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Medical/Dental Insurance
Monthly Premiums for Faculty, Staff & Librarians

Premium Surcharges

The Washington State Legislature established two additional medical premiums or "surcharges" effective July 1, 2014:

  1. Tobacco use premium surcharge
  2. Spouse or domestic partner coverage premium surcharge

This means that all employees enrolled in a PEBB medical plan are now required to complete a Premium Surcharge Attestation Form. Newly-eligible employees must complete this form within 31 days of eligibility. Responses on the form determine whether or not you are subject to pay premium surcharges. If you are, then you must pay one of the following amounts in addition to your base monthly premium rate:

A.) Monthly $25 surcharge if you or an enrolled family member uses a tobacco product. Note: This surcharge applies "by default" if no Attestation Form is submitted.

B.) Monthly $50 surcharge if you have a spouse or domestic partner enrolled on your PEBB medical coverage, and your spouse or domestic partner has chosen not to enroll in medical coverage through his or her employer that is comparable to Uniform Medical Plan (UMP) Classic. Note: This surcharge applies "by default" if you elect to enroll your spouse/domestic partner and no Attestation Form is submitted.

C.) Monthly $75 surcharge if both A & B apply to you.

If any premium surcharges apply to you, they will be added to your base medical premiums and deducted pre-tax from your paycheck—unless you elected to waive participation in the Section 125 Premium Payment Plan, in which case they will be deducted on an after-tax basis. Total annual premiums will be included in contributions for health care coverage on your W-2 tax form.

Base Monthly Premium Rates for 2014

Health Plans Employee Employee & Spouse or
Qualified Domestic Partner
Employee and Children* Full Family
Uniform Medical Classic
Uniform Medical Consumer-Directed Health Plan with Health Savings Account (CDHP-HSA)
Group Health Classic
Group Health Value
Group Health CDHP-HSA
Kaiser Permanente Classic

*Birth or Adoption: The PEBB 2014 Enrollment Guide (page 16) states: "If the child’s date of birth or adoption is before the 16th day of the month, you pay the higher premium for the full month (if adding the child increases the premium). If the child's date of birth or adoption is on or after the 16th, the higher premium will begin the next month."

Dental Insurance Premium

There is no employee or dependent contribution for dental insurance coverage. The UW pays the entire premium.

Section 125 Plan

The Section 125 Plan, or Premium Payment Plan, provides tax savings by deducting employee medical premiums from your gross salary prior to calculation of federal income and social security taxes, as allowed under Internal Revenue Code (IRC) Section 125.

Medical premiums will automatically be taken as pre-tax, unless a Premium Payment Plan Election/Change Form is submitted to the Benefits Office. Learn more and download the form.

Newly eligible employees may elect to waive Section 125 at the time they choose a medical plan; otherwise, it can only be waived during the open enrollment, for a January 1 effective date.

Disclaimer: The information on this page does not substitute for official plan documents. If there is a conflict between the information on this site and an official plan document, the official plan document will govern. Refer to the Benefits Forms & Publications page.

Plan availability and eligibility may change depending on your employment status and/or actions of the Washington State Health Care Authority (HCA), the agency that purchases and coordinates health insurance benefits for public employees, including employees of the University of Washington, through the Public Employees Benefits Board (PEBB) program.

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