WAC 182-12-265
What options for continuing health plan
enrollment are available to widows, widowers and dependent
children if the employee or retiree dies? The surviving
dependent of an eligible employee or retiree who meets the
eligibility criteria in subsection (1), (2), or (3) of this
section is eligible to enroll in PEBB retiree insurance
coverage as a surviving dependent. An eligible surviving
spouse, Washington state registered domestic partner, or child
must enroll in or defer enrollment in a PEBB medical plan no
later than sixty days after the date of the employee's or
retiree's death.
(1) Dependents who lose eligibility due to the death of
an eligible employee may continue enrollment in a PEBB health
plan enrollment as a survivor under retiree insurance coverage
provided they immediately begin receiving a monthly retirement
benefit from any state of Washington sponsored retirement
system.
(a) The employee's spouse or Washington state registered
domestic partner may continue health plan enrollment until
death.
(b) Children may continue health plan enrollment until
they lose eligibility under PEBB rules.
(c) If a surviving spouse, Washington state registered
domestic partner, or child of an eligible employee is not
eligible for a monthly retirement benefit (or a lump-sum
payment because the monthly pension payment would be less than
the minimum amount established by the department of retirement
systems) the dependent is not eligible for PEBB retiree
insurance as a survivor. However, the dependent may continue
health plan enrollment under provisions of the federal
Consolidated Omnibus Budget Reconciliation Act (COBRA) or WAC 182-12-270.
(d) The two federal retirement systems, Civil Service
Retirement System and Federal Employees Retirement System,
shall be considered a Washington sponsored retirement system
for Washington State University extension service employees
who were covered under PEBB insurance coverage at the time of
death.
(2) Dependents who lose eligibility due to the death of a
PEBB eligible retiree may continue health plan enrollment
under retiree insurance.
(a) The retiree's spouse or Washington state registered
domestic partner may continue health plan enrollment until
death.
(b) Children may continue health plan enrollment until
they lose eligibility under PEBB rules.
(c) Dependents, who are not enrolled in a PEBB health
plan at the time of the retiree's death, are eligible to
enroll or defer enrollment in PEBB retiree insurance. A form
to enroll or defer PEBB health plan enrollment must be
hand-delivered or mailed to the PEBB program no later than
sixty days after the retiree's death. To enroll in a PEBB
health plan, the dependent must provide satisfactory evidence
of continuous enrollment in other medical coverage from the
most recent open enrollment for which enrollment in PEBB was
deferred.
(3) Surviving spouses, Washington state registered
domestic partners, or eligible children of a deceased school
district or educational service district employee who were not
enrolled in PEBB insurance coverage at the time of the
subscriber's death may enroll in a PEBB health plan provided
the employee died on or after October 1, 1993, and the
dependent(s) immediately began receiving a retirement benefit
allowance under chapter 41.32, 41.35 or 41.40 RCW.
(a) The employee's spouse or Washington state registered
domestic partner may continue health plan enrollment until
death.
(b) Children may continue health plan enrollment until
they lose eligibility under PEBB rules.
(4) Surviving dependents must notify the PEBB program of
their decision to enroll or defer enrollment in a PEBB health
plan no later than sixty days after the date of death of the
employee or retiree.
Note:
If premium payment sufficient to maintain health plan enrollment continues after the employee's or retiree's death,
the PEBB program will consider the payment as notice of the survivor's intent to continue enrollment.
If PEBB health plan enrollment ended due to the death of
the employee or retiree, PEBB will reinstate health plan
enrollment without a gap subject to payment of premium. In
order to avoid duplication of group medical coverage,
surviving dependents may defer enrollment in a PEBB health
plan under WAC 182-12-200 and 182-12-205. To notify the PEBB
program of their intent to enroll or defer enrollment in a
PEBB health plan, the surviving dependent must submit the
appropriate forms to the PEBB program no later than sixty days
after the date of death of the employee or retiree.