Open Enrollment Update: “Family with Eligible Spouse” is now called “Family with Spousal Surcharge” to help eliminate confusion for our members who are subject to the spousal surcharge. If you previously submitted a Spousal Surcharge Affidavit, and your status has not changed, you do not need to submit a new affidavit during this open enrollment.  Your previous affidavit remains in effect.

​PEIA is required by law to apply a monthly spousal surcharge to active employees of State agen​cies, colleges, universities, and county boards of education if your spouse is eligible for employer-sponsored coverage through his/her employer, and has PEIA coverage. The spousal surcharge will be added to health insurance premiums each month. If your spouse is eligible for coverage as an employee of a PEIA-participating agency, has Medicare, Medicaid, TRICARE or is retired, the spousal coverage surcharge does not apply.

If both spouses are public employees, the surcharge does not apply, but you may need to act to avoid the surcharge.  If the spouse who is not the health policyholder has Basic Life insurance, you do not need to complete a Spousal Surcharge Affidavit.  If the spouse who is not the health policyholder DOES NOT have Basic Life insurance, you must complete a Spousal Surcharge Affidavit to avoid paying the surcharge.  If you previously submitted a Spousal Surcharge Affidavit, and your status has not changed, you do not need to submit a new affidavit during​ open enrollment.  Your previous affidavit remains in effect.​

​​If your spouse’s coverage status changes - spouse loses or obtains health coverage through their employer, you must report the change in writing to PEIA during the month the change occurs or the two following months. Failure to notify PEIA in a timely manner will result in your being billed for any additional spouse surcharge due, and no refunds will be granted.  If you remove your spouse from your PEIA coverage, that loss of coverage is a qualifying event for your spouse to add coverage under his/her employer’s coverage.  PEIA can provide you documentation of the termination of coverage, just call us at 1-888-680-7342.  If your spouse drops coverage from their employer, that is a qualifying event to add them to your coverage, but the spousal surcharge will apply.​​

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