Form HCA51-0007 (E) Pebb Retiree Change Form - Washington

Form HCA51-0007 (E) Pebb Retiree Change Form - Washington

What Is Form HCA51-0007 (E)?

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 the purpose of Form HCA51-0007 (E)?
A: The purpose of Form HCA51-0007 (E) is to make changes to PEBB retiree benefits in Washington.

Q: Who should use this form?
A: This form should be used by PEBB retirees in Washington who need to make changes to their benefits.

Q: What kind of changes can be made using this form?
A: Form HCA51-0007 (E) can be used to make changes to various PEBB retiree benefits, such as adding or removing dependents, changing coverage options, or updating contact information.

Q: Is this form specific to Washington state only?
A: Yes, this form is specific to PEBB retirees in Washington state.

Q: Are there any fees or costs associated with submitting this form?
A: No, there are no fees or costs associated with submitting Form HCA51-0007 (E).

Q: What should I do after completing this form?
A: After completing Form HCA51-0007 (E), you should submit it to your PEBB retiree benefits administrator for processing.

Q: Can I make changes to my benefits at any time using this form?
A: No, there are specific enrollment periods during which changes to PEBB retiree benefits can be made using this form. Check with your benefits administrator for more information.

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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 HCA51-0007 (E) by clicking the link below or browse more documents and templates provided by the Washington State Health Care Authority.

Download Form HCA51-0007 (E) Pebb Retiree Change Form - Washington

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