PEBB Eligible Employees: Premium payment plan election/change form

The majority of eligible employees pay for their share of medical premiums with pre-tax dollars, as allowed by Internal Revenue Service Code Section 125 (also known as the state’s Premium Payment Plan).

During open enrollment or a special open enrollment, employees can choose to waive their participation in the state’s Premium Payment Plan and have their medical premiums deducted after taxes. Employees who previously waived participation in the Premium Payment Plan may re-enroll during open enrollment. Tp initiate these changes, complete the Premium Payment Plan Election/Change form.

For more information on how IRS code Section 125 applies to PEBB coverage, refer to the Employee Enrollment Guide, page 12, under “How do I pay for coverage?”

Please contact Benefit Services at 509.335.4521 or email hrs@wsu.edu if you have questions.

By Communications staff, Washington State University

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