You MUST complete a spousal attestation for the 2015 plan year, if you have or will have a spouse or registered domestic partner enrolled on your PEBB medical coverage in 2015. The attestation must be completed between November 1 through 30.If you are an existing subscriber whose spouse or registered domestic partner is already enrolled on your PEBB medical coverage:
- Attest via your HCA My Account starting November 1, 2014, OR
- Complete and submit the 2015 Premium Surcharge Change Form*. Use the 2015 Premium Surcharge Help Sheet to fill out the form.
If you are a new or existing subscriber whose spouse or registered domestic partner is not enrolled in PEBB medical coverage in 2014, but will be enrolled effective January 1, 2015:
- Complete and submit the Open Enrollment 2015 enrollment/change form.* Use the 2015 Premium Surcharge Help Sheet to fill out the form.
*The forms will be available no later than November 3, 2014 at http://wsu.edu/OpenEnrollment2015.
Failure to attest/re-attest during Open Enrollment will result in a $50 per month surcharge applied to your monthly premium. You will not be able to have this charge removed unless there is a Special Open Enrollment event (change in your spouse’s job, divorce, etc.)
For more information or to ask questions, please contact HRS at 509-335-4521 or email hrs@wsu.edu.
