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>> PEBB offers benefit eligible employees several medical plan choices from Group Health,
Kaiser, and Uniform Medical Plan or UMP based on your county of residence.
Regardless of the plan you choose, all PEBB medical plans offer about the same comprehensive coverage.
The plans offer annual preventive care, vision care, and hearing exams,
as well as, prescription drug coverage, hospitalization, and doctor visits.
There is no waiting period for pre-existing health conditions. Not all plans
are available in every county.
The map shows the plan availability by county. The yellow and white striped areas show
the counties and zip codes within a county where Group Health and UMP are available.
The blue and white striped areas show the counties and zip code areas within a county
where Kaiser and UMP are available. UMP is available in all counties in Washington,
represented on the map by the white areas. In addition UMP has providers both nationwide
and worldwide. If you live outside of Washington, refer to the Employee Enrollment Guide
for additional plan availability. In most cases you must live in the plan area to enroll in the plan.
Group Health, Kaiser, and UMP offer two to three types of plans. The types of plans include
Classic, Value, and the Consumer Directed Health Plan or CDHP. If you choose one of the classic
plans from Group Health, Kaiser, or UMP you can expect to pay a higher monthly premium
but,less out of pocket when you require services.
If you choose the Value plan from Group Health, the monthly premiums will be lower than
the classic plan, but you may pay more out of pocket than the classic plan when you require
services. If you choose a CDHP from Group Health, Kaiser, or UMP you will pay a significantly
lower premium, but you will pay more out of pocket than the classic or value plans
when you require services.
The CDHP has two components: a high deductible health plan and a Health Savings Account or HSA.
The high deductible health plan is exactly what it sounds like; you will pay more
out-of-pocket before the plan will begin to pay.
The HSA is a tax-exempt savings and spending account used to pay for qualified medical
expenses that helps off-set the higher out-of-pocket costs of the plan.
Your HSA will be partially funded by your employer. You also have the option to deposit
money into the HSA through payroll deduction, if your employer offers payroll deduction,
electronic bank transfers or by mailing a check to Health Equity. You may fund your HSA up to the
annual maximum allowed by the IRS. The IRS has guidelines as to who is eligible for an HSA.
You must be eligible for the HSA to enroll in the CDHP. Refer to the Employee Enrollment Guide
or the PEBB website for eligibility requirements, employer contribution amounts and annual maximums.
To enroll in the health plan of your choice, you must submit the Employee Enrollment/Change form
to your personnel, payroll, or benefits office no later than 31 days after the date you become
eligible for benefits. You may choose to waive your medical coverage if you are enrolled in other
comprehensive group medical coverage. Failure to return the enrollment form within the 31 days
will result in enrollment in Uniform Medical Plan Classic as a single subscriber.
In addition, UMP will deny your claims until you submit the form. You would have the opportunity
to change your plan and add your dependents during the next annual open enrollment.