WebMidyear Change Form Qualified Status Change (QSC) Office use only Approved by: Approved date: Effective date: See the Summary Plan Description and the QSC Matrix at www.pebbinfo.com. Section 1: Employee information PEBB benefit number (P#####), OR#, University ID or Lottery ID Gender c M c F c Other Last name First name M.I. WebStarting January 1, 2024, UMP will transfer certain medical and prescription drug accumulators, such as deductibles and out-of-pocket limits, for the existing plan year when subscribers and their enrolled dependents change between the PEBB Program and the SEBB Program during a special open enrollment and stay with UMP.
2024 Open Enrollment - PEBB
Web1. Because I experienced a qualified midyear change, I want to: Add an individual to coverage Remove an individual from coverage (complete Section 5) Change my current plan enrollments 2. Contact Information You must complete all fields. PEBB Benefit Number (P#####), OR# or University ID Last Name First Name M Agency Gender M F WebPublic Employees’ Retirement System (PERS) Plan 2 PERS Plan 2 is a lifetime retirement pension plan available to public employees in Washington. You and your employer contribute a percentage of income to fund the plan. Your contributions PERS Plan 2 employee contribution rate: 6.36% cheap guitar amp
PEBB Continuation Coverage Washington State Health Care …
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