WebForms & Documents The following forms and documents are available for you to download in PDF format. Current Plan Year 2024 Mid-Year Enrollment Form Enrollment Form for newly eligible participants enrolling in a 2024 Medical FSA, Limited Purpose FSA, or DCAP. Medical FSA, Limited Purpose FSA, and DCAP 2024 Claim Form Claim form for the […] WebThe PEBB Program offers two kinds of LTD insurance: ... Mail to Standard Insurance Company at PO Box 2800, Portland OR, 97208-2800, or; Fax the forms to 1-888-878-3686. Learn more about the employer process for filing an LTD claim in the LTD Administration Manual. Related rules.
Group Basic Life Insurance - standard.com
WebApr 14, 2024 · Certified Peer Counselor Training Services Washington State Health Care Authority. Free or low-cost health care. Employee & retiree benefits. Billers, providers & partners. About HCA. Contact. Home. About the Health Care Authority (HCA) Submitted by Peter.Raines on Fri, 04/14/2024 - 15:45. WebComplete the PEBB Retiree Election form to enroll in or defer retiree coverage: 60 days after their employer-paid, COBRA, or Continuation Coverage (Unpaid leave) ends. The employee may lose the right to enroll in or defer PEBB retiree insurance coverage in the future. Mail, hand-deliver, or fax the Retiree Election form to the HCA. can woodpecker damage roof
Employee worksheets Washington State Health Care Authority
http://www.peba.sc.gov/insurance-plans/standard-plan WebTo determine if you are eligible for Optional Life insurance, and for more information about … WebStandard. Retirees are not required to be insured for Basic Life through The Standard • An active employee of a PEBB participating organization as defined in Oregon Administrative Rules (OAR) 101-010-0005 regularly scheduled to work, who meets the terms of eligibility for insurance outlined in the Public bridgwater equitix