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 Surcharge when Spouse/Partner Waives Other Employer Coverage

Some couples in our group include one person who works for the state and one who works for a different employer that also offers group health benefits. Some of these couples decide to waive (forgo) coverage through the other employer and take coverage only through PEBB.

This decision is usually based on personal economics. Compared with other employer plans, PEBB typically offers more comprehensive coverage at lower member costs.

But waiving coverage offered by the other employer shifts total health risks and associated costs to PEBB, when they could be shared more broadly across other group plans.

So, when a member’s spouse or domestic partner waives coverage in another employer’s group plan for coverage only in PEBB, the member has $50 deducted from his or her monthly pay to balance the risks and costs to our group.

If the spouse/partner loses access to that other group coverage (for example, loses their job with that other employer), the member can submit a midyear change form to have the surcharge end.