(Effective Until January 1, 2009.)
WAC 182-12-133
What options for continuing coverage are
available to employees when they are no longer eligible for
PEBB insurance coverage paid for by their employer? Eligible
employees covered by PEBB insurance coverage have options for
providing continued coverage for themselves and their
dependents during temporary or permanent loss of eligibility.
Except in the case of approved family and medical leave, and
except as otherwise provided, only employees in pay status
eight or more hours per month are eligible to receive the
employer contribution.
(1) When an employee is on leave without pay due to an
event described in (a) through (f) of this subsection,
insurance coverage may be continued at the group rate by
self-paying premiums. Employees may self-pay for a maximum of
twenty-nine months. The number of months that an employee
self-pays premium during a period of leave without pay will
count toward the total months of continuation coverage allowed
under the federal Consolidated Omnibus Budget Reconciliation
Act (COBRA). Employees may continue any combination of
medical, dental and life insurance; however, only employees on
approved educational leave may continue long-term disability
insurance. The following types of leave qualify to continue
coverage under this provision:
(a) The employee is on authorized leave without pay;
(b) The employee is laid off because of a reduction in
force (RIF);
(c) The employee is receiving time-loss benefits under
workers' compensation;
(d) The employee is applying for disability retirement;
(e) The employee is called to active duty in the
uniformed services as defined under the Uniformed Services
Employment and Reemployment Rights Act (USERRA); or
(f) The employee is on approved educational leave.
(2) Part-time faculty and part-time academic employees
may self-pay premium at the group rate between periods of
eligibility for a maximum of eighteen months. These
employees may continue any combination of medical, dental and
life insurance.
(3) The federal Consolidated Omnibus Budget
Reconciliation Act (COBRA) gives enrollees the right to
continue medical and dental for a period of eighteen to
twenty-nine months when they lose eligibility due to one of
the following qualifying events.
(a) Termination of employment.
(b) The employee's hours are reduced to the extent of
losing eligibility.
(4) Employees who are approved for leave under the
federal Family and Medical Leave Act (FMLA) are eligible to
receive the employer contribution toward premium for up to
twelve weeks, as provided in WAC 182-12-138.
[Statutory Authority: RCW 41.05.160. 07-20-129 (Order
07-01), § 182-12-133, filed 10/3/07, effective 11/3/07;
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. 04-18-039, § 182-12-133, filed 8/26/04, effective
1/1/05.]
(Effective January 1, 2009.)
WAC 182-12-133
What options for continuing coverage are
available to employees when they are no longer eligible for
PEBB insurance coverage paid for by their employer? Eligible
employees covered by PEBB insurance coverage have options for
providing continued coverage for themselves and their
dependents during temporary or permanent loss of eligibility.
Except in the case of approved family and medical leave, and
except as otherwise provided, only employees in pay status
eight or more hours per month are eligible to receive the
employer contribution.
(1) When an employee is on leave without pay due to an
event described in (a) through (f) of this subsection,
insurance coverage may be continued at the group rate by
self-paying premiums. Employees may self-pay for a maximum of
twenty-nine months. The number of months that an employee
self-pays premium during a period of leave without pay will
count toward the total months of continuation coverage allowed
under the federal Consolidated Omnibus Budget Reconciliation
Act (COBRA). Employees may continue any combination of
medical, dental and life insurance; however, only employees on
approved educational leave may continue long-term disability
insurance. The following types of leave qualify to continue
coverage under this provision:
(a) The employee is on authorized leave without pay;
(b) The employee is laid off because of a reduction in
force (RIF);
(c) The employee is receiving time-loss benefits under
workers' compensation;
(d) The employee is applying for disability retirement;
(e) The employee is called to active duty in the
uniformed services as defined under the Uniformed Services
Employment and Reemployment Rights Act (USERRA); or
(f) The employee is on approved educational leave.
(2) Part-time faculty and part-time academic employees
may self-pay premium at the group rate between periods of
eligibility for a maximum of eighteen months. These employees
may continue any combination of medical, dental and life
insurance.
(3) The federal Consolidated Omnibus Budget
Reconciliation Act (COBRA) gives enrollees the right to
continue medical and dental for a period of eighteen to
twenty-nine months when they lose eligibility due to one of
the following qualifying events.
(a) Termination of employment.
(b) The employee's hours are reduced to the extent of
losing eligibility.
(4) Employees who are approved for leave under the
federal Family and Medical Leave Act (FMLA) are eligible to
receive the employer contribution toward premium for up to
twenty-six weeks, as provided in WAC 182-12-138.
[Statutory Authority: RCW 41.05.160. 08-20-128 (Order
08-03), § 182-12-133, filed 10/1/08, effective 1/1/09;
07-20-129 (Order 07-01), § 182-12-133, filed 10/3/07,
effective 11/3/07; 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. 04-18-039, § 182-12-133, filed
8/26/04, effective 1/1/05.]