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Enrollment Information

 
 

Open Enrollment corrections can be made until February 29, 2020. Click on the Forms link below to find the Open Enrollment & Correction Form. 

  1. Members with active employment and actively enrolled in a Medical plan must complete the Open Enrollment process by 10/31/19. Agencies have until 11/13/19 to input any OE forms received no later than 10/31/19.

  2. Members who do not actively enroll during Open Enrollment will:
    • Default to the benefit elections they had for 2019, and will move from any 'standard deductible medical plan' to the higher deductible (not premium) medical plan as a HEM Non-Participant. All enrolled eligible dependents will follow.
      • This action is: Not Correctable
    • 2019 MODA Summit enrollees will default to the MODA Synergy higher deductible plan. All enrolled eligible dependents will follow.
      • Plan change is: Correctable
      • Higher deductible is: Not Correctable
    • If enrolled in an Optional life plan, move to the “Tobacco” user Optional life plan tier (both Employee and Spouse/Partner are affected).
      • This action is: Correctable
    • Tobacco use status will be changed to: Both my Spouse/Partner and I currently use tobacco.
      • This action is: Correctable
    • Other Employer Group coverage will be changed if the member has an existing Spouse or Partner enrolled in the Medical plan to: My Spouse/Partner has other employer group coverage available and waives that coverage.
      • This action is: Correctable
FSA Corrections can be made until December 20, 2019, IF you did not complete Open Enrollment, then you are not eligible to enroll in or make corrections to a FSA. Click on the Forms link below to find the FSA Open Enrollment & Correction Form. 

2020 Enrollment Resources

PEBB Reminders

www.PEBBreminders.com

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