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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 HCA50-0135
for the current year.
Form HCA50-0135 Pebb Continuation Coverage (Unpaid Leave) Election / Change - Washington
What Is Form HCA50-0135?
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 HCA50-0135?A: Form HCA50-0135 is the document used to elect or make changes to Pebb Continuation Coverage (Unpaid Leave) in Washington.
Q: What is Pebb Continuation Coverage (Unpaid Leave)?A: Pebb Continuation Coverage (Unpaid Leave) is a health insurance coverage option available in Washington for employees who are on unpaid leave.
Q: Who is eligible for Pebb Continuation Coverage (Unpaid Leave)?A: Employees who are on unpaid leave are eligible for Pebb Continuation Coverage (Unpaid Leave) in Washington.
Q: What can I use Form HCA50-0135 for?A: You can use Form HCA50-0135 to elect or make changes to your Pebb Continuation Coverage (Unpaid Leave) in Washington.
Form Details:
- Released on October 1, 2022;
- 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 HCA50-0135 by clicking the link below or browse more documents and templates provided by the Washington State Health Care Authority.
Download Form HCA50-0135 Pebb Continuation Coverage (Unpaid Leave) Election / Change - Washington
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