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Information for K-12 School Districts and Educational Service Districts
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How to Contact Us

Need more information on PEBB benefits, or want to schedule a presentation for your employees? Contact PEBB's Outreach and Training Unit or call 1-800-700-1555.

Things to Know About Participating in the PEBB Program

Group Participation

  • PEBB participation is available to entities defined in WAC 182-12-111, including K-12 school districts and educational service districts. Specific agencies or instrumentalities of employer groups may participate apart from the larger employer group.
  • PEBB group coverage is available to your entire group, groups of bargaining unit employees, or all non-represented employees.
  • School districts and educational service districts must purchase the full package of medical, vision, dental, life/accidental death & dismemberment, and long-term disability.
  • The HCA will review the application and other materials for compliance with HCA terms and conditions of participation.
  • Once reviewed and approved for participation, a start-up fee will be assessed based on size. Failure to pay the start-up fee or return the signed Interlocal Agreement prior to the group's effective date of coverage may result in a delayed coverage date.

Application Requirements

For groups of 100 or more, the group must submit a letter of application at least 120 days before the requested effective date. For groups of fewer than 100 employees, the group must submit a letter of application 90 days before the requested effective date.

Send the application to:

Steve Norsen, Manager
PEBB Outreach and Training
Health Care Authority
P.O. Box 42684
Olympia, WA 98504-2684
Phone: 1-800-700-1555
Fax: 360-923-2608

Please include the following items:

  1. A letter of application
  2. A resolution from your governing body (see sample )
  3. Signed Government Function Attestation form that the employees and all departments or agencies of the applying group fulfill government functions.
  4. W-9 form with your group's Taxpayer Identification Number (TIN)
  5. An estimate of the number of employees and dependants to be enrolled.
  6. Which employee group(s) will be joining (e.g., all, bargaining unit(s) or all non-represented)

Failure to submit the necessary documentation prior to the effective date of coverage may result in a delayed coverage effective date.

Review Process

The HCA will review the application for compliance with HCA terms and conditions of participation. We will respond within 30 days and process your group's enrollment or request additional information. Please contact us if you have questions or have not heard from us as expected.

Group Start-up Fees

Group Size
(includes employees)		 Fee
Less than 100 potential enrollees $10 per person
100 - 500 potential enrollees $1,500
501 - 700 potential enrollees $2,000
701 - 1,000 potential enrollees $2,500
More than 1,001 potential enrollees $4,000

Operational Information

  • Rates - There are two components to this rate structure,
    1. The employer portion
      • Often times referred to as the base rate or composite rate is allocated by the Legislature and becomes effective September 1 of each year.
      • The employer portion is based on the Legislative allocation for State employees and may vary slightly from what is funded for School District employees.
      • K-12 School Districts and ESDs will see a rate change for the employer portion of the rate structure effective September 1 of each year. Notification of the rate change is sent via email to School Districts and ESDs in the spring, before the September 1 effective date.
    2. The employee portion
      • Based on the employee's selection of health plan and family size.
      • The employee portion of the rate structure is set for a plan year - January 1 through December 31.
      • Notification of the rate change is sent via email to School Districts and ESDs in the fall, prior to the January 1 effective date.
  • Monthly Billing – An invoice will be sent around the 25th of the month prior to the month of coverage. Payment in full is required by the 20th of the month of coverage. For example, around May 25th an invoice will be sent for June coverage. Payment in full for June coverage is due by June 20th.
  • Account Maintenance – Groups will be expected to maintain their own accounts. You will need to identify who within your agency will be responsible for "keying" account information into the PEBB Insurance System. The PEBB Outreach and Training staff will help facilitate this process and will provide your staff with the appropriate training.

Terminating Participation

  • The interlocal agreement outlines the process for termination of participation in the PEBB Program.
    • Termination of PEBB coverage includes all employees, and individuals on COBRA. Leave Without Pay or Extension of Coverage
  • The group must submit written notification of their intent to terminate at least 60 days before the end of the plan year (December 31).
  • The Outreach and Training Manager will acknowledge the acceptance of the group's termination in writing.
  • The PEBB Program will notify each employee of the termination.
  • PEBB staff will terminate all employee accounts in the PEBB insurance system.
  • HCA will send a Certificate of Creditable Coverage to each enrolled member after the termination.