WAC 182-12-171
When are retiring employees eligible to
enroll in retiree insurance? (1) Procedural requirements.
Retiring employees must meet these procedural requirements, as
well as have substantive eligibility under subsection (2) or
(3) of this section.
(a) The employee must submit the appropriate forms to
enroll or defer insurance coverage within sixty days after the
employee's employer paid or COBRA coverage ends. The
effective date of health plan enrollment will be the first day
of the month following the loss of other coverage.
Exception:
The effective dates of health plan enrollment for retirees who defer enrollment in a PEBB health plan
at or after retirement are identified in WAC 182-12-200 and 182-12-205.
Employees who do not enroll in a PEBB health plan at
retirement are only eligible to enroll at a later date if they
have deferred enrollment as identified in WAC 182-12-200 or 182-12-205 and maintained comprehensive employer sponsored
medical as defined in WAC 182-12-109.
(b) The employee and enrolled dependents who are entitled
to medicare must enroll and maintain enrollment in both
medicare parts A and B if the employee retired after July 1,
1991. If the employee or an enrolled dependent becomes
entitled to medicare after enrollment in PEBB retiree
insurance, he or she must enroll and maintain enrollment in
medicare.
(2) Eligibility requirements. Eligible employees (as
defined in WAC 182-12-114 and 182-12-131) who end public
employment after becoming vested in a Washington
state-sponsored retirement plan (as defined in subsection (4)
of this section) are eligible to continue PEBB insurance
coverage as a retiree if they meet procedural and eligibility
requirements. To be eligible to continue PEBB insurance
coverage as a retiree, the employee must be eligible to retire
under a Washington state-sponsored retirement plan when the
employee's employer paid or COBRA coverage ends.
Employees who do not meet their Washington
state-sponsored retirement plan's age requirements when their
employer paid or COBRA coverage ends, but who meet the age
requirement within sixty days of coverage ending, may request
that their eligibility be reviewed by the PEBB appeals
committee to determine eligibility (see WAC 182-16-032). Employees must meet retiree insurance election procedural
requirements.
• Employees must immediately begin to receive a monthly
retirement plan payment, with exceptions described below.
• Employees who receive a lump-sum payment instead of a
monthly retirement plan payment are only eligible if this is
required by department of retirement systems because their
monthly retirement plan payment is below the minimum payment
that can be paid.
• Employees who are members of a Plan 3 retirement, also
called separated employees (defined in RCW 41.05.011(15)), are
eligible if they meet their Plan 3 retirement plan's
eligibility criteria when PEBB employee insurance coverage
ends. They do not have to receive a retirement plan payment.
• Employees who are members of a Washington higher
education retirement plan are eligible if they immediately
begin to receive a monthly retirement plan payment, or meet
their plan's retirement eligibility criteria, or are at least
age fifty-five with ten years of state service.
• Employees who are permanently and totally disabled are
eligible if they start receiving or defer a monthly disability
retirement plan payment.
• Employees not retiring under a Washington
state-sponsored retirement plan must meet the same age and
years of service as if the person had been employed as a
member of either public employees retirement system Plan 1 or
Plan 2 for the same period of employment.
• Employees who retire from a local government or tribal
government that participates in PEBB insurance coverage for
their employees are eligible to continue PEBB insurance
coverage as retirees if the employees meet the procedural and
eligibility requirements under this section.
(a) Local government employees. If the local government
ends participation in PEBB insurance coverage, employees who
enrolled after September 15, 1991, are no longer eligible for
PEBB retiree insurance. These employees may continue PEBB
health plan enrollment under COBRA (see WAC 182-12-146).
(b) Tribal government employees. If a tribal government
ends participation in PEBB insurance coverage, its employees
are no longer eligible for PEBB retiree insurance. These
employees may continue PEBB health plan enrollment under COBRA
(see WAC 182-12-146).
(c) Washington state K-12 school district and educational
service district employees for districts that do not
participate in PEBB benefits. Employees of Washington state
K-12 school districts and educational service districts who
separate from employment after becoming vested in a Washington
state-sponsored retirement system are eligible to enroll in
PEBB health plans when retired or permanently and totally
disabled.
Except for employees who are members of a retirement Plan
3, employees who separate on or after October 1, 1993, must
immediately begin to receive a monthly retirement plan payment
from a Washington state-sponsored retirement system.
Employees who receive a lump-sum payment instead of a monthly
retirement plan payment are only eligible if department of
retirement systems requires this because their monthly
retirement plan payment is below the minimum payment that can
be paid or they enrolled before 1995.
Employees who are members of a Plan 3 retirement, also
called separated employees (defined in RCW 41.05.011(15)), are
eligible if they meet their Plan 3 retirement plan's
eligibility criteria when employer paid or COBRA coverage
ends.
Employees who separate from employment due to total and
permanent disability, and are eligible for a deferred
retirement allowance under a Washington state-sponsored
retirement system (as defined in chapter 41.32, 41.35 or 41.40 RCW) are eligible if they enrolled before 1995 or within sixty
days following retirement.
Employees who retired as of September 30, 1993, and began
receiving a retirement allowance from a state-sponsored
retirement system (as defined in chapter 41.32, 41.35 or 41.40 RCW) are eligible if they enrolled in a PEBB health plan not
later than the HCA's annual open enrollment period for the
year beginning January 1, 1995.
(3) Elected and full-time appointed officials of the
legislative and executive branches. Employees who are elected
and full-time appointed state officials (as defined under WAC 182-12-114(4)) who voluntarily or involuntarily leave public
office are eligible to continue PEBB insurance coverage as a
retiree if they meet procedural and eligibility requirements. They do not have to receive a retirement plan payment from a
state-sponsored retirement system.
(4) Washington state-sponsored retirement systems
include:
• Higher education retirement plans;
• Law enforcement officers' and firefighters' retirement
system;
• Public employees' retirement system;
• Public safety employees' retirement system;
• School employees' retirement system;
• State judges/judicial retirement system;
• Teachers' retirement system; and
• State patrol retirement system.
The two federal retirement systems, Civil Service
Retirement System and Federal Employees' Retirement System,
are considered a Washington state-sponsored retirement system
for Washington State University Extension employees covered
under the PEBB insurance coverage at the time of retirement or
disability.