Benefits 24/7 stabilization update - week of February 17-21

Washington State Health Care Authority sent this bulletin at 02/21/2025 03:50 PM PST

2.21.2025

Dear Benefits Administrators,

Here are updates on HCA’s priorities and progress to stabilize the Benefits 24/7 platform for PEBB and SEBB employees. Our intention is to keep you informed on identified issues, how we’re prioritizing them, and when they’re addressed.

This list does not include all the identified issues, but several that we are prioritizing based on their impact on members’ enrollment. Keep in mind that we’re balancing the work on these issues with additional system issues affecting other PEBB and SEBB members, including retirees.

New priorities

Members not seeing their SmartHealth wellness incentive: HCA has become aware that some Kaiser Permanente WA members are not seeing their SmartHealth wellness incentive applied to their 2025 deductible. HCA is investigating this issue and whether other carriers are also involved.

Updates on previously reported priorities

Premium discrepancies: HCA identified three scenarios affecting some PEBB retiree accounts in which the wrong premiums are being charged. HCA has identified the underlying issues and is working to identify and implement solutions.

Incorrect signature dates sent to carriers prevented enrollment: Of the 200 early retiree post-open enrollment accounts sent to UnitedHealthcare and Kaiser Permanente WA and NW with incorrect signature dates that prevented their enrollment, an additional 129 UnitedHealthcare accounts were identified. HCA continues to work on the remaining UnitedHealthcare accounts with this issue.

Issues that have been addressed

Employer group enrollments: For three employer groups who were new to PEBB coverage effective January 1, their employee enrollment information was sent to the carriers before carriers’ systems were ready to enroll them. This also affected two employer groups that switched from PEBB medical-only coverage to PEBB full benefits coverage effective January 1. HCA has confirmed with the dental, vision, and medical carriers that these employer groups have been enrolled properly.

Spouse and dependent coverage terminated in error. The enrollment files sent to carriers on December 31 included 846 spouses and dependents whose coverage had been terminated in error. Their enrollment has been resolved.

If you continue to have challenges on an issue that has been addressed, please submit a new ticket to HCA’s Outreach & Training team.

You can access weekly updates on the Benefits Administrator website via the pink alert box and under Notices and updates.

We appreciate your patience and understanding as we diligently work on resolving these and other issues.

About the Health Care Authority (HCA)

Functioning as both the state's largest health care purchaser and its behavioral health authority, the Washington State Health Care Authority (HCA) is a leader in ensuring Washington residents have the opportunity to be as healthy as possible.

There are three pillars of our work: Apple Health (Medicaid); the Public Employees Benefits Board (PEBB) and School Employees Benefits Board (SEBB) programs; and behavioral health and recovery. Under these pillars, HCA purchases health care, including behavioral health treatment for more than 2.7 million Washington residents and provides behavioral health prevention, crisis, and recovery supports to all Washington residents.

Please do not reply directly to this message. For more information, visit the HCA website, where you'll also find contact information.

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Nondiscrimination

The Washington State Health Care Authority (HCA) complies with all applicable federal and Washington state civil rights laws and is committed to providing equal access to our services. Visit HCA’s website to view complete nondiscrimination statements.