Options for Continuing PEBB Medical Coverage When medical coverage ends, the Subscriber and their Dependents covered by this medical plan may be eligible to continue PEBB medical coverage during temporary or permanent loss of eligibility. There are three options the Subscriber and their Dependents may qualify for when coverage ends.  PEBB Continuation Coverage (COBRA)  PEBB Continuation Coverage (Unpaid Leave)  PEBB retiree insurance coverage A Subscriber also has the right to convert to individual medical insurance coverage with the Plan when continuation of group medical insurance coverage is no longer possible. PEBB Continuation Coverage The PEBB Program administers the following Continuation Coverage options to temporarily extend group insurance coverage when the Enrollee’s PEBB medical plan coverage ends due to a qualifying event:  PEBB Continuation Coverage (COBRA) includes eligibility and administrative requirements under federal COBRA laws and regulations. Some Enrollees who are not qualified beneficiaries under federal COBRA, may also qualify for PEBB Continuation Coverage (COBRA).  PEBB Continuation Coverage (Unpaid Leave) is an option created by the PEBB Program with wider eligibility criteria and qualifying event types than COBRA. An Enrollee who qualifies for both types of PEBB Continuation Coverage (COBRA and Unpaid Leave) may enroll in only one of these options. See “Continuation Coverage Enrollment” and the PEBB Continuation Coverage Election Notice. Premium Payments for PEBB Continuation Coverage If a Subscriber enrolls in Continuation Coverage, the Subscriber is responsible for timely payment of premiums and applicable premium surcharges. PEBB Retiree Insurance Coverage The following are eligible to continue enrollment or defer enrollment in PEBB retiree insurance coverage if they meet procedural and substantive eligibility requirements:  Retiring employee  Retiring school employee  Eligible elected or full-time appointed official of the legislative or executive branch of state government leaving public office  Dependent becoming eligible as a survivor  Retiree or survivor enrolled in PEBB retiree insurance coverage For details, see the PEBB Retiree Enrollment Guide. Family and Medical Leave Act of 1993 An employee on approved leave under the federal Family and Medical Leave Act (FMLA) may continue to receive the employer contribution toward PEBB benefits in accordance with the federal FMLA. The Employing Agency determines if the employee is eligible for leave and the duration of the leave under FMLA. The employee must continue to pay their monthly premium contribution and applicable premium surcharges during this period to maintain eligibility. EWCLGHDHP1983ACT0124 28 WAPEBB-CD-ACT