Current through Register Vol. 24-18, September 15, 2024
(1)
When a National Medical Support Notice (NMSN) requires a subscriber to provide
health plan coverage for a dependent child the following provisions apply:
(a) The subscriber may enroll their dependent
child and request changes to their health plan coverage as described under
subsection (c) of this section. Employees submit the required forms to their
employing agency. All other subscribers submit the required forms to the public
employees benefits board (PEBB) program.
(b) If the subscriber fails to request
enrollment or health plan coverage changes as directed by the NMSN, the
employing agency or the PEBB program may make enrollment or health plan
coverage changes according to (c) of this subsection upon request of:
(i) The child's other parent; or
(ii) Child support enforcement
program.
(c) Changes to
health plan coverage or enrollment are allowed as directed by the NMSN:
(i) The dependent will be enrolled under the
subscriber's health plan coverage as directed by the NMSN;
(ii) An employee who has waived PEBB medical
under WAC
182-12-128 will be enrolled in
medical as directed by the NMSN, in order to enroll the dependent;
(iii) The subscriber's selected health plan
will be changed if directed by the NMSN;
(iv) If the dependent is already enrolled
under another PEBB subscriber, the dependent will be removed from the other
health plan coverage and enrolled as directed by the NMSN;
(v) If the dependent is enrolled in both
school employees benefits board medical and PEBB medical as a dependent as
described in WAC
182-12-123 (6)
(f) and there is a NMSN in place, enrollment
will be in accordance with the NMSN; or
(vi) If the subscriber is eligible for and
elects Consolidated Omnibus Budget Reconciliation Act (COBRA) or other
continuation coverage, the NMSN will be enforced and the dependent must be
covered in accordance with the NMSN.
(d) Changes to health plan coverage or
enrollment as described in (c)(i) through (iii) of this subsection will begin
the first day of the month following receipt by the employing agency or the
PEBB program of the NMSN. If the NMSN is received on the first day of the
month, the change to health plan coverage or enrollment begins on that day. A
dependent will be removed from the subscriber's health plan coverage as
described in (c)(iv) of this subsection the last day of the month the NMSN is
received. If that day is the first of the month, the change in enrollment will
be made the last day of the previous month.
(2) When a NMSN requires a spouse, former
spouse, or other individual to provide health plan coverage for a dependent who
is already enrolled in PEBB coverage, and that health plan coverage is in fact
provided, the dependent may be removed from the subscriber's PEBB health plan
coverage prospectively.
Statutory
Authority:
RCW
41.05.160 and
2012 2nd sp.s. c
3 . WSR 13-22-019 (Admin. 2013-01),
§182-12-263, filed 10/28/13, effective 1/1/14. Statutory Authority:
RCW
41.05.160. WSR 12-20-022 (Order 2012-01),
§182-12-263, filed 9/25/12, effective 11/1/12. WSR 13-21-033,
§182-12-263, filed 10/9/2013, effective
11/9/2013
