PEBB Benefits Eligibility
Non-student temporary hourly employees (NSTE) can become eligible for PEBB benefits in the following ways:
At the Time of the Initial Appointment: If, at the time of initial appointment, it is known that an NSTE is anticipated to work for more than a six-month consecutive period, and average at least 80 hours per month with at least eight hours in each month, they may become eligible for benefits as of the beginning of the appointment. (WAC 182-12-114(1)(a)(i)).
Based on Work Pattern or Change in Work Pattern: If it is unknown or not anticipated at the time of the initial appointment that an NSTE will meet the above criteria, but 1) their appointment is later modified or 2) the employee’s actual work pattern ends up meeting the criteria, the employee may become benefits eligible at that time. At WSU, this is referred to as the 480/6 month criteria, which reflects a work pattern in which an NSTE has worked more than a consecutive six-month period, and averaged at least 80 hours per month with at least eight hours in each month. (WAC 182-12-114(1)(a)(ii-iii)). In other words, any NSTE who has worked 480 hours (80 x 6 months) in a consecutive six-month period, with eight hours of pay in each of the months will be eligible for insurance benefits beginning the seventh month of continuous employment.
After establishing eligibility in the above two scenarios, if an employee does not work a minimum of eight hours in any month, the employee will lose benefit eligibility and must re-establish eligibility.
Recurring Seasonal Employment: NSTE who work performing similar type work on a recurring seasonal basis, who average at least 80 hours per month with at least eight hours in each month of the season, may become eligible. (WAC 182-12-114(2)). A season is identified as a period as short as three consecutive months that occurs on a recurring annual basis.
After establishing eligibility, employees will be eligible for benefits during the recurring seasonal period, provided they work each season performing similar work. In the event there is a season in which the employee does not work, or the work is substantially different, the employee will lose benefit eligibility and must re-establish eligibility. Employees who become eligible will be able to self-pay for their coverage during the off season.
Appeals & Review Process: HRS will notify employees of any changes in eligibility and employees have the right to ask HRS to re-evaluate their benefit eligibility at any time. Employees have 30 days from the decision date to appeal eligibility decisions made through the PEBB Appeals Process. The appeals process and forms are available by contacting HRS.
Non-student temporary hourly employees (NSTE) who work at least 70 hours per month for five months, in the preceding 12-month period, become eligible for retirement participation with the Washington State Department of Retirement Systems.
NSTE will be initially enrolled in the Public Employee Retirement System (PERS) Plan 2, and will be given 90 days to elect permanent participation with either PERS Plan 2 or PERS Plan 3.