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PEBB Program Rules and Policies

Program Policies
Proposed Policies
Policies Proposed To Be Rescinded
Rescinded Policies
Contact Information

Program Rules

The rules that the PEBB Program follows are recorded in Washington Administrative Code (WAC). Below are links to the detailed rules for circumstances most common to employees, retirees and dependents.

• Eligible and noneligible employees
• When are retiring employees eligible to enroll in retiree insurance?
• Who are eligible dependents?
• When must newly eligible employees select PEBB benefits and complete enrollment forms?
• When may subscribers enroll or remove eligible dependents?
• When may subscribers change plans?
• PEBB appeals rules

To find a specific WAC number look under chapters 182-08, 182-12, or 182-16.

Program Policies

The PEBB Program's administrative policies describe how we implement a law or rule affecting participation in PEBB benefits. The statements made in these documents reflect our interpretations of the eligibility and enrollment rules.

Number	Title	Effective Date
Employee eligibility and enrollment
11-1	Providing notifications to employees and employers	6/1/2010
15-1	Determining eligibility for seasonal employees and maintenance of employer contribution through the off-season	1/1/2011
17-1	Determining faculty eligibility for summer/short class sessions	1/1/2010
17-2	Determining faculty eligibility after a layoff	1/1/2010
17-3	Determining faculty eligibility for off-quarter/semester and for decreases in workload	1/1/2010
19-1	Termination Due To Loss of Eligibility Addendum 19-1A: Employee/Dependent Loses Eligibility Addendum 19-1B: Self-Pay Subscriber/Dependent Loses Eligibility	1/1/2013
Retiree eligibility and enrollment
21-1	Retiree Deferral Form Exemption	1/1/2013
26-1	Administering PEBB insurance in coordination with Medicare Part D	1/1/2013
Dependent eligibility and enrollment
31-1	Verifying Dependent Eligibility before Enrollment	1/1/2013
36-1	Certifying eligibility for dependent children with disabilities who are age 26 and older	1/1/2012
37-1	Certifying eligibility for extended dependents	1/1/2013
Open enrollment
41-1	Extension of PEBB open enrollment deadline for coverage effective in 2013 for individuals affected by Hurricane Sandy	12/19/2012
45-2	Special Open Enrollment (SOE) Addendum 45-2A: Special Open Enrollment (SOE) Matrix	1/1/2013

Proposed Policies

There are none at this time.

Policies Proposed To Be Rescinded

There are none at this time.

Rescinded Policies

Request rescinded policies through the PEBB Policy and Rules contact below.

Contact Information

Submit questions about PEBB policies by mail to:

PEBB Policy and Rules
P.O. Box 42684
Olympia, WA 98504-2684