Plan Designated Facility or Dentist: A licensed dentist or dental facility that has agreed to perform services under this plan. Primary Care Dentist (PCD): Dentist or facility that enrollee or dependent has selected. Public Employees Benefits Board (PEBB): A group of representatives, appointed by the governor, who approves insurance benefit plans for employees and their dependents, and establishes eligibility criteria for participation in insurance benefit plans. Public Employees Benefits Board (PEBB) Program: The HCA program that administers PEBB benefit eligibility and enrollment. Retired Employee of a Former Employer Group — includes a retired employee from a PEBB employer group and a retired school employee from a SEBB employer group who is continuing enrollment in PEBB health plan coverage by self-paying premiums after losing eligibility for PEBB retiree insurance coverage upon the employer group ending participation in insurance plans and contracts with the health care authority (HCA). School Employees Benefits Board (SEBB): A group of representatives, appointed by the governor, who designs and approves insurance benefit plans for school employees and their dependents, and establishes eligibility criteria for participation in insurance benefit plans. School Employees Benefits Board (SEBB) Organization: A public school district or educational service district or charter school established under Washington State statute that is required to participate in benefit plans provided by the School Employees Benefits Board (SEBB). School Employees Benefits Board (SEBB) Program: The program within HCA that administers insurance and other benefits for eligible school employees and eligible dependents. SEBB Employer group — for the School Employees Benefits Board (SEBB) Program means an employee organization representing school employees and a tribal school as defined in RCW 28A.715.010, obtaining employee benefits through a contractual agreement with the Health Care Authority (HCA) to participate in benefit plans developed by the SEB board. State agency: An office, department, board, commission, institution, or other separate unit or division, however designated, of the Washington state government. It includes the legislature, executive branch, and agencies or courts within the judicial branch, as well as institutions of higher education and any unit of state government established by law. Subscriber: Eligible employee, retiree, continuation coverage enrollee, retired employee of a former employer group, or survivor who has been determined eligible and is enrolled in this dental plan, and is the individual to whom the PEBB Program or this Plan will issue notices, information, requests, and premium bills on behalf of an Enrollee. Retiree Participation Retirees and eligible survivors enrolled in retiree coverage must be enrolled in a medical plan to be eligible to enroll in the dental plan. If retirees or eligible survivors enroll in the medical and dental plans, any eligible dependents they elect to enroll must also be enrolled under both plans. Choosing a Primary Care Dentist (PCD) When you enroll in the DeltaCare Plan, you must complete the enrollment information and should indicate your preferred DeltaCare Network Dentist choices at that time. New enrollees have 60 days to select and notify us of your preferred Primary Care Dentist (PCD). A PCD is a Washington state General Practitioner that has chosen to participate in the DeltaCare Network. 2024-01-03100-BB 4 DCL 20240101