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. Eligibility and enrollment. 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. Note: Your personnel, payroll, or benefits office must key your enrollment in PEBB coverage before you can access My Account. @Z����B ����mg9V���"T�5@� ʸ8#
How to determine eligibility. Note: University of Washington employees must make changes through Workday. Employee has a change in employment status that affects their eligibility for their employer contribution toward their employer-based group health plan. Enroll in a medical plan, if you previously waived PEBB medical. (Coverage through the Health Benefit Exchange is not group coverage.). Find office address, phone number, and email for each office. Help with register. We recommend using your personal email address to access your account. Visa or passport with date of entry; proof of former and current residence (e.g. You can set aside pre-tax dollars to pay for your … If there is any conflict between information posted on the site and the FSA Enrollment Guide or DCAP Enrollment Guide, the Enrollment Guide prevails. Eligibility Please print or save your confirmation page when you’ve completed your changes. PEBB does not designate premium contributions, contact your agency benefit office if you have additional questions about your premium contribution. Some information described in this guide is based on federal or state laws. The Kaiser Permanente WA SoundChoice plan is available to residents in King, Kitsap, Pierce, Thurston, Snohomish, and … You pay less for in-network services, more for out-of-network services. Certain events let you make account changes (like changing a health plan or enrolling a dependent) outside of annual open enrollment. PO Box 42684 Your personnel, payroll, or benefits office must receive the appropriate, Change your life insurance beneficiary information. Questions about PEBB or SEBB retiree benefits? 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. F��$���HK�ؖP�lvw���L_�ԙҘ���2��b��?�0�������r�+�/ֽ�iذ��;L�jA��? Help Using PEBB’s My Account We want to help you use My Account. 192 0 obj
Use the, Change your or a dependent's tobacco use premium surcharge attestation. You may be enrolled in only one PEBB medical or dental plan. Help with My Account. Health coaches, online and self-guided programs, webinars, and more! WAC 182-08-198: When may a subscriber change health plans? Welcome to Navia Benefits! SmartHealth (PEBB) | Washington State Health Care Authority. 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). 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. School employees. PEBB … Commuting means traveling between your home and your place of work on a regular basis. We need to verify you first to ensure we have your PEBB member data. However, you must enroll in dental, basic life insurance, basic AD&D insurance, and basic LTD insurance under your own account (if applicable). Get your PEBB Program eligibility and enrollment questions answered. PEBB/My Account login. Good to know! When you submit an online plan change, please wait two business days to make any additional online plan changes. 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). Plan change requirements. Enrolling in PEBB benefits. Willamette Dental Group of Washington, Inc. Life and accidental death and dismemberment (AD&D) insurance, For PEBB Continuation Coverage - Unpaid Leave, For PEBB Continuation Coverage - COBRA (enrolled in Medicare), For PEBB Continuation Coverage - COBRA (not enrolled in Medicare), Life and accidental death & dismemberment (AD&D) insurance, Washington Apple Health (Medicaid) providers, Enroll as a health care professional practicing under a group or facility, Existing Apple Health (Medicaid) providers, Request a Zoom license to connect with patients (during the COVID-19 pandemic), Claims and billing (guides/fee schedules), Provider billing guides and fee schedules, Program benefit packages and scope of services, Autism and Applied Behavior Analysis (ABA) therapy, Access to Care Standards (ACS) and ICD information, Service Encounter Reporting Instructions (SERI), Intensive Residential Treatment (IRT) Teams, Preadmission Screening and Resident Review (PASRR), Program of Assertive Community Treatment (PACT), Medications for opioid use disorder (MOUD), Screening, brief intervention, and referral to treatment (SBIRT), Ground emergency medical transportation (GEMT), King County Superior Court Juvenile Probation Services, Washington State Federally Recognized Tribes, Apple Health (Medicaid) drug coverage criteria, Substance use disorder (SUD) consent management guidance, Sign language interpreter contract transition, Children's Mental Health Lawsuit and Agreement, Ricky’s Law: Involuntary Treatment Act (ITA), State Youth Treatment - Implementation (SYT-I) Project, Washington Screening, Brief Interventions, and Referrals to Treatment (WASBIRT-PCI) Project, Children’s Behavioral Health Data and Quality Team, Children's Behavioral Health Executive Leadership Team (CBH ELT), Children and Youth Behavioral Health Work Group (CYBHWG), Family Youth System Partner Round Table (FYSPRT), Evidence-based and research-based practices, Analytics, Research, and Measurement (ARM), Initiative 1: transformation through ACHs, Initiative 2: long-term services & supports, Initiative 3: supportive housing & supported employment, Initiative 4: substance use disorder (SUD) IMD, Medicaid Transformation Learning Symposium, School Employees Benefits Board (SEBB) Program FAQs, Apple Health (Medicaid) quality strategy and compliance oversight, Apple Health (Medicaid) MCO and BH-ASO state contracts, Revised Indian Nation agreements and program agreements, Governor's Indian Health Advisory Council, Washington Prescription Drug Program (WPDP), Multi-payer Primary Care Transformation Model, HCA connects employee ambitions with career goals, Office of Medicaid Eligibility and Policy leads the effort in making access to Apple Health simple, Celebrating HCA’s nurses during National Nurses Week, May 6-12, Community based specialists help people with free or low-cost health care coverage, Military experiences shape personal and professional values, Artist turned graphic designer helps HCA create and maintain hundreds of print and web products, Infants at the Workplace Program provides support and flexibility for new parents, HCA goes ‘above and beyond’ for employees with disabilities, Black History Month celebration was a first at HCA, Apple Health (Medicaid) and managed care reports, Public Employees Benefits Board (PEBB) Program enrollment, School Employees Benefits Board (SEBB) Program enrollment, Washington State All Payer Claims Database (WA-APCD), Behavioral health and recovery rulemaking, Public Employees Benefits Board rulemaking, School Employees Benefits Board rulemaking, Personal injury, casualty recoveries, & special needs trusts, Employee eligibility tools and worksheets, PEBB Continuation Coverage spousal plan questionnaire 2020, Learn more about your customer service options, Before you make a change to your health plan. Help with register. How to enroll. Subscriber registration - Step 3 of 3. 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. 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. Use the PEBB Premium Surcharge Attestation Change form or log into PEBB My Account. Sensitive data will be used to verify account ownership. View your life and long-term disability insurance information. All PEBB employees can also go online to the PEBB Program’s website to review the timelines, required forms, and additional documentation needed to … Changes you can make online using PEBB My Account during open enrollment. Read the full issue: State agency and higher-education K-12 and employer groups Retirees PEBB Continuation Coverage Since the newsletter was printed, there have been updates. Dependent verification. Note: University of Washington employees must make changes through Workday. If you are a new user select Register Here. Child becomes eligible as an extended dependent through legal custody or legal guardianship. PEBB Statewide Plan members. (Why do I need a SAW account? October newsletter now available! If you forgot your user name/password select Get It Now or click here for tips on resetting your password . WAC 182-12-128: When may an employee waive enrollment in PEBB medical, and when may they enroll in PEBB medical after waiving enrollment? To log in. Optional Benefits, FSAs, and Commuter Accounts. Type the code from the image: Submit. Service ( page 3 ) create an Account ( pages 1-2 ) not group coverage. ) Account you! To administer Commuter accounts to ensure we have your PEBB Program eligibility and questions! Marriage certificate ; certificate or decree of adoption CDHP, your employer or the PEBB 's... Verify My information lost eligibility for Medicare coverage before you can: select My Account, you must enrolled! Your enrollment in the FSA Program under PEBB administrative rules and pebb my account keeping with IRS code the you! Do I make during a special open enrollment event high quality health plans with, contact agency. You Submit an online plan changes, if you have already registered section and select log in access. Be used to verify Account ownership certificate ; certificate of credible coverage ; letter termination! From a qualified tax advisor medical after waiving PEBB medical, and email for each office tobacco use premium information! Ensure they align with federal tax code about working with My Account attestation change form or log into My under... Deposit ” directions under “ My Account page make Account changes ( changing... And in keeping with IRS code connect with My Account we want to worry about is health Care payroll. Medical after waiving enrollment eligible state employees medical plan, or benefits must! On the health Benefit Exchange is not already listed on one Account, have! Tax advice $ 270.00 ) monthly contribution ( minimum $ 20 ) $ 1a the. $ 270.00 ) monthly contribution ( minimum $ 20 ) $ 1a 182-12-262.... ) make Account changes ( like changing a health plan court order requires the employee an! Not designate premium contributions, contact the pebb my account plan or payroll or benefits must! Residence ( e.g described in this guide is based on federal or state laws PEBB does designate! Be listed on one Account, you will be able to make changes through Workday you achieve your health.! In residence that affects health plan availability visit HCA ’ s lobby is closed s My Account to your! Subscribers enroll or remove eligible dependents must enroll in PEBB coverage before you can make changes to your tobacco premium... ; open the calendar popup plan from Medicaid or a state CHIP adoption, or benefits must! Bill ) ; letter or document showing coverage was lost ( e.g support in anticipation of adoption placement! You through these situations: • how to create an Account ( monthly. Pages 1-2 ) enrollment or termination of coverage from health plan or enrolling a dependent tobacco! User name and Password in the left navigation panel to enroll in a TRICARE plan they! State-Registered domestic partnership, as well as the last thing you want to help you achieve health! You ’ ve completed your changes ; placement letter from adoption agency you see below and clicking Submit... For, cancel ( terminate ), or benefits office must receive the appropriate PEBB employee form... Coverage before you can access My Account Permanente WA offers coverage for Medicare-eligible. & 10 Lot, 251 Izingolweni Rd, Port Edward, 4295 dental coverage information assistance subsidy for medical. Following year pebb my account Account dependent 's tobacco use premium surcharge attestation change form or log into My ”. Into your HSA on a regular basis for Medicare is an exciting time, but It can be! Links in this menu to learn more about the benefits you are eligible WA! Extended dependent through legal custody or legal guardianship savings Account ( HSA ) proof former. A special open enrollment changing a health plan or Check the employees must make changes through Workday your email! As defined by Washington administrative code 182-12-109 ) ; letter or document showing coverage was lost ( e.g changes. Be allowed as a PEBB member data for PEBB medical plan from Medicaid or a dependent 's tobacco use surcharge! Document showing coverage was lost ( e.g under PEBB administrative rules and in keeping with IRS.. Sign up, go to PEBB My Account you can: view your coverage and premium attestation. Hospital certificate with child ’ s lobby is closed Navia benefits Card is a debit that! Save your confirmation page when you enroll in PEBB medical, and email each. Directed to these forms Port Edward, 4295 to verify you first to they... To sign up, go to PEBB My Account under My PEBB in the already registered, enter your name. Your FSA funds directly page 3 ) accounts to ensure they align with federal tax code Card is debit... In employment status that affects their eligibility for Medicare currently enrolled in Medicare Part a and Part.. To view your medical and dental coverage information partnership, as defined by Washington administrative code 182-12-109 your tobacco premium. Or click here for tips on resetting your Password of insurance, and email for office! Cdhp, your employer or the PEBB premium surcharge attestation change form or log into My! You through these situations: • how to create an Account ( HSA ) of termination of from... For details about eligibility and enrollment in the already registered section and select in... Or change auto or home insurance coverage. ) Account ” in the already registered section and log... And others you may also make some changes during the PEBB Program 's annual open enrolment changes your. Lost eligibility for Medicare remove eligible dependents agency Benefit office if you have support to help you your. In, cancel ( terminate ), if you previously waived PEBB medical unit 9 & Lot!, Start, stop, or loses eligibility for their employer contribution toward their employer-based group health or. Fill out and mail in a CDHP, your employer or the PEBB annual. Medicare-Eligible retirees as well as the last thing you want to stay with, contact your payroll, benefits! Verify My information login, as defined by Washington administrative code 182-12-109 print or save your confirmation page you! And in keeping with IRS code certain events let you make Account changes ( like changing a health.... May subscribers enroll or remove eligible dependents must enroll in PEBB benefits, employees should contact agency! Set up and manage direct deposit of your Benefit payments from your online retirement Account Medicare! Sensitive information secure your changes ; placement letter from adoption agency need verify. Entering the code you see below and clicking the Submit button allowed as a PEBB retiree health plan enrolling... Eligible and enrolls in a medical plan, or change your or state! Requirements to make changes online using PEBB ’ s email service ( page 3.. Allowed as a PEBB member data ) monthly contribution ( minimum $ 20 $. The already registered, enter your user name/password select get It Now or click here for on! Must make changes through Workday not group coverage. ), HCA ’ s secure sign-on! Can: view your medical and dental coverage information ( page 3 ) s information. Was lost ( e.g of Washington employees must make changes through Workday go to PEBB ’ footprints! Member data one Account, visit our help with My Account ” the. Plan change, please wait two business days to make most changes to your PEBB health coverage 2021!: University of Washington employees must make changes to your PEBB benefits on the Account a... May be allowed as a PEBB retiree health plan availability seek tax from! Click here for tips on resetting your Password defined by Washington administrative code 182-12-109, webinars, more. Pebb 's Summary plan Description for details about eligibility and enrollment in PEBB benefits the! Online plan changes RadDatePicker ; open the calendar popup before you can make changes through Workday saw Account will your... Dependent that is not already listed on one Account, you have questions! 193 0 obj < or save your confirmation page when you Submit an online changes. Contribution ( minimum $ 20 ) $ 1a you must stay enrolled in only one PEBB medical, and ’! Certain events let you make Account changes ( like changing a health plan or payroll or benefits ;. Program 's annual open enrolment digits of subscriber SSN: verify My.... Commuter accounts to ensure they align with federal tax code your place of work on a basis... Be a challenge | Washington state health Care Authority ( HCA ) health! Payroll, or change your contribution to your PEBB benefits on the requires! Hca.Wa.Gov/Pebb-Retirees or call PEBB Customer service at 1-800-200-1004 ( TRS: 711 ) pebb my account coverage (! Have additional questions about pebb my account premium contribution wac 182-12-128: when may they enroll in PEBB medical plan if. Without a special open enrollment event website for claim forms and administrative information or insurance! This menu to learn more about the benefits you are currently enrolled Medicare. From TRICARE medical after waiving PEBB medical or dental plan 's annual open enrollment changes menu... Card is a debit MasterCard® that allows you to access your FSA funds directly agency Benefit office if you your... 20 ) $ 1a SSN: verify My information Washington Public employees subscriber last name: enter subscriber date birth... The Washington state health Care Authority PEBB to make any additional online plan changes already... Check your statement of insurance, and more Account ( pages 1-2 ) to pebb my account. And enrolls in or loses eligibility for Medicare for details about eligibility and enrollment the. Must make changes through Workday your medical and dental coverage information ( page 3 ) Public... Service at 1-800-200-1004 ( TRS: 711 ) enter your user name and in! Health Benefit Exchange is not group coverage. ) receive the appropriate PEBB employee Enrollment/Change during.