Form HCA52-0030 Pebb Employee Enrollment / Change Form for Medical Only Groups - Washington

What Is Form HCA52-0030?

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 HCA52-0030?
A: Form HCA52-0030 is the Pebb Employee Enrollment/Change Form for Medical Only Groups in Washington.

Q: Who can use Form HCA52-0030?
A: Form HCA52-0030 can be used by employees in medical-only groups under the Public Employees Benefits Board (PEBB) in Washington.

Q: What is the purpose of Form HCA52-0030?
A: The purpose of Form HCA52-0030 is to enroll or make changes to medical benefits for employees in medical-only groups under PEBB in Washington.

Q: Is Form HCA52-0030 only for Washington residents?
A: Yes, Form HCA52-0030 is specifically for residents of Washington who are part of medical-only groups under the PEBB.

Q: What information is required on Form HCA52-0030?
A: Form HCA52-0030 requires personal information, employment details, and medical benefit selections.

Q: When should I submit Form HCA52-0030?
A: You should submit Form HCA52-0030 within 31 days of becoming eligible for PEBB coverage or during the PEBB annual open enrollment period.

Q: Can I make changes to my medical benefits using Form HCA52-0030?
A: Yes, you can use Form HCA52-0030 to make changes to your medical benefits during the annual open enrollment period or if you have a qualifying event.

Q: What happens after I submit Form HCA52-0030?
A: After you submit Form HCA52-0030, your medical benefit changes will be processed by the Public Employees Benefits Board (PEBB) and you will receive confirmation of the changes.