Get the free 51-0205 PEBB Retiree Enrollment Guide

WEBB Retiree Enrollment Guidebook WEBB benefits for2021 Monthly Premiums Pages 79Eligibility Summary Pages 1012Choosing the WEBB medical plan that's right for you Page 2528 Benefits Comparisons Pages

How to fill out 51-0205 pebb retiree enrollment

How to fill out 51-0205 pebb retiree enrollment

1. To fill out the 51-0205 PEBB retiree enrollment form, follow these steps:
2. Begin by entering your personal information, such as your name, address, and contact details, in the designated fields.
3. Next, provide your Social Security number and date of birth.
4. Indicate whether you are electing PEBB retiree coverage for yourself only or for yourself and your dependents.
5. If you are adding dependents, provide their names, relationship to you, and their eligibility status.
6. Choose the appropriate health plan option from the available options provided.
7. If you are enrolling in dental, vision, or life insurance coverage, select the desired options.
8. Review the information you have entered to ensure accuracy and make any necessary corrections.
9. Sign and date the form, certifying that the information provided is accurate and complete.
10. Submit the completed form as instructed by your employer or the PEBB program.

Who needs 51-0205 pebb retiree enrollment?

1. The 51-0205 PEBB retiree enrollment form is needed by individuals who are retiring from public employment and wish to enroll in the PEBB retiree coverage. This form is specifically designed for retirees who are eligible for the Public Employees Benefits Board (PEBB) program and want to continue receiving health insurance benefits after retirement. It is required for retirees to indicate their enrollment choices and provide necessary personal and dependent information to ensure proper coverage.

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What is 51-0205 pebb retiree enrollment?

51-0205 Pebble retiree enrollment is a form used by retired individuals to enroll in the Public Employees Benefits Board (PEBB) health insurance plans, which provide medical and other types of insurance coverage for eligible retirees.

Who is required to file 51-0205 pebb retiree enrollment?

All retirees who wish to enroll in PEBB health insurance plans must file the 51-0205 form to ensure they receive the benefits. This typically includes retired public employees and their eligible dependents.

How to fill out 51-0205 pebb retiree enrollment?

To fill out the 51-0205 form, retirees should provide personal information such as name, address, social security number, and details regarding their retirement benefits. Specific instructions and sections of the form must be followed carefully to ensure proper enrollment.

What is the purpose of 51-0205 pebb retiree enrollment?

The purpose of the 51-0205 pebb retiree enrollment is to facilitate the process of enrolling eligible retirees into the PEBB health insurance program, allowing them to access necessary healthcare coverage after retiring from public service.

What information must be reported on 51-0205 pebb retiree enrollment?

The form requires personal information, retirement date, employment history, dependent information, and a selection of desired health plans, as well as signature and date certifying the information provided is accurate.