14-01-054

WSR 14-01-054

POLICY STATEMENT

HEALTH CARE AUTHORITY

(Public Employees Benefits Board)

[Filed December 12, 2013, 12:06 p.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, 2014. You can download the complete policy statements at www.hca.wa.gov/pebb/Pages/policy.aspx.

Policy #11-3: Correcting employing agency enrollment errors. This policy clarifies the requirements placed on an employing agency when the employing agency corrects its enrollment errors according to WAC 182-08-187.

Policy #17-2: Determining faculty eligibility after a layoff. The purpose of this policy is to apply the criteria for maintaining the employer contribution toward insurance coverage after a layoff, as described in WAC 182-12-129.

Policy #17-3: Determining faculty eligibility for off-quarter/semester or for decreases in workload. The purpose of this policy is to clarify when a faculty qualifies for the employer contribution toward insurance coverage during an off-quarter/semester or when there is a decrease in workload.

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.

Addendum #19-1A: Termination due to loss of eligibility: Employee.

Addendum #19-1B: Termination due to loss of eligibility: Self-Pay Subscriber.

Policy #21-1: Retiree deferral form exemption. This policy exempts certain retirees from the procedural requirement of completing a deferral form in WAC 182-12-171 (1)(a) and 182-12-205(2).

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

Policy #36-1: Certifying eligibility for a dependent child with a disability who is age 26 or older. This policy applies whenever a subscriber requests to enroll a dependent child with a disability who is age twenty-six and older to his or her PEBB subscriber account.

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.

Addendum #45-2A: Special Open Enrollment (SOE) matrix: Summary of permitted changes.

Policy #90-1: Allowable mid-year employer group terminations. This policy clarifies when employer group participation may terminate mid-year.

The PEBB program is rescinding the following policy:

Policy #41-1: Extension of PEBB open enrollment deadline for coverage effective in 2013 for individuals affected by Hurricane Sandy. The purpose of this policy was to extend the open enrollment deadline for a Hurricane Sandy affected individual.

To receive a hard copy of the policy statements, contact Rob Parkman at 626 8th Avenue S.E., Olympia, WA 98501-2684, phone [phone].