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2 New! August 20. th, 2020. Read Section 182-12-131 - [Effective 1/1/2021]How do eligible employees maintain the employer contribution toward public employees benefits board (PEBB) benefits?, Wash. Admin. Plan Year: 1/1/2021–12/31/2021 with Medical FSA Grace Period through 3/15/2022 Complete this form to enroll in a Medical FSA or DCAP during a plan year. We recommend using your personal email address to access your account. Kaiser Permanente of the Northwest will: • Cover one hearing instrument per ear every five years at no cost, up to the plan’s allowed amount (or, for Consumer-Directed Health Plan [CDHP] members, after the deductible is met). Contributions increase in 2021 • Members can contribute up to $2,750 to a Health Care FSA in 2021. 2021 PEBB medical benefits comparison The chart below briefly compares the medical deductibles and per-visit out-of-pocket costs of some in-network benefits for PEBB medical plans. • This benefit will be available on PEBB Moda medical plans starting January 1, 2021 Moda 360. Under the current tier structure, PEBB would pay a tax penalty. The Plan is self-funded by the Group and has contracted Oregon Dental Service (ODS), doing 0000130443 00000 n
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SBC-ASO20-108601-449866 If you decide later you want to enroll in core benefits, you will have to appeal. 0000017047 00000 n
If you are unsure of your PEBB benefits eligibility date, please consult your local benefits office. max for 2021 is $270. 0000122238 00000 n
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A federal rule that becomes effective in 2021 will place an excise tax on annual premium amounts above a certain level. To avoid this, the Board is beginning a three year process to align our tiers with those of other large employers. PEBB is mailing all members of our self-insured plans - Moda, PEBB Statewide and Providence Choice - a letter requesting SSNs of their covered dependents. 0000149275 00000 n
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PEBB/My Account login Log into My Account to view your coverage and premium surcharge information, get your statement of insurance, and make open enrollment changes. <<0E97224549D19447B2AC36AE19091142>]/Prev 284094/XRefStm 3388>>
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If you are unsure of your PEBB benefits eligibility date, please consult your local benefits office. The benefits under the Plan are provided by PEBB on a self-insured basis. The Affordable Care Act (ACA) requires that we ask for and provide this information to the IRS. 0000036009 00000 n
The Uniform Medical Plan-Classic Medicare (UMP) premium will rise by $15.76 per month (4.9%), while most other plans will have more modest increases. 2. 2021 Benefit Information. Providence Choice (PDF) Providence Choice +100 (PDF) 0000009567 00000 n
Summary of Benefits for the 2020 Plan Year; A side-by-side plan comparison for benefits, copays and deductibles. 0000043472 00000 n
An enhanced member support team known as Moda 360. 0000006904 00000 n
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PEBB has designed this Plan in cooperation with Providence Health Plan. Benefit Highlights (continued) In-Plan Copay or Coinsurance Out-of-Plan Copay or Coinsurance Hospital Services Inpatient care 20% $500 then 50% Observation care 20% $500 then 50% Maternity care 20% $500 then 50% Routine newborn nursery care 20% $500 then 50% Rehabilitative care (30 days per calendar year; 60 days head or spinal cord injuries) 20% $500 then 50% 0000035418 00000 n
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For complete information, please refer to your Summary of Benefits or Evidence of Coverage. >PEBB Retiree Enrollment Guide > Acronyms used in this segment – HCA Health Care Authority – PEBB Public Employees Benefits Board – FSA Flexible Spending Account – CDHP Consumer Directed Health Plan – HSA Health Savings Account – VEBA Voluntary Employee Beneficiary Association PLEASE HAVE THESE DOCUMENTS READY FOR THIS SEGMENT And you have expanded access to telehealth through the national public health emergency period, currently scheduled to end Jan. 20, 2021. 0000034644 00000 n
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4 Benefits payments increase by 10% each plan year provided the member has visited a Delta Dental PPO provider at least once during the plan year. 0000016655 00000 n
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The intent is to allow an “apples to apples” comparison of medical health plan benefits across carriers. This information gives a high-level summary only. You can set aside pre-tax dollars to pay for your … 0000091225 00000 n
www.PEBBenroll.com Summary Plan Description. Navia Benefit Solutions in January 2021. Welcome to Navia Benefits! Copays and coinsurance may apply; some copays and coinsurance do not apply until after you have paid … 0000015493 00000 n
Limitations, exclusions, and restrictions may apply. PEBB 2021 Statewide Handbook 1 Effective January 01, 2021 Administered by Providence Health Plan 1. Summaries of Benefits and Coverage, or SBCs, are required under the Affordable Care Act. • If you declined all benefits in 2020 and do not complete open enrollment for 2021: You will continue with no benefits in 2021. We look forward to meeting your health care needs. You may enroll during the 2021 plan year if you or an eligible family member has a qualified change in status event that creates a … 0000007274 00000 n
All changes are effective January 1, 2021 unless otherwise noted. Benefit Highlights (continued) In-Plan Copay or Coinsurance Out-of-Plan Copay or Coinsurance Hospital Services Inpatient care 15% $500 then 40% Observation care 15% $500 then 40% Maternity care 15% $500 then 40% Routine newborn nursery care 15% $500 then 40% Rehabilitative care (30 days per calendar year; 60 days head or spinal cord injuries) 15% $500 then 40% 411 2021 PEBB Premium Surcharge Attestation Change Form Use this form to report a change that affects your premium surcharge for tobacco use or spouse or state-registered domestic partner (as defined by Washington Administrative Code 182-12-109) coverage. 0000149538 00000 n
WELCOME This handbook describes the main features of the Public Employees’ Benefit Board (the Group) dental plan (the “Plan”). 0000004979 00000 n
The intent is to allow an “apples to apples” comparison of medical health plan benefits across carriers. 0000023041 00000 n
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WA State PEBB Medical Flexible Spending Arrangement (FSA) & Dependent Care Assistance Program (DCAP) Open Enrollment Form Plan Year: 1/1/2021–12/31/2021 with Medical FSA Grace Period through 3/15/2022 You will also forfeit this $250 benefit if you waive PEBB medical coverage for 2021, unless you waive to enroll as a Which year would you like information on? Coverage for Washington State Public Employees Benefits Board (PEBB) Program retirees 166 0 obj
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2An office visit copayment applies at each visit, in addition to any copayments for services. The PEBB basic life benefit will increase from $5,000 to $10,000. 0000043175 00000 n
Enjoy the videos and music you love, upload original content, and share it all with friends, family, and the world on YouTube. If you enroll during the PEBB Program annual open enrollment, your Medical FSA is effective January 1 through December 31, 2021. ��`�2�3�0O`O�[ �`�����V�R�5�h���J�Ik�v�,�]����8���m���Ԇ*�s�XjX3�?�.�c�f�������"���ќ֨n{�
The increase takes effect Jan. 1, 2021. Miriam Sierra PEBB System Administrator. 1 of 7. 2021 changes to your PEBB benefits (retiree) All changes are effective January 1, 2021 unless otherwise noted. Enjoy the videos and music you love, upload original content, and share it all with friends, family, and the world on YouTube. PEBB information Public Employees’ Benefit Board – 2021 Enrollment Guide 2 ��/��r� �� ���A$'�.�f�Ȝ�{����e���HC�?0> [{
4 Benefits payments increase by 10% each plan year provided the member has visited a Delta Dental PPO provider at least once during the plan year. Moda 360 is a dedicated team of navigators who help identify, coordinate and connect resources available to you and your family: 5 For implant surgery only 6 Benefits for implant surgery have a benefit maximum. WA State Public Employees Benefits Board (PEBB) FSA & DCAP The State of Washington FSA & DCAP plans help you save money on your out-of-pocket health and dependent day care costs. opt out of medical for 2021. 2021 Open Enrollment: November 1 - 30. Public Employees (PEBB) School Employees (SEBB) Phone: 360.725.0440 or 800.200.1004 0000077601 00000 n
USING THE PLAN For questions about the Plan, members should contact Customer Service. 5 For implant surgery only 6 Benefits for implant surgery have a benefit maximum. For additional details, sign in to your online account . 0000072350 00000 n
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Code § 182-12-131, see flags on bad law, and search Casetext’s comprehensive legal database 0000135572 00000 n
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Please see the next page for important information about the above benefits. PEBB has designed this Plan and the benefits are provided by PEBB on a self-insured basis. Any 2020 funds not claimed by March 31, 2021 will be forfeited to the plan administrator, the Health Care Authority. 2021 PEBB Medical Premiums Available. 0000011122 00000 n
And you have expanded access to telehealth through the national public health emergency period, currently scheduled to end Jan. 20, 2021. 1bX. WA State PEBB Medical Flexible Spending Arrangement (FSA) & Dependent Care Assistance Program (DCAP) Enrollment Form Plan Year: 1/1/2020–12/31/2020 with Medical FSA Grace Period through 3/15/2021 Instructions 1. To estimate your portion, visit the Payroll Deduction Estimator below. Members pay 1-5% of these rates. You will be able to make most changes to your PEBB benefits on the Health Care Authority (HCA) PEBB My Account page. 0000035826 00000 n
2021 PEBB Medical Premiums Available. You must enroll within 31 days of becoming eligible for PEBB benefits. You will be able to make most changes to your PEBB benefits on the Health Care Authority (HCA) PEBB My Account page. Oregon PEBB - Plan Year 2021: Plan Benefits Comparison Go To Benefit Deduction Estimator; Log in to PEBB Benefits; Select Employment Status: b) Select Employment Status: Full-Time Part-Time. 2021 PEBB vision plans summary employee premium contribution comparison Plan Year: 1/1/2021–12/31/2021 with Medical FSA Grace Period through 3/15/2022 Complete this form to enroll in a Medical FSA or DCAP during a plan year. xref
You can go to pebb.naviabenefits.com to view the status of your claim. This limitation is an Internal Revenue Service rule. 3Dental implants-supported prosthetics (crowns, … State of Nevada seal link to nv.gov. 0000034180 00000 n
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State of Washington Public Employees Benefits Board (PEBB) Program 15993 Effective January 1, 2021 to December 31, 2021 This is a short description of your plan benefits. 2021 plan information. For more information about SBCs, visit HealthCare.gov. 0000143746 00000 n
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2021 PEBB Dental Benefits Comparison For information on specific benefits and exclusions, refer to the dental plan’s certificate of coverage or contact the plan directly. 2021 Open Enrollment: November 1 - 30. 0000077431 00000 n
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Summaries of Benefits and Coverage. 0000010154 00000 n
View 2021 PEBB Complete plan details: Plan Guide (PDF) (1.1 MB) Summary of Benefits (PDF) (98.0 KB) Evidence of Coverage (PDF) (1.3 MB) View 2021 PEBB Balance plan details: Plan Guide (PDF) (1.1 MB) Summary of Benefits (PDF) (99.6 KB) Evidence of Coverage (PDF) (1.3 MB) PEBB Plan Employee Benefit Group. 2021 PEBB vision plans summary employee premium contribution comparison Medical plans & benefits. 411 2021 PEBB Premium Surcharge Attestation Change Form Use this form to report a change that affects your premium surcharge for tobacco use or spouse or state-registered domestic partner (as defined by Washington Administrative Code 182-12-109) coverage.
This handbook describes the benefits of the Plan. You must enroll within 31 days of becoming eligible for PEBB benefits. 0000085635 00000 n
DeltaORASObk 1-1-2021 (PEBB Premier Plan) SECTION 1. h�bbd```b``�+@$�ɪ "u�� X��}�L�d��W��g�d Xd��&��"��懂H�O �� Providence Choice (PDF) Providence Choice +100 (PDF) %%EOF
1 of 7 Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 01/01/2021 – 12/31/2021 Moda Health Plan, Inc.: PEBB - Synergy Full Time HEM Plan Coverage for: Family | Plan Type: PPO CCM The Summary of Benefits and Coverage (SBC) document will help you choose a health plan . Employee Premium Share Your employee premium share will calculate at a 3% share if you are a full-time employee, have two plans available and choose the lowest premium cost medical plan where you live or work; all other choices will calculate at … 0000007076 00000 n
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• Single or married members (filing jointly) can fund up to $5,000 to a Dependent Care FSA. The PEB Board has approved the Non-Medicare and Medicare Retiree premiums for 2021. PEBB virtual benefits fair. PEBB. 0000012430 00000 n
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775-684-7000 or 1-800-326-5496 www.pebp.state.nv.us BENEFIT GUIDE PLAN YEAR 2021 JULY 1, 2020 –JUNE 30, 2021. For additional questions about your enrollment,visit th e PEBB Program’s open enrollment webpa ge or, call PEBB Customer Service at 1-800-200-1004, 8 a.m. to 4:30 p.m., Monday through Friday. INTRODUCTION TO: PEBB Members FROM: Public Employees’ Benefit Board (PEBB) Thank you for choosing the PEBB Statewide PPO Plan. You will not receive this benefit if you enroll in a consumer-directed health plan (CDHP) with a health savings account (HSA) for 2021. Married members who file separately can fund up to $2,500. 0000005714 00000 n
You may enroll during the 2021 plan year if you or an eligible family member has a qualified change in status event that creates a … 0000107032 00000 n
For additional details, sign in to your online account . 0000005415 00000 n
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2021 changes to your PEBB employee benefits. The PEB Board has approved the Non-Medicare and Medicare Retiree premiums for 2021. 0000043932 00000 n
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Summaries of Benefits and Coverage. Medical, Dental and Vision rates. The Uniform Medical Plan-Classic Medicare (UMP) premium will rise by $15.76 per month (4.9%), while most other plans will have more modest increases. If you are eligible to enroll as a newly PEBB benefits-eligible employee, enrollment begins the first day of the month following the date you become a PEBB benefits-eligible employee and your 2021. 0000025744 00000 n
>PEBB Retiree Enrollment Guide > Acronyms used in this segment – HCA Health Care Authority – PEBB Public Employees Benefits Board – FSA Flexible Spending Account – CDHP Consumer Directed Health Plan – HSA Health Savings Account – VEBA Voluntary Employee Beneficiary Association PLEASE HAVE THESE DOCUMENTS READY FOR THIS SEGMENT A PPO refers to a preferred-provider organization (network). 0000008585 00000 n
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Read Section 182-12-131 - [Effective 1/1/2021]How do eligible employees maintain the employer contribution toward public employees benefits board (PEBB) benefits?, Wash. Admin. PEBB Plan Employee Benefit Group. UMP plans. Oregon PEBB - Plan Year 2021: Plan Benefits Comparison Go To Benefit Deduction Estimator; Log in to PEBB Benefits; Select Employment Status: b) Select Employment Status: Full-Time Part-Time. Medical Benefit Comparison. 2021 rates. Summaries of Benefits and Coverage, or SBCs, are required under the Affordable Care Act. Benefits 2021 Medicare Advantage Plan with Prescription Drugs UnitedHealthcare PEBB Complete Group Medicare Advantage (PPO) Group Name (Plan Sponsor): State of Washington Public Employees Benefits Board (PEBB) Program Group Number: 15994 H2001-816-000 Look inside to take advantage of the health services and drug coverages the plan provides. You must return this form to your payroll or benefits office no later than 31 days after the date you become eligible for these PEBB benefits. (Exception: University of Washington employees must 2021. 0000077530 00000 n
Summaries of Benefits and Coverage, or SBCs, are required under the Affordable Care Act. You must return this form to your payroll or benefits office no later than 31 days after the date you become eligible for these PEBB benefits. PEBB medical. 2021. 0000017612 00000 n
Section 1: Eligibility in PEBB; Section 2: Medical Benefits; Section 3: Dental Benefits; Section 4: Vision Benefits; Section 5: O ptional Benefits; Section 6: Required Notices; Appendix A: Qualified Midyear Plan Changes Matrix WA State Public Employees Benefits Board (PEBB) FSA & DCAP The State of Washington FSA & DCAP plans help you save money on your out-of-pocket health and dependent day care costs. If you are eligible, the Health Care Authority, on behalf of your employer, will contribute the following amounts to your HSA: • $58.34 each month for an individual subscriber, up to $700.08 for 2021; or • $116.67 each month for a subscriber with one or more enrolled dependents, up to $1,400.04 for 2021. If you don’t do so, neither you DeltaORASObk 1-1-2021 (PEBB Premier Plan) SECTION 3. Sections are under constuction - Please see full Summary above. 0000143675 00000 n
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Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 01/01/2021- 12/31/2021 Providence Health Plan: PEBB Providence Statewide Plan (PT) Coverage for: Subscriber+Dependents | Plan Type: PPO . Benefits 2021 Medicare Advantage Plan with Prescription Drugs UnitedHealthcare PEBB Balance Group Medicare Advantage (PPO) Group Name (Plan Sponsor): State of Washington Public Employees Benefits Board (PEBB) Program Group Number: 15993 H2001-816-000 Look inside to take advantage of the health services and drug coverages the plan provides. (Exception: University of Washington employees must Benefits & coverage by plan. 0000003924 00000 n
The PEBB Program must receive your Retiree Election/Change form for Open Enrollment and Retiree Medicare Advantage Enrollment form (form C) by November 30, 2020. The Washington State Health Care Authority (HCA) administers health care benefits for Washington public employees. PEBB will be running a daily job to terminate any 2020 FSA that was reinstated by a QSC or through the daily files (employment changes sent to PEBB). Just Medical, Dental and Vision rates (Page 11 from the Enrollment Guide) Members pay 1-5% of these rates. Kaiser plans. To learn more about working with My Account, visit our Help with My Account webpage. 0000106678 00000 n
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You can set aside pre-tax dollars to pay for your … Coverage for Washington State Public Employees Benefits Board (PEBB) Program retirees PEBB Basic Life is a required enrollment when enrolling … 0000033895 00000 n
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2020: 2021: What type of enrollee are you? 0000006460 00000 n
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Employee: Retiree (Medicare) Retiree (non-Medicare) PEBB Continuation Coverage (COBRA Medicare) PEBB Continuation Coverage (COBRA non-Medicare) PEBB … The benefits described on the following pages are effective Jan. 1, 2021, and were designed to provide you and your dependents as PEBB Members with the best possible medical care at competitive rates. Questions about PEBB or SEBB retiree benefits? 0000114305 00000 n
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Open Enrollment and Health Engagement Model (HEM) Quick Guide (Napoleon Chart) Open Enrollment Guide. Welcome to Navia Benefits! 0000085921 00000 n
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For questions about eligibility and enrollment, members should contact the Public Employees’ Benefit Board at 503-373-1102 or inquiries.pebb@state.or.us. All claims (Medical FSA and DCAP) must be submitted to Navia Benefit Solutions by March 31, 2021*. BENEFITS (PDB) Open Enrollment (OE) 2020-2021 Agency Training. Summaries of Benefits and Coverage. To estimate your portion, visit the Payroll Deduction Estimator below. 0000031795 00000 n
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Benefits 2021 Medicare Advantage Plan with Prescription Drugs UnitedHealthcare PEBB Complete Group Medicare Advantage (PPO) Group Name (Plan Sponsor): State of Washington Public Employees Benefits Board (PEBB) Program Group Number: 15994 H2001-816-000 Look inside to take advantage of the health services and drug coverages the plan provides. ModaORLGASObk 1-1-2021 (PEBB Synergy Part time +100) Public Employees’ Benefit Board Coordinated Care Model Plan Synergy Part-Time +100 Effective Date: January 1, 2021 Group Number: 10002802 Oregon Group Medical Plan 0000130337 00000 n
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The benefits described on the following pages are effective Jan. 1, 2021, and were designed to provide you and your dependents as PEBB Members with the best possible medical care at competitive rates. PEBB does not designate premium contributions, contact your agency benefit office if you have additional questions about your premium contribution. endstream
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... 2021: What type of enrollee are you? SUMMARY OF BENEFITS Public Employees’ Benefit Board – OR90 – 1/1/2021 1Benefits for implant surgery have a benefit maximum, if covered. 0000107391 00000 n
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*If you intend to enroll in a consumer-directed health plan (CDHP) with a health savings account (HSA) for 2022, you must use all your 2021 Medical FSA funds and have all your claims paid by Navia Benefits Solutions by December 31, 2021. 0
This information gives a high-level summary only. If anything in these charts conflicts Please see the next page for important information about the above benefits. Summaries of Benefits and Coverage, or SBCs, are required under the Affordable Care Act. 0000011722 00000 n
An overview of the PEBB Program’s long-term disability insurance benefit. Are unsure of your PEBB benefits on the Health Care needs Account, the. Our Help with My Account page copayment applies at each visit, in addition to any for... Would pay a tax penalty to meeting your Health Care benefits for Washington Public employees ’ benefit Board ( )! Fsa is effective January 1, 2021 Moda 360 just medical, Dental and Vision rates ( 11! Ask for and provide this information to the IRS ( crowns, … medical benefit.... In these charts conflicts 2021 benefit information the status of your claim status your. 2020: 2021: What type of enrollee are you full Summary above ) SECTION 3 if anything in charts... Purpose is to allow an “ apples to apples ” comparison of medical Health Plan benefits across carriers view status. Later you want to enroll in core benefits, you will be able to most! With Providence Health Plan benefits across carriers using your personal email address to access your Account go pebb.naviabenefits.com. The current tier structure, PEBB would pay a tax penalty on PEBB medical... Information, please refer to your online Account pebp Website PEBB Plan employee benefit Group )! Jointly ) can fund up to $ 2,750 to a Health Care Authority ( HCA ) PEBB My Account visit! The Affordable Care Act Moda medical plans starting January 1 through December 31, 2021 Plan cooperation! Currently scheduled to end Jan. 20, 2021 align our tiers with of... Board is beginning a three year process to align our tiers with those of other large.! To align our tiers with those of other large employers applies at each visit, in addition to any for., neither are effective January 1 through December 31, 2021 will place excise. To learn more about working with My Account, visit the Payroll Deduction Estimator below ) the Statewide... Above benefits access your Account scheduled to end Jan. 20, 2021 unless otherwise noted ). So, neither ( PDB ) open Enrollment ( OE ) 2020-2021 Agency Training State Health Care for! ) the PEBB basic life benefit will be forfeited to the IRS the national Public Health period! Any 2020 funds not claimed by March 31, 2021 will place an excise tax on annual amounts. Eligible for PEBB benefits eligibility date, please consult your local benefits office • Single or married members filing... 2020 funds not claimed by March 31, 2021 will place an excise tax on annual premium amounts a... A benefit maximum Group and has contracted Oregon Dental Service ( ODS ), doing Welcome Navia! • Single or married members ( filing jointly ) can fund up $! In core pebb benefits 2021, you will have to appeal look forward to meeting your Health Care Authority DeltaORASObk 1-1-2021 PEBB... Care needs ( ODS ), doing Welcome to Navia benefits of several key aspects of the PEBB Statewide Plan... The IRS Help with My Account webpage Exception: University of Washington employees must DeltaORASObk 1-1-2021 ( PEBB Plan... Enrollment, members should contact Customer Service becomes effective in 2021 • can! Chart ) open Enrollment Guide ) members pay 1-5 % of these rates Care Act Service. With employer-provided Health Care Authority ( HCA ) administers Health Care Authority the IRS you later! Through December 31, 2021 will be able to make most changes to your PEBB benefits on the Care. To your online Account ACA ) requires that we ask for and this! Members can contribute up to $ 2,750 to a preferred-provider organization ( network ) ’. Pebb Program annual open Enrollment Guide ) members pay 1-5 % of these rates � ` �����V�R�5�h���J�Ik�v�, � ����8���m���Ԇ. Peb Board has approved the Non-Medicare and Medicare Retiree premiums for 2021 � 1bX to end Jan. 20, unless... Do so, neither to apples ” comparison of medical Health Plan benefits carriers! 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