182-12-131  <<  182-12-133 >>   182-12-136

WAC 182-12-133

Agency filings affecting this section

What options for continuation coverage are available to employees on certain types of leave or whose work ends due to a layoff?

Employees who have established eligibility for public employees benefits board (PEBB) benefits under WAC 182-12-114 have options for providing continuation coverage for themselves and their dependents by self-paying the full premium set by the health care authority (HCA) during temporary or permanent loss of the employer contribution toward insurance coverage.
(1) When an employee is no longer eligible for the employer contribution toward insurance coverage due to an event described in (a) through (f) of this subsection, insurance coverage may be continued by self-paying the full premium set by the HCA, with no contribution from the employer. Employees may self-pay for a maximum of twenty-nine months. The employee must pay the premium amounts for insurance coverage as premiums become due. If premiums are more than sixty days delinquent, insurance coverage will end as of the last day of the month for which a full premium was paid. Employees may continue any combination of medical, dental and life insurance; however, only employees on approved educational leave or called in to active duty in the uniformed services as defined under the Uniformed Services Employment and Reemployment Rights Act (USERRA) may continue either basic or both basic and optional long-term disability insurance. Employees in the following circumstances qualify to continue coverage under this subsection:
(a) The employee is on authorized leave without pay;
(b) The employee is on approved educational leave;
(c) The employee is receiving time-loss benefits under workers' compensation;
(d) The employee is called to active duty in the uniformed services as defined under the Uniformed Services Employment and Reemployment Rights Act (USERRA);
(e) The employee's employment ends due to a layoff as defined in WAC 182-12-109; or
(f) The employee is applying for disability retirement.
(2) The number of months that an employee self-pays the premium while eligible under subsection (1) of this section will count toward the total months of continuation coverage allowed under the federal Consolidated Omnibus Budget Reconciliation Act (COBRA). An employee who is no longer eligible for continuation coverage as described in subsection (1) of this section but who has not used the maximum number of months allowed under COBRA may continue medical and dental for the remaining difference in months by self-paying the premium under COBRA as described in WAC 182-12-146.
[Statutory Authority: RCW 41.05.160 and 2012 2nd sp.s. c 3. WSR 13-22-019 (Admin. 2013-01), § 182-12-133, filed 10/28/13, effective 1/1/14. Statutory Authority: RCW 41.05.160. WSR 12-20-022 (Order 2012-01), § 182-12-133, filed 9/25/12, effective 11/1/12; WSR 10-20-147 (Order 10-02), § 182-12-133, filed 10/6/10, effective 1/1/11; WSR 09-23-102 (Order 09-02), § 182-12-133, filed 11/17/09, effective 1/1/10; WSR 08-20-128 (Order 08-03), § 182-12-133, filed 10/1/08, effective 1/1/09; WSR 07-20-129 (Order 07-01), § 182-12-133, filed 10/3/07, effective 11/3/07; WSR 06-11-156 (Order 06-02), § 182-12-133, filed 5/24/06, effective 6/24/06. Statutory Authority: RCW 41.05.160 and 41.05.165. WSR 04-18-039, § 182-12-133, filed 8/26/04, effective 1/1/05.]