PEBB Surcharge FAQ Updated

The surcharge FAQ posted on the PEBB website will be updated with the following information:

The October 2013 For Your Benefit newsletter says that subscribers will have to pay a $50 surcharge if they cover a spouse or state-registered domestic partner who has waived enrollment in other employer-sponsored coverage that is comparable to PEBB. How can an employee determine if their spouse or partner’s coverage is comparable to PEBB’s?

The legislation requires the PEBB Program to add “…a surcharge of not less than $50 per month to the premiums due from employees who cover a spouse or domestic partner where the spouse or domestic partner has chosen not to enroll in other employer-based group health insurance that has benefits and premiums with an actuarial value of not less than 95 percent of the actuarial value of the public employees’ benefits board (PEBB) plan with the largest enrollment.”

We will compare the 95% actuarial value standard for other employer-based group health insurance to Uniform Medical Plan (UMP) Classic, which is the PEBB plan with the largest enrollment.
HCA staff are working on a tool to help employees determine if their spouse or domestic partner’s employer-based benefits are within the 95% actuarial value of UMP Classic’s benefits. The tool will be available within the next few months.

Additionally, the premium charged by the spouse or domestic partner’s employer must be below $84.55 per month to qualify for the $50 surcharge.  For calendar year 2014, employees will pay $89 per month in premiums to cover a spouse or domestic partner on UMP Classic. Therefore, if the spouse or domestic partner would pay more than $84.55 ($89 x 95%) per month for health insurance premiums, then the $50 surcharge would not apply to the employee.

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Page Updated 12.19.2013