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NEW RETIREE ENROLLMENT
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Are you a new retiree or planning to retire? This page describes the health benefits available to you through the Public Employees Benefits Board (PEBB) Program.

2013 Enrollment

How Can I Learn More About the Benefits and Enrollment Process?

Register to attend a retirement seminar from the Department of Retirement Services.
Read the Retirement Overview
Read the Retiree Enrollment Guide (3 MB)

Retiree enrollment forms (Need help with enrollment forms?)

What Are the Benefits?

Medical and Dental
Compare medical plan benefits
Review eligibility for consumer-directed health plans with health savings accounts
Review health savings account information
Compare dental plan benefits
Compare medical plan rates
Compare dental plan rates
Find a provider who participates with your medical or dental plan
Contact the plans or visit their websites

Life Insurance
Provided by ReliaStar Life Insurance Company

Summary (28.3 KB)
Booklet: Term Life Insurance Certificate (350 KB)
Group Life Portability Application (61.8 KB)

Auto and Home Insurance
Provided by Liberty Mutual Insurance Company
Summary (26.2 KB)

Long-term Care Insurance
Provided by John Hancock Life Insurance Company (U.S.A.)
Summary (28.2 KB)

When Are My Enrollment Forms Due?

You must enroll in or defer retiree health coverage no later than 60 days from the date your active employer or continuous COBRA coverage ends. To do this, complete the Retiree Coverage Election Form (Form A ), and mail or hand-deliver it to us no later than 60 days after your active employer or continuous COBRA coverage ends. If you don't, you may lose your right to enroll later unless you regain eligibility.

If you and/or your covered dependents are entitled to Medicare Part A and Part B, you must enroll in both Part A and Part B to qualify for retiree health coverage. You must send a copy of your and your covered dependent's Medicare card to PEBB as proof of enrollment.

Dependent Certifications

If enrolling family members, also complete the appropriate forms (if applicable):

Enrolling in a Medicare Advantage Plan?

You will need to fill out and send in Form A and the Medicare Advantage Enrollment (Form C) to PEBB.
(What is a Medicare Advantage plan?)

Enrolling in a Medicare Supplement Plan?

You will need to fill out and send in Form A and the Medicare Supplement Enrollment (Form B) to PEBB.
(What is a Medicare supplement health plan?)