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I have an employee who wants to terminate coverage for a dependent that is under age 19. Can the employee terminate the dependent’s coverage?

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I have an employee who wants to terminate coverage for a dependent that is under age 19. Can the employee terminate the dependent’s coverage?

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Yes, the employee must complete the Employee Enrollment/Change form (HCA 50-400) to terminate the dependent’s coverage. If the employee wants to later re-enroll the dependent in PEBB coverage, the employee must again complete the Employee Enrollment/Change (722.9 KB) form and provide proof of loss of other comprehensive group coverage or wait until the annual open enrollment period.

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