New way for employees to send appeals to the PEBB Program and reminder about entering enrollments

Washington State Health Care Authority sent this bulletin at 04/28/2025 03:30 PM PDT

4.28.2025

Dear Benefits Administrators,

On April 1, 2025, the PEBB Appeals Unit launched an all-new online appeals portal. Employees can use this secure online portal to request a brief adjudicative proceeding (a simplified legal hearing, also referred to as an appeal) of a PEBB Program decision and have it immediately go to the PEBB Appeals Unit.

The online appeal portal has advantages over mailing in a request—it’s a fast, secure, paperless way to submit an appeal. Requests are sent instantly to the PEBB Appeals Unit, reducing overall processing and wait times. Appellants can also check the status of their requests online instead of having to call or wait for acknowledgment letters.

For more information, visit the PEBB benefits administrators appeals process webpage.

Instructions for employees on how to access and use the appeals portal:

From the HCA Support home page, select “Public Inquiry” and log in to SAW. If you do not have a SAW account, you will need to create one.
Once logged in, select “Make A Request” and choose “Benefits Appeal Request.” You should see a screen asking you to choose the primary account holder.
Select the applicable option. Next, select your relationship to the appellant. Once you do this, the appeal form will populate additional selections that mirror the paper form.

BA guidelines for entering employee enrollments

We've observed some instances where a Benefits Administrator (BA) may enter employee enrollments into Benefits 24/7 using their own BA login without obtaining a signed paper form from the employee. While this might seem efficient, it is not advisable and could expose your organization to unnecessary risk.

Please carefully follow these guidelines:

Do not use your BA login to enter enrollments in Benefits 24/7 for employees unless you have a signed paper form from the employee on file. Without this documentation, there is no official record that the employee authorized the benefit elections.
When assisting employees with enrollments, ensure that either you or the employee is logged into the employee's own account.

Why is this important?

Entering enrollments without a proper record places your organization at risk. In cases of disputes, the absence of verified employee authorization could result in financial liabilities, compliance issues, or audit findings.

Thank you for your attention to this matter.

Thank you for your attention to this matter. For further clarification or assistance, please reach out to our Outreach & Training team via HCA Support or call 1-800-700-1555.

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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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.