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How to Make Changes to Your Coverage

Making changes in coverage outside of open enrollment?

PEBB rules recognize certain events that allow you to make changes to your PEBB enrollment or benefits outside of annual open enrollment.

Employees: Refer to pages 12-15 of the Employee Enrollment Guide and the Employee Enrollment/Change Form (if you have medical and dental coverage) or the Employee Enrollment/Change Form for Medical Only Groups (if you have medical coverage only).

Retirees: Refer to pages 17-21 of the Retiree Enrollment Guide and the Retiree Coverage Election Form .

For more details, you may also refer to the Washington Administrative Code (WAC) for rules that explain when a subscriber may make changes.

• WAC 182-08-198: When may a subscriber change health plans?
• WAC 182-08-199: When may an employee enroll in or change his or her election under the premium payment plan, medical flexible spending arrangement (FSA) or dependent care assistance program (DCAP)?
• WAC 182-12-128: May an employee waive health plan enrollment?
• WAC 182-12-205: May a retiree defer enrollment in a PEBB health plan at or after retirement?
• WAC 182-12-262: When may subscribers enroll or remove eligible dependents?

Other changes you can make throughout the year

• Apply to enroll in or increase supplemental life insurance: Complete the Life and AD&D Insurance Enrollment/Change Form and Life Insurance Evidence of Insurability Form
• Change/update your life insurance beneficiary information: Complete the Life and AD&D Insurance Enrollment/Change Form
• Apply for optional long-term disability insurance, or change the benefit waiting period: Complete the Long Term Disability Enrollment/Change Form and Long Term Disability Evidence of Insurability Form
• Apply for auto and home insurance
• Apply for long-term care insurance

Coverage effective dates vary.

Things to remember

• All eligible family members must enroll in the same medical and/or dental plan. However, each family member may have a different doctor or other health care provider.
• If you have a specific doctor you want to stay with, you must contact your chosen medical plan to verify that he or she will continue to have a contract with that plan to serve PEBB members.
• Even if your doctor, dentist, or health care facility no longer contracts with your plan, you may not change plans until the next open enrollment period or if you have a corresponding special open enrollment event.
• PEBB does not allow dual coverage. If you and your spouse or state-registered domestic partner are eligible employees or retirees, you need to decide which of you will cover any eligible children on your medical and/or dental plan. An enrolled family member may be listed on one account, but not both. This means you could waive the medical coverage on your account and enroll on your spouse's or domestic partner's account.

What information should I read before making a change?

• Review the medical plan benefit comparisons.
• Review the rates. (School district and employer group employees need to contact their personnel, payroll, or benefits office to find their monthly premiums.)
• Find how the different types of dental plans work and where the dental plans are offered.
• Review the dental benefits comparison.
• If you still have questions, contact the plans.

When can I make Flexible Spending Account (FSA) and Dependent Care Assistance Program changes?

To find out what qualifying events will allow you to enroll in or change your annual contribution for the state's flexible spending account or Dependent Care Assistance Program (DCAP), see the appropriate enrollment guide on the ASIFlex website.