In addition to the eligibility requirements, you must also meet the procedural requirements. The procedural requirements for enrolling in or deferring PEB retiree coverage include submitting your retiree coverage election form and any other required documents to the Healthcare Authority no later than 60 days after your employer-sponsored or COBRA coverage ends. If you or your dependent is entitled to Medicare, the entitled individual must enroll in and maintain Medicare Parts A and B to enroll in and maintain PEB retiree coverage. This includes a copy of the Medicare card showing enrollment in Medicare Parts A and B for you and any dependent entitled to Medicare. If you don't have the option or don't want to pay your monthly health premiums through pension deduction, submit your first payment with your retiree coverage election form. If you're a retiree not entitled to Medicare and wish to add eligible dependents to your account, you must provide proof of eligibility within the 60-day enrollment period or your dependents will not be enrolled. A list of valid dependent verification documentation is available on the PEB website. If you will be retiring at age 65, contact the Social Security Administration 90 days prior to your retirement to enroll in Medicare Parts A and B. If retiring after age 65 and you've deferred your Medicare Part B coverage while covered under your employer-sponsored coverage, contact the Social Security Administration 90 days prior to your retirement to enroll in Medicare Part B. PEB requires that retirees entitled to Medicare enroll in and maintain Medicare Parts A and B to enroll in and maintain PEB retiree coverage. If you are retiring from one of the Washington state sponsored retirement plans, contact DRS six months before your planned retirement date or visit the DRS website to request an estimate of your...
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Dd 2656 january 2022-2024 Form: What You Should Know
OMB File No. 12-3113. OMB number is 0704 – 0569. The application must contain the following information: †name and address of the military dependent; †current position or rank previously held (unless you already have worked in the defense area for more than one year); the date of your spouse's death; a statement which, within the judgment of the service records official and except: · a spouse under age of 20 who is entitled to a survivor annuity under the Civilian Retrocession Act, · an eligible dependent who is also entitled to any special survivor annuity under the Family Medical Leave Act, · a dependent of an eligible service member who died while on active duty and a former spouse who is also a dependent, if the dependent or former spouse does not qualify as an annuitant under the Civilian Retrocession Act, · a disability annuitant. Your application and supporting documentation MUST be submitted to: DIAS is established by the Legislature to provide information and facilitate the administration of the U.S. Public Health Service Act, with certain limited exceptions. In order to obtain information about a special need of the department's constituents, it is established and conducted by the Office of the Governor or the agency of this State that has charge of its operation.
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