Benefits 24/7 stabilization update - week of April 28-May 2

Washington State Health Care Authority sent this bulletin at 05/02/2025 01:00 PM PDT

5.2.2025

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.

Below are the larger issues that have been identified or resolved.

New priorities

Kaiser Permanente WA Medicare service area issue: Nearly 50 retirees enrolled in Kaiser Permanente WA Medicare who were required to change plans due to living outside of the service area were incorrectly kept in the Kaiser Permanente WA Medicare plan for 2025. HCA sent letters on April 28 to affected subscribers to select a new plan within their service area before June 1.

Issues that have been addressed

Dual vision enrollments: When a PEBB member’s status changed from a dependent to a subscriber, they were incorrectly enrolled in vision coverage as a dependent in addition to their subscriber account, which caused a dual enrollment error. HCA has made system updates to correct the 50 affected accounts to remove the dual enrollment on a dependent record, as well as prevent this error from occurring in the future.

System checks for dual medical enrollment: The Benefits 24/7 query that checks for dual medical enrollment was only checking enrollments created in an initial eligibility period, not for enrollments created during an open enrollment or special open enrollment, or for self-pay subscribers. HCA has implemented system query updates for all applicable enrollments.

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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