legal union. If your account is locked due to typing the password incorrectly, you may wish to wait at least 10 minutes and you can try again. Use the appropriate, Remove dependent(s) from coverage due to loss of eligibility due to divorce, annulment, dissolution, or a qualifying event of a dependent ceasing to be eligible as a dependent child (required). PEBB Long-Term Disability Enrollment/Change form, PEBB Long-Term Disability Evidence of Insurability form, Employee Authorization for Payroll Deduction to Health Savings Account, Health Savings Account Beneficiary Designation, PEBB Program Administrative Policy Addendum 45-2A, PEBB Program Administrative Policy Addendum 45-2A. See PEBB's Summary Plan Description for details about eligibility and enrollment in the FSA program. Waive enrollment in PEBB medical if you have or are enrolling in other employer-based group medical insurance, a TRICARE plan, or Medicare effective January 1. There is something for everyone! • Check your Statement of Insurance (page 3). Parking Account (Maximum monthly contribution or reimbursement is $270.00) Monthly contribution (minimum $20) $ 1a. Employee or dependent becomes eligible and enrolls in a TRICARE plan, or loses eligibility for a TRICARE plan. Get your PEBB Program eligibility and enrollment questions answered. Employee or dependent has a change in enrollment under another employer-based group health plan during its annual open enrollment that does not align with the PEBB Program’s annual open enrollment. PEBB contracts with ASIFlex to administer Commuter Accounts to ensure they align with federal tax code. Sensitive data will be used to verify account ownership. Pebb Enterprises Accounts Payable, Contact Information, and Licenses On this page you can find Pebb Enterprises Accounts Payable information to get paid and other important information. Use the, Change your HSA beneficiary information. Instead of paying out-of-pocket and waiting for a reimbursement, whenever you use the card, you pay for your purchase using the funds in your benefit! Waiving medical coverage. endstream endobj startxref Connect with us Contact HCA. PEBB contracts with ASIFlex to administer the FSA program under PEBB administrative rules and in keeping with IRS code. However, you must enroll in dental, basic life insurance, basic AD&D insurance, and basic LTD insurance under your own account (if applicable). • Check your account and coverage information (page 3). You … h�b```a``Nb`e`TNcd@ A�+s�``�q����{'�W4��n\�Q��z��|J40pt40tt�� PO Box 42684 WAC 182-12-262: When may subscribers enroll or remove eligible dependents? The Navia Benefits Card. All changes are effective January 1, 2019. Employee or dependent loses eligibility for other coverage under a group health plan or through health insurance, as defined by the Health Insurance Portability and Accountability Act (HIPAA). PEBB contracts with ASIFlex to administer the FSA program under PEBB administrative rules and in keeping with IRS code. You will be able to make most changes to your PEBB benefits on the Health Care Authority (HCA) PEBB My Account page. Oregon's Public Employees' Benefit Board contracts for and administers benefits for eligible state employees. If enrolling after waiving PEBB medical, only allowed if lost eligibility for Medicare. WAC 182-08-199: When may an employee enroll in or revoke an election and make a new election under the premium payment plan, Medical Flexible Spending Arrangement (FSA) or Dependent Care Assistance Program (DCAP)? These are individual tax-favored accounts; PEBB does not provide tax advice. Health coaches, online and self-guided programs, webinars, and more! Enroll in a medical plan, if you previously waived PEBB medical. We provide high quality health plans and other … Behavioral health services by plan. Phone: 071 084 8294 Proof of former and current residence (e.g. To sign up, go to PEBB My Account at hca.wa.gov/my-account. Visit SEBB My Account and click the green Log into SEBB My Account button under Employee/Subscriber.. You will be directed to SecureAccess Washington (SAW) to create an account. 192 0 obj <> endobj Join Facebook to connect with My Pebb and others you may know. Please seek tax advice from a qualified tax advisor. Help with register. As a PEBB member, you have support to help you achieve your health goals. Navia Benefit Solutions pebb.naviabenefits.com 1-800-669-3539 SmartHealth Limeade smarthealth.hca.wa.gov 1-855-750-8866 The PEBB Program is saving the green Help reduce our reliance on paper mailings — and their toll on the environment — by signing up to receive PEBB mailings by email. Wellness Central; my journey, my health. PEBB Statewide Plan members. If you are a new user select Register Here. What changes can I make during a special open enrollment? When you enroll in a CDHP, your employer or the PEBB Program contributes money into your HSA on a prorated basis. Wellness Central; my journey, my health. Subscriber registration - Step 3 of 3. Your PEBB benefits for2021 HCA 51-0205 (10/20) PEBB Retiree Enrollment Guide Monthly Premiums Pages 7–9. Using PEBB My Account, you can: View your medical and dental coverage information. You can make some changes during the year without a special open enrollment event. Plan change requirements. You may be enrolled in only one PEBB medical or dental plan. Olympia, WA 98504-5502. If adding the child increases your premium, your employer must receive this form no later than 60 days after the date of birth, adoption, or date the legal obligation is assumed for support in anticipation of adoption. c New election c Change my monthly parking contribution c Cancel election 1. Employee or dependent has a change in residence that affects health plan availability. %%EOF Change your or a dependent's tobacco use premium surcharge attestation. Commuting means traveling between your home and your place of work on a regular basis. We call these special open enrollment events. Benefits and coverage by plan. Benefits Comparisons Pages 34–47. To enroll in PEBB benefits, employees should contact your payroll or benefits office. Child becomes eligible as an extended dependent through legal custody or legal guardianship. Please print or save your confirmation page when you’ve completed your changes. Check back in two business days to verify the coverage you selected and your spousal or state-registered domestic partner coverage premium surcharge attestation is correct. Type the code from the image: Submit. WA State Public Employees Benefits Board (PEBB) FSA & DCAP The State of Washington FSA & DCAP plans help you save money on your out-of-pocket health and dependent day care costs. endstream endobj 193 0 obj <. Birth certificate (or hospital certificate with child’s footprints); certificate or decree of adoption; placement letter from adoption agency. Use the PEBB Premium Surcharge Attestation Change form or log into PEBB My Account. %PDF-1.6 %���� How to determine eligibility. Certificate of creditable coverage; letter of termination of coverage from health plan or payroll or benefits office; or COBRA election notice. The Public Employees Benefits Board (PEBB) Program's For Your Benefit newsletter is your source for information and updates about your health benefits. School employees. View your premium surcharge attestations. Kaiser Permanente WA offers coverage for both Medicare-eligible retirees as well as those retiring before they are Medicare-eligible. The last thing you want to worry about is health care. Reattest to the spouse or state-registered domestic partner coverage premium surcharge. Note: University of Washington employees must make changes through Workday. Optional Benefits, FSAs, and Commuter Accounts. Otherwise, you can change your password here. Eligibility Find the right program for you. 221 0 obj <>/Filter/FlateDecode/ID[<8B3B76BEA9CBFE41BE04C5D85DFAECAC><58BE067C9D3E1C4884397EE92039F3C4>]/Index[192 66]/Info 191 0 R/Length 136/Prev 583550/Root 193 0 R/Size 258/Type/XRef/W[1 3 1]>>stream (If you prefer to fill out and mail in a printed form, select this link.) Employee's or dependent’s current health plan becomes unavailable because the employee or dependent is no longer eligible for a health savings account (HSA). What changes can I make during open enrollment? PEBB Statewide Plan members. Choose optional benefits you are currently enrolled in or will enroll in 2021. Some information described in this guide is based on federal or state laws. This guide walks you through these situations: • How to create an account (pages 1-2). We need to verify you first to ensure we have your PEBB member data. Employee hire letter from their employer that contains information about benefits eligibility; employment contract; termination letter; letter of resignation; statement of insurance; certificate of coverage. You … From November 1 – 30, 2018, you can make changes to your PEBB account that will be effective January 1, 2019.You can make your changes online in My Account. How do I make changes during the PEBB Program annual open enrollment? PEBB Statewide is a PPO plan. Note: "Employer contribution" means contributions made by the dependent's current or former employer toward health coverage as described in Treasury Regulation 54.9801-6. Your personnel, payroll, or benefits office must receive the appropriate PEBB Employee Enrollment/Change form no later than 60 days after the event that created the special open enrollment along with proof of the event that created the special open enrollment (See PEBB Program Administrative Policy Addendum 45-2A for a list of valid documents). Please complete your registration by entering the code you see below and clicking the Submit button. You can only change medical or dental plans during the PEBB Program's annual open enrollment (November 1 through 30) or if a special open enrollment event occurs. ), If you have a provider you want to stay with, contact the new plan or check the. A court order requires the employee or any other individual to provide a health plan for an eligible child of the employee. 3Waiving for this event is allowed only if the employee enrolls in medical under the new spouse or state-registered domestic partner's employer-based group health plan. Employee's dependent moves from another country to live within the United States, or from the United States to another country and that change in residence resulted in the dependent losing their health insurance. Birth, adoption, or assuming a legal obligation for support in anticipation of adoption. Employee or dependent enrolls in or loses eligibility for Apple Health (Medicaid) or a state Children’s Health Insurance Program (CHIP). Please confirm the email address you use to login, as well as the last 4 digits of the Subscriber SSN. Certain events let you make account changes (like changing a health plan or enrolling a dependent) outside of annual open enrollment. How to enroll. Get assistance with your PEBB account. University of Washington employees must make changes through Workday. If you do not enroll in PEBB retiree insurance Just follow the “Direct Deposit” directions under “My Account” in the navigation menu. How and When Can I change my Commuter Account? When you submit an online plan change, please wait two business days to make any additional online plan changes. @Z����B ����mg9V���"T�5@� ʸ8# Employee's dependent has a change in their own employment status that affects their eligibility for the employer contribution under their employer-based group health plan. Get Audio Code. Public Employees (PEBB) School Employees (SEBB) Phone: 360.725.0440 or 800.200.1004 You can access multiple government services … 2021 Open Enrollment: November 1 - 30. utility bill); letter or document showing coverage was lost (e.g. Unit 9 & 10 Lot, 251 Izingolweni Rd, Port Edward, 4295. 5. Connect with us Contact HCA. The PEBB Parking account is not used to pay for monthly state lot parking.) Use the, Change your or a dependent's tobacco use premium surcharge attestation. Get your statement of insurance. Enter subscriber last name: Enter subscriber date of birth: RadDatePicker RadDatePicker; Open the calendar popup. ) $ 1a I change My pebb my account Account 9 & 10 Lot 251... Certificate ( or hospital certificate with child ’ s secure single sign-on portal external! Their employer-based group health plan availability pages 1-2 ) eligible state employees if have... 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