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Dear Benefits Administrators,
This message only applies to our employers who offer Medical Only PEBB benefits.
As an employer who offers PEBB “Medical Only” benefits to your employees, we are reaching out to inform you of an important update regarding the Medical Only (MO) Waived Surcharge.
Earlier this year it was identified that there was an inconsistency in the application of the MO Waived Surcharge—some subscribers who showed as waiving medical coverage in our system were charged the surcharge, while others were not. Upon discovery, we immediately took action to stop billing all affected accounts.
Additionally, previous guidance from Outreach and Training was that employees who wished to waive medical coverage did not need to be entered into our system as being “eligible.” We are changing/correcting our guidance on this for 2026. All eligible employees should be entered into Benefits 24/7 and then the employee can elect to waive coverage in Benefits 24/7.
Beginning January 1, 2026, the MO Waived Surcharge will be reinstated and consistently applied to all MO Waived subscribers.
What do you need to do?
As a Benefits Administrator, we need your support to ensure compliance with this change:
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By 12/22/2025: Please ensure that any employees eligible for PEBB medical who have waived their medical coverage are properly entered into Benefits 24/7 (B 24/7). Once the employee is entered, the "Newly Eligible" wizard will appear. At that point, you can either waive the coverage on behalf of the employee (if they provide you with a paper enrollment form indicating their wish to waive medical coverage) or have the employee log in to B 24/7 and complete the waiver themselves.
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Ongoing: All employees newly eligible for PEBB Medical benefits should be entered into B 24/7. These employees then have their 31-day enrollment window to either elect a medical plan or waive medical coverage. Newly eligible employees who do not elect a medical plan, or fail to elect to waive medical coverage, will be defaulted into the UMP Classic Medical Plan. They would be eligible to change their medical plan if they experience a qualified “special open enrollment (SOE)” event or wait until the next annual open enrollment (OE) period.
Accurate and timely entry into B 24/7 will ensure proper surcharge billing and avoid potential discrepancies.
If you have any questions or need assistance, please don’t hesitate to reach out to Outreach and Training.
Thank you for your attention to this matter and for your continued partnership.
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