Qualifying Life Events
Under the IRS Code, Section 125, the employee must pay the same amount of premium each month during the year, unless the employee has a qualifying change in family status.
Changes to your PEIA Health Insurance, Optional and Dependent Life Insurance can be made online. Follow these instructions to properly make your changes during a qualifying event. *Please note, this method will only allow changes to your health and life benefits.Paper Change-In-Status Form
*FBMC requires a paper Change-In-Status form for changes in flexible benefits.
All required forms and *supporting documentation must be submitted electronically, printed, mailed or faxed
NO PHOTOS will be accepted.
Mailing address:Benefits Administration