Current through Register Vol. 24-18, September 15, 2024
The employer contribution toward public employees benefits
board (PEBB) benefits begins as described in WAC
182-12-114. This section
describes under what circumstances employees maintain eligibility for the
employer contribution toward PEBB benefits.
(1)
Maintaining the employer
contribution. Except as described in subsections (2), (3), and (4) of
this section, employees who have established eligibility for benefits as
described in WAC
182-12-114 are eligible for the
employer contribution each month in which they are in pay status eight or more
hours per month.
(2)
Maintaining the employer contribution - Benefits-eligible seasonal
employees.
(a) Benefits-eligible
seasonal employees (eligible as described in WAC
182-12-114(2))
who work a season of less than nine months are eligible for the employer
contribution in any month of the season in which they are in pay status eight
or more hours during that month. The employer contribution toward PEBB benefits
for seasonal employees returning after their off season begins on the first day
of the first month of the season in which they are in pay status eight hours or
more.
(b) Benefits-eligible
seasonal employees (eligible as described in WAC
182-12-114(2))
who work a season of nine months or more are eligible for the employer
contribution:
(i) In any month of the season
in which they are in pay status eight or more hours during that month;
and
(ii) Through the off season
following each season worked, but the eligibility may not exceed a total of 12
consecutive calendar months for the combined season and off
season.
(3)
Maintaining the employer contribution - Eligible faculty.
(a) Benefits-eligible faculty anticipated to
work half time or more the entire instructional year or equivalent nine-month
period (eligible as described in WAC
182-12-114
(3)(a)(i)) are eligible for the employer
contribution each month of the instructional year, except as described in
subsection (7) of this section.
(b)
Benefits-eligible faculty who are hired on a quarter/semester to
quarter/semester basis (eligible as described in WAC
182-12-114
(3)(a)(ii)) are eligible for the employer
contribution each quarter or semester in which employees work half-time or
more.
(c) Summer or
off-quarter/semester coverage: All benefits-eligible faculty (eligible as
described in WAC
182-12-114 (3)(a) and
(b)) who work an average of half-time or more
throughout the entire instructional year or equivalent nine-month period and
work each quarter/semester of the instructional year or equivalent nine-month
period are eligible for the employer contribution toward summer or
off-quarter/semester PEBB benefits.
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Exception:
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Eligibility for the employer contribution toward
summer or off-quarter/semester PEBB benefits ends on the end date specified in
an employing agency's termination notice or an employee's resignation letter,
whichever is earlier, if the employing agency has no anticipation that the
employee will be returning as faculty at any institution of higher education
where the employee has employment. If the employing agency deducted the
employee's premium for PEBB insurance coverage after the employee was no longer
eligible for the employer contribution, PEBB benefits end the last day of the
month for which employee premiums were deducted.
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(d)
Two-year averaging: All benefits-eligible faculty (eligible as described in WAC
182-12-114 (3)(a) and
(b)) who worked an average of half-time or
more in each of the two preceding academic years are potentially eligible to
receive uninterrupted employer contribution toward PEBB benefits. "Academic
year" means summer, fall, winter, and spring quarters or summer, fall, and
spring semesters and begins with summer quarter/semester. In order to be
eligible for the employer contribution through two-year averaging, the faculty
must provide written notification of their potential eligibility to their
employing agency or agencies within the deadlines established by the employing
agency or agencies. Faculty continue to receive uninterrupted employer
contribution for each academic year in which they:
(i) Are employed on a quarter/semester to
quarter/semester basis and work at least two quarters or two semesters;
and
(ii) Have an average workload
of half-time or more for three quarters or two semesters.
Eligibility for the employer contribution under two-year
averaging ceases immediately if the eligibility criteria is not met or if the
eligibility criteria becomes impossible to meet.
(e) Faculty who lose eligibility for the
employer contribution: All benefits-eligible faculty (eligible as described in
WAC 182-12-114 (3)(a) and
(b)) who lose eligibility for the employer
contribution will regain it if they return to a faculty position where it is
anticipated that they will work half-time or more for the quarter/semester no
later than the twelfth month after the month in which they lost eligibility for
the employer contribution. The employer contribution begins on the first day of
the month in which the quarter/semester begins.
(4)
Maintaining the employer
contribution - Employees on leave and under the special circumstances listed
below.
(a) Employees who are on
approved leave under the federal Family and Medical Leave Act (FMLA) or the
paid family and medical leave program continue to receive the employer
contribution as long as they are approved under the act.
(b) Unless otherwise indicated in this
section, employees in the following circumstances receive the employer
contribution only for the months they are in pay status eight hours or more:
(i) Employees on authorized leave without
pay;
(ii) Employees on approved
educational leave;
(iii) Employees
receiving time-loss benefits under workers' compensation;
(iv) Employees called to active duty in the
uniformed services as defined under the Uniformed Services Employment and
Reemployment Rights Act (USERRA); or
(v) Employees applying for disability
retirement.
(5)
Maintaining the employer contribution - Employees who move from an
eligible to an otherwise ineligible position due to a layoff maintain
the employer contribution toward PEBB benefits as described in WAC
182-12-129.
(6)
Employees who are in pay status
less than eight hours in a month. Unless otherwise indicated in this
section, when there is a month in which employees are not in pay status for at
least eight hours, employees:
(a) Lose
eligibility for the employer contribution for that month; and
(b) Must reestablish eligibility for PEBB
benefits as described in WAC
182-12-114 in order to be
eligible for the employer contribution again.
(7)
The employer contribution toward
PEBB benefits ends in any one of these circumstances for all employees:
(a) When employees fail to maintain
eligibility for the employer contribution as indicated in the criteria in
subsections (1) through (6) of this section.
(b) When the employment relationship is
terminated. As long as the employing agency has no anticipation that the
employee will be re-hired, the employment relationship is terminated:
(i) On the date specified in an employee's
letter of resignation; or
(ii) On
the date specified in any contract or hire letter or on the effective date of
an employer-initiated termination notice.
(c) When employees move to a position that is
not anticipated to be eligible for PEBB benefits as described in WAC
182-12-114, not including changes
in position due to a layoff.
(d)
The employer contribution toward PEBB benefits cease for employees and their
enrolled dependents the last day of the month in which employees are eligible
for the employer contribution under this section.
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Exception:
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If the employing agency deducted the employee's
premium for PEBB insurance coverage after the employee was no longer eligible
for the employer contribution, PEBB benefits end the last day of the month for
which employee premiums were deducted.
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(8)
Options for continuation coverage
by self-paying. During temporary or permanent loss of the employer
contribution toward PEBB benefits, employees have options for providing
continuation coverage for themselves and their dependents by self-paying the
premium and applicable premium surcharges set by the health care authority
(HCA). These options are available as described in WAC
182-12-133,
182-12-141,
182-12-142,
182-12-146,
182-12-148, and
182-12-270.
Statutory
Authority:
RCW
41.05.160 and
2012 2nd sp.s. c
3 . WSR 13-22-019 (Admin. 2013-01),
§182-12-131, filed 10/28/13, effective 1/1/14. Statutory Authority:
RCW
41.05.160. WSR 12-20-022 (Order 2012-01),
§182-12-131, filed 9/25/12, effective 11/1/12. Statutory Authority:
RCW
41.05.160 and
2011 c
8 . WSR 11-22-036 (Order 11-02), §182-12-131,
filed 10/26/11, effective 1/1/12. Statutory Authority:
RCW
41.05.160. WSR 10-20-147 (Order 10-02),
§182-12-131, filed 10/6/10, effective 1/1/11; WSR 09-23-102 (Order 09-02),
§182-12-131, filed 11/17/09, effective 1/1/10; WSR 07-20-129 (Order
07-01), §182-12-131, filed 10/3/07, effective 11/3/07. Statutory
Authority:
RCW
41.05.160 and
41.05.165. WSR 04-18-039,
§182-12-131, filed 8/26/04, effective 1/1/05. WSR 13-21-033,
§182-12-131, filed 10/9/2013, effective
11/9/2013
