Eligibility for insurance

Eligible UW employees are offered insurance through the Public Employees Benefits Board (PEBB) program, which is administered by the Washington State Health Care Authority (HCA). PEBB purchases and coordinates the health insurance benefits for all state employees, including UW employees. Below is a summary of how PEBB eligibility rules impact various employee groups.

Employee

Academic staff, professional, and classified staff and librarians are eligible for PEBB insurance if they are appointed to an eligible job class that is at least an average of 80 hours per month (480 hours) UW salaried per month and the appointment is expected to continue for more than six months.

If you do not meet the immediate eligibility listed above you can obtain eligibility in one of two ways.

You’re eligible beginning your first full month of employment following your start date when your job description initially includes a planned worked schedule that meets the eligibility criteria.
You work enough hours to meet the eligibility criteria during a period of six consecutive months (does not have to be your initial six months of work). Then, you’ll become eligible starting the month immediately following the six consecutive months during which you met the eligibility criteria. (You must work at least eight hours into your seventh month to maintain eligibility).

Your hours worked at UW are monitored and you will be notified when you become eligible for PEBB benefits by an electronic notice sent via Workday to your UW email address. Note: student employment is not eligible for consideration toward faculty and staff benefits.

Faculty (as defined in WAC 182-12-109)

Faculty eligibility rules are complex and depend on the nature of your appointment. Please note that if you are paid directly from a non-UW entity your benefits eligibility may be affected:

Faculty with a 9 through 12 month appointment are eligible for PEBB insurances at the beginning of their appointment, if the appointment is 50 percent or more paid through UW.

Faculty with a quarter-to-quarter appointment who are in a UW paid appointment of at least 50 percent or more are eligible for PEBB insurance on the first day of the month following the start of their second consecutive academic quarter.

Faculty with a one quarter appointment who are in a UW paid appointment of at least 50 percent or more, and who at any time during the last 12 months were eligible under faculty rules at the UW or another Washington state higher education institution, are eligible for PEBB benefits on the first day of the month in which the academic quarter begins. Under PEBB rules, you are required to notify the UW of the prior period of employment in a timely way in order to establish your eligibility. Failure to notify UW may result in loss of eligibility.

Faculty who had an appointment of one or more quarters during each of the preceding two academic years (beginning with summer quarter) and who on average received 50 percent or more of their pay from UW, are eligible for PEBB benefits on the first day of the month following the start of the academic quarter. If you are paid directly from a non-UW entity your benefits eligibility may be affected. You are required to notify UW in a timely way of your prior employment at UW or other Washington state higher education institutions in order to establish your eligibility. Failure to notify UW may result in loss of eligibility.

Spouse and partner

If you’re enrolled in PEBB insurance, you can enroll your spouse or partner in the same plan. This includes your lawful spouse or your state-registered domestic partner. You can find guidance here on valid dependent verification documentation that must be submitted with enrollment .

Dependent child or children

If you’re enrolled in PEBB insurance, you can enroll your dependent child in the same plan until your child turns 26.

Your child is defined as your biological child, stepchild, legally adopted child, child whom you’ve assumed legal obligation in anticipation of adoption, partner’s child, child as specified by court order, or child defined in Washington statutes.

A child may also include an extended dependent in your spouse’s or partner’s legal custody or guardianship. Extended dependent coverage requires approval by the state Health Care Authority.

A child of any age with a developmental disability or physical handicap is eligible as long as the child’s condition occurred before age 26. The child must be incapable of self-sustaining employment and chiefly dependent upon the employee for support.

File an appeal of eligibility

You may appeal an eligibility determination in writing within 30 days of receiving an eligibility notice. You’ll need to complete an appeal form and note the specific reasons for your appeal.

If you need more information about the appeal process, see file an appeal on the PEBB website. You’ll need to send your appeal form to UW Benefits for a first-level review, not the Health Care Authority.