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182-08-235  <<  182-08-237 >>   182-08-240

PDFWAC 182-08-237

May a local government entity or tribal government entity applying for participation in public employees benefits board (PEBB) insurance coverage include their retirees?

A local government or tribal government that applies for participation in public employees benefits board (PEBB) insurance coverage under WAC 182-08-235 will have a one-time opportunity to request inclusion of retired employees who are covered under its retiree health plan at the time of application.
(1) The authority will use the following criteria to approve or deny a request to include retirees:
(a) The local government or tribal government retiree health plan must have existed at least three years before the date of the employer group application;
(b) Eligibility for coverage under the local government's or tribal government's retiree health plan must have required immediate enrollment in retiree health plan coverage upon termination of employee coverage; and
(c) The retirees must have maintained continuous enrollment in the local government or tribal government retiree health plan.
(2) If the local government's or tribal government's application is for a subset of their employees (e.g., bargaining unit) only retirees previously within the bargaining unit may be included in the transfer.
(3) Retirees and dependents included in the transfer unit are subject to the enrollment and eligibility rules outlined in chapters 182-08, 182-12 and 182-16 WAC.
(4) Employees eligible for retirement subsequent to the local government or tribal government transferring to PEBB health plan coverage must meet retiree eligibility as outlined in chapter 182-12 WAC.
(5) To protect the integrity of the risk pool, if total local government or tribal government retiree enrollment exceeds ten percent of the total PEBB retiree population, the PEBB program may:
(a) Stop approving inclusion of retirees with local government or tribal government unit transfers; or
(b) Adopt a new rating methodology reflective of the cost of covering local government or tribal government retirees.
[Statutory Authority: RCW 41.05.021, 41.05.160, 2016 c 67, and PEBB policy resolutions. WSR 16-20-080, § 182-08-237, filed 10/4/16, effective 1/1/17. Statutory Authority: RCW 41.05.160. WSR 12-20-022 (Order 2012-01), § 182-08-237, filed 9/25/12, effective 11/1/12.]
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