WSR 13-02-100



(Public Employees Benefits Board)

[ Filed January 2, 2013, 10:15 a.m. ]

Notice of Administrative Policy Statements

     The following is a list of administrative policies issued by the public employees benefits board (PEBB) program. These policies are effective January 1, 2013. The complete policy statements can be downloaded on-line from

     Policy #19-1: Termination Due to Loss of Eligibility. This policy applies whenever coverage for a subscriber or a subscriber's dependent is terminated due to loss of eligibility.

     Policy #21-1: Retiree Deferral Form Exemption. This policy exempts certain retirees from the deferral form requirement under WAC 182-12-171 (1)(a) and 182-12-205(2). This is the procedural requirement that a retiree must have submitted an enrollment/change form requesting deferral within the required time limit.

     Policy #26-1: Administering PEBB insurance in coordination with Medicare Part D. The purpose of this policy is to administer PEBB retiree medical plan enrollment in order to participate in the employer incentive program established in Section 1860D-22 of the Medicare Prescription Drug Improvement and Modernization Act of 2003.

     Policy #31-1: Verifying Dependent Eligibility before Enrollment. This policy clarifies which documents the PEBB program considers valid for dependent verification.

     Policy #37-1: Certifying eligibility for extended dependents. The purpose of this policy is to clarify the criteria used by the PEBB program to certify the eligibility of an extended dependent.

     Policy #45-2: Special Open Enrollment (SOE). This policy applies whenever a subscriber requests an enrollment change or election change outside of the PEBB annual open enrollment.

     The PEBB program is rescinding the following policies:

     Policy #7-01: Employer Group with Past Due Accounts. The purpose of this policy was to provide guidelines to the PEBB program and the health care authority (HCA) accounts receivable unit when an employer group has a delinquent account balance. The information contained in this policy is now addressed in the individual contracts with the employer groups.

     Policy #7-06: Eligibility of political subdivision employees for PEBB retiree coverage subsequent to PEBB COBRA coverage. This policy provided PEBB staff with clarification in applying WAC 182-12-171 to employees who are enrolled in PEBB COBRA coverage following the transfer of a political subdivision bargaining unit to PEBB benefits. This information is now contained in rule.

     To receive a hard copy of the policy statements, contact Rob Parkman, 626 8th Avenue S.E., Olympia, WA 98501, [Mailstop] 42684, phone (360) 725-0883.

Kevin M. Sullivan

Rules Coordinator