pebb my account

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). PEBB Retirees. Visa or passport with date of entry; proof of former and current residence (e.g. All valid documents for proof of this event must show the name of the parent who is the subscriber, subscriber’s spouse, or the subscriber’s state-registered domestic partner. Optional Benefits, FSAs, and Commuter Accounts. Certain events let you make account changes (like changing a health plan or enrolling a dependent) outside of annual open enrollment. It allows access to care from a national network of primary care providers, specialists and pharmacies of your choice, including OHSU, without a referral. • Check your account and coverage information (page 3). Olympia, WA 98504-5502. It allows access to care from a national network of primary care providers, specialists and pharmacies of your choice, including OHSU, without a referral. Please seek tax advice from a qualified tax advisor. There is something for everyone! Type the code from the image: Submit. View your premium surcharge attestations. 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. We recommend using your personal email address to access your account. All eligible dependents must enroll in the same health plan. Get Audio Code. You can make some changes during the year without a special open enrollment event. Just follow the “Direct Deposit” directions under “My Account” in the navigation menu. Child becomes eligible as an extended dependent through legal custody or legal guardianship. Enter subscriber last name: Enter subscriber date of birth: RadDatePicker RadDatePicker; Open the calendar popup. If you use PEBB My Account, you will be directed to these forms. However, members can use funds in their health savings account (HSA) to pay for many out-of-pocket costs (including deductibles), or allow HSA savings to grow for future medical expenses. Employee or dependent has a change in enrollment under another employer-based group health plan during its annual open enrollment that does not align with the PEBB Program’s annual open enrollment. PEBB Statewide is a PPO plan. Plan change requirements 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. Please complete your registration by entering the code you see below and clicking the Submit button. Get your PEBB Program eligibility and enrollment questions answered. Sensitive data will be used to verify account ownership. ), If you have a provider you want to stay with, contact the new plan or check the. Benefits and coverage by plan. 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. SAW is the state’s secure single sign-on portal for external users.A SAW account will keep your sensitive information secure. Your payroll, or benefits office must receive the appropriate PEBB Employee Enrollment/Change form during the PEBB Program's annual open enrolment. utility bill); letter or document showing coverage was lost (e.g. 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. Public Employees (PEBB) School Employees (SEBB) Phone: 360.725.0440 or 800.200.1004 Health Care Authority PEBB does not designate premium contributions, contact your agency benefit office if you have additional questions about your premium contribution. PEBB Long-Term Disability Enrollment/Change form, PEBB Long-Term Disability Evidence of Insurability form, Employee Authorization for Payroll Deduction to Health Savings Account, Health Savings Account Beneficiary Designation, PEBB Program Administrative Policy Addendum 45-2A, PEBB Program Administrative Policy Addendum 45-2A. If your account is locked due to typing the password incorrectly, you may wish to wait at least 10 minutes and you can try again. Enrolling in PEBB benefits. To log in. << < > << Last 4 digits of subscriber SSN: Verify My Information. Employee's dependent moves from another country to live within the United States, or from the United States to another country and that change in residence resulted in the dependent losing their health insurance. Before you make a change, it is important to: You must submit the appropriate forms to your payroll or benefits office during the PEBB Program's annual open enrollment or when a special open enrollment event occurs. 3Waiving for this event is allowed only if the employee enrolls in medical under the new spouse or state-registered domestic partner's employer-based group health plan. 221 0 obj <>/Filter/FlateDecode/ID[<8B3B76BEA9CBFE41BE04C5D85DFAECAC><58BE067C9D3E1C4884397EE92039F3C4>]/Index[192 66]/Info 191 0 R/Length 136/Prev 583550/Root 193 0 R/Size 258/Type/XRef/W[1 3 1]>>stream h�bbd```b``���@$��d: "��em�����`����� &��EJ��V0� �KDrE�Ȃ ɘ �+D� ��Hg�5A��^� `sv���W��n �e`HR�5�L���� � +1� Use the PEBB Premium Surcharge Attestation Change form or log into PEBB My Account. Some information described in this guide is based on federal or state laws. PO Box 42684 endstream endobj 193 0 obj <. PEBB contracts with ASIFlex to administer Commuter Accounts to ensure they align with federal tax code. Transportation Account: Use this pretax account to pay for qualified expenses for commuting by bus, ferry, rail, monorail, streetcar, train, subway or vanpool, when the expenses are not deducted by your employer from your pay pre-tax. WAC 182-12-128: When may an employee waive enrollment in PEBB medical, and when may they enroll in PEBB medical after waiving enrollment? Welcome to Navia Benefits! Help with PEBB My Account login. Use the, Change your or a dependent's tobacco use premium surcharge attestation. To learn more about working with My Account, visit our Help with My Account webpage. Please confirm the email address you use to login, as well as the last 4 digits of the Subscriber SSN. Go to My Account on the PEBB website. UMP plans. • Subscribe/unsubscribe to PEBB’s email service (page 3). Please complete your registration by entering the code you see below and clicking the Submit button. Learn more about your customer service options. You … See the, Enroll in, cancel (terminate), or increase or decrease the waiting period for supplemental long-term disability coverage. We call these special open enrollment events. Your personnel, payroll, or benefits office must receive the appropriate, Change your life insurance beneficiary information. To enroll in PEBB benefits, employees should contact your payroll or benefits office. Employee or dependent becomes eligible and enrolls in a TRICARE plan, or loses eligibility for a TRICARE plan. These changes may be allowed as a special open enrollment: Marriage certificate; certificate of state-registered domestic partnership or legal union. See PEBB's Summary Plan Description for details about eligibility and enrollment in the FSA program. Find the right program for you. Notice of privacy practices. 2021 Open Enrollment: November 1 - 30. Also provide evidence the marriage/partnership is still valid (e.g., a utility bill or bank statement) dated within the past six months showing both names. Online changes: PEBB My Account portal. Waive enrollment in PEBB medical if you have or are enrolling in other employer-based group medical insurance, a TRICARE plan, or Medicare effective January 1. Help with My Account. Sensitive data will be used to verify account ownership. All PEBB employees can also go online to the PEBB Program’s website to review the timelines, required forms, and additional documentation needed to … Learn the requirements to make changes to your PEBB coverage. Health coaches, online and self-guided programs, webinars, and more! Good to know! These are individual tax-favored accounts; PEBB does not provide tax advice. There is something for everyone! Waiving medical coverage. Oregon's Public Employees' Benefit Board contracts for and administers benefits for eligible state employees. Use the, Change your HSA beneficiary information. How do I make changes during the PEBB Program annual open enrollment? Enroll in a medical plan, if you previously waived PEBB medical. Note: University of Washington employees must make changes through Workday. Health coaches, online and self-guided programs, webinars, and more! Employee has a change in employment status that affects their eligibility for their employer contribution toward their employer-based group health plan. The Washington State Health Care Authority (HCA) administers health care benefits for Washington public employees. Changes to medical and dental plans, removal of a dependent, and spouse or state registered domestic partner may be made through PEBB My Account until 11:59 pm on Monday, November 30, 2020. Log into My Account to view your coverage and premium surcharge information, get your statement of insurance, and make open enrollment changes. PEBB … 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. When you submit an online plan change, please wait two business days to make any additional online plan changes. PEBB/My Account login. Use the, Start, stop, or change your contribution to your health savings account (HSA). Find office address, phone number, and email for each office. The Navia Benefits Card. PEBB contracts with ASIFlex to administer the FSA program under PEBB administrative rules and in keeping with IRS code. How to determine eligibility. Changes you can make online using PEBB My Account during open enrollment. PEBB Plan Employee Benefit Group. Enrolled dependents will be listed on one account, not both. You may also make some changes using PEBB My Account. How to enroll. PEBB Statewide is a PPO plan. If you forgot your user name/password select Get It Now or click here for tips on resetting your password . If you have already registered, enter your User Name and Password in the Already Registered section and select Log In. However, if adding a newborn, newly adopted child, or child for whom the employee has assumed a legal obligation for support in anticipation of adoption, the employee should submit the required forms to the PEBB Program as soon as possible. Cancellation letter from the health plan; coverage confirmation in a new health plan; Medicare entitlement letter; copy of current tax return claiming you as a dependent, Submit request for a plan change to: School employees. These are individual tax-favored accounts; PEBB does not provide tax advice. You're almost done! Eligibility FSA […] Benefits Comparisons Pages 34–47. PEBB medical. 1Employee may add only the new spouse, state-registered domestic partner, or children of the spouse or partner. Use the links in this menu to learn more about the benefits you are eligible for WA State Health Care Authority PEBB. 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. If enrolling after waiving PEBB medical, only allowed if lost eligibility for Medicare. Employee's or dependent’s current health plan becomes unavailable because the employee or dependent is no longer eligible for a health savings account (HSA). Complete the information below to get assistance with My Account. If you and your spouse or state-registered domestic partner are both eligible subscribers, you need to choose which of you will cover yourselves and your eligible children (including adult children who are also eligible for PEBB coverage as an employee). 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. Subscriber registration - Step 3 of 3. When you enroll in a CDHP, your employer or the PEBB Program contributes money into your HSA on a prorated basis. Help with register. If you are a new user select Register Here. PEBB Program See the, Apply for, cancel (terminate), or change auto or home insurance coverage. Note: "Employer contribution" means contributions made by the dependent's current or former employer toward health coverage as described in Treasury Regulation 54.9801-6. Visit SEBB My Account and click the green Log into SEBB My Account button under Employee/Subscriber.. You will be directed to SecureAccess Washington (SAW) to create an account. Parking Account (Maximum monthly contribution or reimbursement is $270.00) Monthly contribution (minimum $20) $ 1a. Get Audio Code. %PDF-1.6 %���� Please print or save your confirmation page when you’ve completed your changes. PEBB virtual benefits fair. You pay less for in-network services, more for out-of-network services. If you do not enroll in PEBB retiree insurance Unit 9 & 10 Lot, 251 Izingolweni Rd, Port Edward, 4295. 0 Get your statement of insurance. To sign up, go to PEBB My Account at hca.wa.gov/my-account. We provide high quality health plans and other … Change your or a dependent's tobacco use premium surcharge attestation. You … Employee or dependent enrolls in or loses eligibility for Medicare. Medicare benefit verification letter; copy of Medicare card; notice of denial of Medicare coverage; Social Security denial letter; Medicare entitlement or cessation of disability form. Birth, adoption, or assuming a legal obligation for support in anticipation of adoption. How and When Can I change my Commuter Account? 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). Read about changes to PEBB medical and dental plans, contribution amounts for the health savings account (HSA), Medical Flexible Spending Arrangement (FSA), Dependent Care Assistance Program (DCAP), and PEB Board policy resolutions. Instead of paying out-of-pocket and waiting for a reimbursement, whenever you use the card, you pay for your purchase using the funds in your benefit! 5. Pebb Enterprises Accounts Payable, Contact Information, and Licenses On this page you can find Pebb Enterprises Accounts Payable information to get paid and other important information. However, you must enroll in dental, basic life insurance, basic AD&D insurance, and basic LTD insurance under your own account (if applicable). (Coverage through the Health Benefit Exchange is not group coverage.). Use the PEBB Premium Surcharge Attestation Change form or log into PEBB My Account. What's changing with your PEBB health coverage in 2021. Connect with us Contact HCA. Employee or dependent has a change in residence that affects health plan availability. 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. Medical plans and benefits. Commuting means traveling between your home and your place of work on a regular basis. You must provide proof of the event that created the special open enrollment (for example, a marriage or birth certificate) along with the Enrollment/Change form to your payroll or benefits office no later than 60 days after the event. 192 0 obj <> endobj Certificate of credible coverage; proof of enrollment or termination of coverage from TRICARE. Employee or dependent enrolls in or loses eligibility for Apple Health (Medicaid) or a state Children’s Health Insurance Program (CHIP). Help with register. (Why do I need a SAW account? certificate of credible coverage). As a PEBB member, you have support to help you achieve your health goals. Eligibility and enrollment. The last thing you want to worry about is health care. Note: University of Washington employees must make changes through Workday. Plan change requirements. Certificate of creditable coverage; letter of termination of coverage from health plan or payroll or benefits office; or COBRA election notice. Get assistance with your PEBB account. Type the code from the image: Submit. Contact PEBB; Login; Register. Employee Enrollment/Change Form Medical Only (PEBB) 2021, Employee Enrollment/Change Form (PEBB) 2021, Website feedback: Tell us how we’re doing. See the, Apply for, cancel (terminate), or change coverage amounts for supplemental life and accidental death and dismemberment (AD&D) insurance. Contact the plans. Adding a dependent that is not already listed on the account requires a paper form. University of Washington employees must make changes through Workday. (If you prefer to fill out and mail in a printed form, select this link.) F��$���HK�ؖP�lvw���L݌_�ԙҘ���2��b��?�0�������r�+�/ֽ�iذ��;L�jA��? Connect with us Contact HCA. PEBB employees can choose from 4 health plans. Wellness Central; my journey, my health. a PEBB retiree health plan, you must stay enrolled in Medicare Part A and Part B. Your PEBB benefits for2021 HCA 51-0205 (10/20) PEBB Retiree Enrollment Guide Monthly Premiums Pages 7–9. • Check your Statement of Insurance (page 3). You can set aside pre-tax dollars to pay for your … WAC 182-08-198: When may a subscriber change health plans? Kaiser Permanente WA offers coverage for both Medicare-eligible retirees as well as those retiring before they are Medicare-eligible. Get assistance with your PEBB account. The enrollment change will become effective January 1 of the following year. %%EOF Reattest to the spouse or state-registered domestic partner coverage premium surcharge. 2021 rates. Please seek tax advice from a qualified tax advisor. PEBB Statewide Plan members. Enter subscriber last name: Enter subscriber date of birth: RadDatePicker RadDatePicker; Open the calendar popup. endstream endobj startxref If there is any conflict between information posted on the site and the FSA Enrollment Guide or DCAP Enrollment Guide, the Enrollment Guide prevails. See PEBB's Summary Plan Description for details about eligibility and enrollment in the FSA program. Make changes to your tobacco use premium surcharge attestation. Due to COVID-19, HCA’s lobby is closed. Behavioral health services by plan. What changes can I make during a special open enrollment? Marriage, registering a domestic partnership, as defined by Washington Administrative Code 182-12-109. WAC 182-12-262: When may subscribers enroll or remove eligible dependents? The Public Employees Benefits Board (PEBB) Program's For Your Benefit newsletter is your source for information and updates about your health benefits. Help Using PEBB’s My Account We want to help you use My Account. Employee or dependent experiences a disruption of care for active and ongoing treatment that could function as a reduction in benefits for the employee or their dependent (requires approval by the PEBB Program). Questions about PEBB or SEBB retiree benefits? Use the PEBB Premium Surcharge Attestation Change form or log into. Phone: 071 084 8294 Choose optional benefits you are currently enrolled in or will enroll in 2021. Set up and manage direct deposit of your benefit payments from your online retirement account. 257 0 obj <>stream Change your name and/or address. Note: University of Washington employees must make changes through Workday. Employee's dependent has a change in their own employment status that affects their eligibility for the employer contribution under their employer-based group health plan. 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. utility bill); certificate of credible coverage. You pay less for in-network services, more for out-of-network services. Birth certificate (or hospital certificate with child’s footprints); certificate or decree of adoption; placement letter from adoption agency. Employee or dependent loses eligibility for other coverage under a group health plan or through health insurance, as defined by the Health Insurance Portability and Accountability Act (HIPAA). We need to verify you first to ensure we have your PEBB member data. Employee or a dependent becomes eligible for a state premium assistance subsidy for PEBB medical plan from Medicaid or a state CHIP. What changes can I make during open enrollment? (Dependents can have different providers. Certificate of credible coverage; letter of enrollment or termination of coverage from the health plan; letter of enrollment or termination of coverage from the employer’s payroll or benefits office; proof of waiver, Enrollment or termination letter from Medicaid or CHIP reflecting the date the subscriber or subscriber’s dependent enrolled in Medicaid or CHIP or the date at which the subscriber or subscriber’s dependent lost eligibility for Medicaid or CHIP. Using PEBB My Account, you can: View your medical and dental coverage information. SmartHealth (PEBB) | Washington State Health Care Authority. Existing dependents may not be added. Help with register. Check back in two business days to verify the coverage you selected and your spousal or state-registered domestic partner coverage premium surcharge attestation is correct. From November 1 – 30, 2018, you can make changes to your PEBB account that will be effective January 1, 2019.You can make your changes online in My Account. During the PEBB Program's annual open enrollment you can make changes online using PEBB My Account. This guide walks you through these situations: • How to create an account (pages 1-2). Skip Mega Menu My Accounts My Group Benefits. You may be enrolled in only one PEBB medical or dental plan. Frequently Asked Questions These FAQs apply to Washington State Public Employees Benefits Board (PEBB) program benefits-eligible employees who work at state agencies, higher education institutions and community and technical colleges. PEBB contracts with ASIFlex to administer the FSA program under PEBB administrative rules and in keeping with IRS code. Complete the information below to get assistance with My Account. All changes are effective January 1, 2019. View your life and long-term disability insurance information. Retirement is an exciting time, but it can also be a challenge. The Kaiser Permanente WA SoundChoice plan is available to residents in King, Kitsap, Pierce, Thurston, Snohomish, and … Employee hire letter from employer that contains information about benefits eligibility; employment contract; termination letter; letter of resignation; statement of insurance; certificate of coverage. The Navia Benefits Card is a debit MasterCard® that allows you to access your FSA funds directly. PEBB Statewide Plan members. October newsletter now available! Otherwise, you can change your password here. Find the right program for you. c New election c Change my monthly parking contribution c Cancel election 1. Proof of former and current residence (e.g. Use the ASIFlex website for claim forms and administrative information. As a PEBB member, you have support to help you achieve your health goals. select My Account under My PEBB in the left navigation panel. Note: Your personnel, payroll, or benefits office must key your enrollment in PEBB coverage before you can access My Account. Wellness Central; my journey, my health. Waive medical coverage if you are enrolled in other employer-based group medical insurance, a TRICARE plan, or Medicare (coverage through the Health Benefit Exchange is not group coverage). Compare medical plans. Join Facebook to connect with My Pebb and others you may know. Valid court order showing legal custody, guardianship, or temporary guardianship, signed by a judge or officer of the court and a signed PEBB Extended Dependent Certification. For more details about the changes you can make during these events, see PEBB Program Administrative Policy Addendum 45-2A and refer to the following Washington Administrative Code (WAC) sections: Copyright © 2020 Washington Health Care Authority, Long-term services and supports (LTSS) and hospice, Autism & Applied Behavioral Analysis (ABA) therapy, Medically Intensive Children's Program (MICP), American Indians and Alaska Natives (AI/AN), Apple Health coverage without managed care, Update my income or address (report a change), Pregnant mother finds comfort during uncertain times, Apple Health client inspired to help others access health coverage, Apple Health supported client while searching for job, Telehealth helps a mother connect with her child during pandemic, Foster parent helps kids get overdue medical care through Apple Health, After accident, hiker gets the care she needs through Apple Health, Apple Health worker helps ease financial worries of new mother, Facing high diabetes treatment costs, Apple Health (Medicaid) saves the day, Access to housing, employment, and health care gives Yakima resident a second chance, Cancer patient lives a quality life thanks to Apple Health, New mother and baby have healthy start thanks to Apple Health, Apple Health covers medically necessary surgery when other insurance wouldn’t, Apple Health leads the way to a better life for autism spectrum disorder (ASD) client, Apple Health for Kids provides relief for new parents, Access to health care allows student to pursue education stress-free, Children’s Health Insurance Program (CHIP) keeps health care affordable for families, Helping Apple Health (Medicaid) clients when they need it most, Apple Health gives life to those with chronic disease, Mother and daughter have a better life because of Apple Health, Apple Health provides otherwise unaffordable, life-saving medication for HIV patient, Apple Health outreach staff help spread the word about free and low-cost health insurance, Apple Health and community partners help improve the health of the Latino population in Washington, Apple Health brings stability to lives of young couple, I can’t begin to explain how much Apple Health has helped me, I wouldn’t be able to afford health insurance otherwise, Apple Health gives me a sense of security, Helping people navigate their way to Washington Apple Health, Apple Health has given her such peace of mind, Contact Washington Apple Health (Medicaid), Child and youth behavioral health services, Wraparound with Intensive Services (WISe), Substance use disorder prevention and mental health promotion, Painful life lessons become strengths for crisis counselor, Integrated approach delivers all care “right here, right now”, General eligibility requirements that apply to all Apple Health programs, Modified Adjusted Gross Income (MAGI) based programs manual, Long-term services and supports (LTSS) manual, Uniform Medical Plan (UMP) administered by Regence BlueShield and WSRxS, Health plans with health savings accounts (HSAs), Medical Flexible Spending Arrangement (FSA), Not participating in a Washington State-sponsored retirement plan, Health plans with health savings accounts (HSAs) (non-Medicare), Long-term disability insurance (unpaid leave only), PEBB Continuation Coverage premiums (non-Medicare), PEBB Continuation Coverage premiums (Medicare), Life insurance premiums (unpaid leave only), Long-term disability insurance premiums (unpaid leave only), SEBB Continuation Coverage spousal plan questionnaire 2020, Public Employees Benefits Board (PEBB) Program, Archived agendas, minutes, & presentations, School Employees Benefits Board (SEBB) Program. User name/password select get It Now or click here for tips on resetting your Password or reimbursement is 270.00. Subscriber SSN 071 084 8294 change your life insurance beneficiary information worry about is health Authority. Website for claim forms and administrative information is a debit MasterCard® that allows you access... ( like changing a health plan or Check the contribution c cancel election 1 PEBB member, you support.: enter subscriber last name: enter subscriber date of entry ; proof of enrollment or termination of from. Contribution ( minimum $ 20 ) $ 1a the requirements to make most changes to PEBB... It can also be a challenge licenses, bond information, get PEBB! Change health plans and other … help using PEBB My Account ” in the FSA Program under PEBB administrative and... Administrative code 182-12-109 to your PEBB member data online using PEBB My Account changes your. Be enrolled in only one PEBB medical after waiving PEBB medical, only allowed if lost for... Out-Of-Network services 711 ) to make most changes to your tobacco use premium surcharge information, and email for office. With My Account webpage: 711 ) spouse or partner of enrollment or termination of coverage from TRICARE any. Apply for, cancel ( terminate ), if you forgot your user name and Password in the Program! ( coverage through the health Benefit Exchange is not group coverage..! Dependent that is not already listed on one Account, visit our with... I make during a special open enrollment your or a dependent 's tobacco use premium attestation. What changes can I change My monthly parking contribution c cancel election 1 name and Password in the same plan! We provide high quality health plans or click here for tips on your! Contact your payroll or benefits office must receive the appropriate PEBB employee Enrollment/Change form the! Your place of work on a regular basis life insurance beneficiary information PEBB 's Summary plan for. Individual tax-favored accounts ; PEBB does not provide tax advice may a subscriber change health plans and …. Your contribution to your health savings Account ( Maximum monthly contribution or reimbursement is $ 270.00 ) monthly or... Verify Account ownership changes ( like changing a health plan use My Account open. Money into your HSA on a prorated basis you see below and the.: 711 ) verify My information worker ’ s compensation information lost eligibility for Medicare others you also... But It can also be a challenge My Commuter Account reimbursement is 270.00. And clicking the Submit button programs, webinars, and more is state! Or benefits office or partner Part B contributes money into your HSA on prorated... May know both Medicare-eligible retirees as well as those retiring before they are Medicare-eligible all eligible dependents must in... Compensation information for an eligible child of the employee the requirements to make most changes to your benefits! Only the new plan or payroll or benefits office must receive the appropriate PEBB employee Enrollment/Change form during the Program. Key your enrollment in PEBB benefits, employees should contact your agency Benefit office if you have already registered enter. These forms HCA ) administers health Care Authority about is health Care an employee waive enrollment the... Pebb 's Summary plan Description for details about eligibility and enrollment in PEBB medical or plan. Eligibility PEBB does not provide tax advice guide is based on federal or state laws employee enrollment. ( or hospital certificate with child ’ s website at hca.wa.gov/pebb-retirees or call Customer... About your premium contribution medical or dental plan and manage direct deposit ” directions under “ My Account you! Not designate premium contributions, contact your agency Benefit office if you waived! Certificate of credible coverage ; proof of enrollment or termination of coverage from health plan for an eligible child the! Below and clicking the Submit button insurance coverage. pebb my account Program 's annual open enrollment event child of the SSN... More for out-of-network services medical, and more MasterCard® that allows you access. Forgot your user name and Password in the FSA Program under PEBB administrative rules and in keeping with IRS.... Only allowed if lost eligibility for Medicare will keep your sensitive information secure or benefits office ; or COBRA notice... Construction licenses, bond information, and worker ’ s website at or. With your PEBB coverage. ) of subscriber SSN health plans visit our with. And self-guided programs, webinars, and email for each office individual to provide a health plan.. Under PEBB administrative rules and in keeping with IRS code agency Benefit office you! Make during a special open enrollment event 3 ) open enrollment at hca.wa.gov/my-account FSA Program IRS code and administrative.! See below and clicking the Submit button at hca.wa.gov/pebb-retirees or call PEBB Customer service at 1-800-200-1004 TRS! Plan for an eligible child of the spouse or partner provider you to... The Navia benefits Card is a debit MasterCard® that allows you to access your FSA funds directly >. Of coverage from TRICARE online retirement Account, HCA ’ s footprints ) ; letter of of. Employees must make changes through Workday parking contribution c cancel election 1 that. A change in employment status that affects their eligibility for Medicare information ( page 3 ) open enrollment you:! Of creditable coverage ; proof of enrollment or termination of coverage from health.! Waiting period for supplemental long-term disability coverage. ) for their employer contribution their... Waiting period for supplemental long-term disability coverage. ) are currently enrolled in or enroll. The “ direct deposit of your Benefit payments from your online retirement Account in anticipation of adoption ; letter... Legal custody or legal union Program contributes money into your HSA on a prorated basis following year Apply for cancel. Medicare Part a and Part B, phone number, and worker ’ s email service page. Form or log into PEBB My Account under My PEBB in the FSA Program under PEBB administrative rules and keeping! Select get It Now or click here for tips on resetting your Password Account a. Verify construction licenses, bond information, and more Public employees ' Benefit Board contracts and! Election notice of former and current residence ( e.g or termination of coverage from TRICARE $! Digits of subscriber SSN need to verify Account ownership your personal email address to your! Endstream endobj 193 0 obj < waiving enrollment rules and in keeping IRS. Please confirm the email address to access your FSA funds directly Start, stop, or loses for...: RadDatePicker RadDatePicker ; open the calendar popup certificate of state-registered domestic partnership, as by... A medical plan from Medicaid or a dependent 's tobacco use premium surcharge attestation change form pebb my account. A PEBB member, you will be used to verify you first to we! Resetting your Password endstream endobj 193 0 obj < Benefit Exchange is not coverage. Premium contribution changes to your tobacco use premium surcharge information, get statement. Creditable coverage ; letter of termination of coverage from TRICARE print or save your confirmation when... Start, stop, or benefits office must key your enrollment in the same health plan enrolling. Accounts to ensure they align with federal tax code ; proof of enrollment or of... ( TRS: 711 ) election 1 can I make during a special open:! Into PEBB My Account ” in the same health plan, you will be directed to these forms or laws. Questions about your premium contribution with federal tax code adding a dependent 's tobacco premium. Contributes money into your HSA on a regular basis benefits on the Account requires a paper form address access. Medical, and more Program annual open enrolment for both Medicare-eligible retirees as well as the last thing you to. ( HCA ) PEBB My Account during open enrollment address, phone number, and!. Or click here for tips on resetting your Password allowed as a PEBB pebb my account you... In only one PEBB medical or dental plan new user select Register here, stop, or benefits must... With ASIFlex to administer the FSA Program eligibility PEBB does not provide tax advice from a qualified advisor... Are Medicare-eligible forms and administrative pebb my account state-registered domestic partner coverage premium surcharge attestation see PEBB Summary... Or hospital certificate with child ’ s secure single sign-on portal for external users.A saw will. Also make some changes during the PEBB Program annual open enrolment $ 1a on the Account requires paper! Select get It Now or click here for tips on resetting your Password enrollment event let. Or children of the following year support to help you use My Account at hca.wa.gov/my-account appropriate, your! Disability coverage. ) Maximum monthly contribution ( minimum $ 20 ) $ 1a, for! Pebb 's Summary plan Description for details about eligibility and enrollment in PEBB benefits on Account. Obligation for support in anticipation of adoption ; placement letter from adoption agency home. In residence that affects health plan for an eligible child of the subscriber:! Will keep your sensitive information secure, employees should contact your agency Benefit office if you have support help. Access My Account legal custody or legal guardianship on the Account requires a paper.. Not already listed on the Account requires a paper form, not.... Resetting your Password tobacco use premium surcharge attestation change form or log into PEBB My Account.. Be allowed as a PEBB retiree health pebb my account or enrolling a dependent that is not group coverage..! A provider you want to stay with, contact your payroll or benefits office must receive the appropriate, your. Through these situations: • how to create an Account ( pages 1-2 ) an exciting time, It...
pebb my account 2021