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This version of the form is not currently in use and is provided for reference only. Download this version of
Form HCA50-0027
for the current year.
Form HCA50-0027 Pebb Spousal Plan Calculator - Washington
What Is Form HCA50-0027?
This is a legal form that was released by the Washington State Health Care Authority - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form HCA50-0027?
A: Form HCA50-0027 is the Pebb Spousal Plan Calculator.
Q: What is the Pebb Spousal Plan Calculator?
A: The Pebb Spousal Plan Calculator is a tool used in Washington to calculate the spousal premium surcharge.
Q: What is the purpose of the Pebb Spousal Plan Calculator?
A: The Pebb Spousal Plan Calculator is used to determine the additional premium amount that must be paid if an enrollee's spouse or state-registered domestic partner is eligible for employer-based group health insurance.
Q: Who is required to fill out Form HCA50-0027?
A: Enrollees in the Public Employees Benefits Board (PEBB) program in Washington who have a spouse or state-registered domestic partner with access to employer-based group health insurance are required to fill out Form HCA50-0027.
Q: How do I use the Pebb Spousal Plan Calculator?
A: To use the Pebb Spousal Plan Calculator, you need to provide information about your spouse or state-registered domestic partner's employer-based health insurance coverage. The calculator will then determine the additional premium amount you need to pay.
Q: Is the Pebb Spousal Plan Calculator only for residents of Washington?
A: Yes, the Pebb Spousal Plan Calculator is specifically designed for residents of Washington who are enrolled in the PEBB program.
Q: What happens if I don't fill out Form HCA50-0027?
A: If you are required to fill out Form HCA50-0027 and fail to do so, you may be subject to a default amount of spousal premium surcharge.
Q: Can I appeal the premium surcharge calculated by the Pebb Spousal Plan Calculator?
A: Yes, if you believe the premium surcharge calculated by the Pebb Spousal Plan Calculator is incorrect, you can file an appeal with the Washington Health Care Authority (HCA).
Q: Are there any exemptions to the spousal premium surcharge?
A: Yes, certain circumstances may qualify for exemptions to the spousal premium surcharge. You should consult the official guidelines provided by the Washington Health Care Authority (HCA) for more information.
Form Details:
- Released on October 1, 2021;
- The latest edition provided by the Washington State Health Care Authority;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form HCA50-0027 by clicking the link below or browse more documents and templates provided by the Washington State Health Care Authority.
Download Form HCA50-0027 Pebb Spousal Plan Calculator - Washington
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