Learn how the Health Care Authority, PEBB Program, SEBB Program, and insurance carriers work together.
The Health Care Authority (HCA) is the state agency that obtains health care for public employees, school employees, and retirees. We also support free or low-cost health care, including Apple Health (Medicaid), and behavioral health and recovery. We’re honored to be the state’s largest health care purchaser and to facilitate health care for a third of Washington’s residents. We strive to provide equitable, high-quality health care and behavioral health prevention, crisis, and recovery supports through innovative health policies and purchasing strategies to support a healthier Washington.
What is PEBB or SEBB?
The Public Employees Benefits Board (PEBB) Program and the School Employees Benefits Board Program provide access to benefits such as medical, vision, and dental insurance for employees and retirees of Washington's school districts, charter schools, educational service districts (ESDs), state agencies, higher education, and participating employer groups (like many hospital districts, counties, etc.). For retirees on Medicare, PEBB provides options to supplement Medicare coverage. We also provide health care benefits to continuation coverage subscribers to help them temporarily continue their coverage when they are no longer employed. The programs are governed by boards that guide decision making and policies, including those that affect eligibility and the types of benefits we provide. The members of the boards are appointed by the Governor.
Where does Regence, Premera, Kaiser Permanente, or UnitedHealthcare fit in?
While the PEBB and SEBB Programs work to make sure there are plan choices available for coverage, insurance carriers like Regence BlueShield, Premera Blue Cross, Kaiser Permanente, or UnitedHealthcare administer the benefits and coordinate with Medicare as applicable. They are responsible for the day-to-day activities like issuing ID cards, processing claims, and preauthorizing services. This makes them the best resource for questions about your PEBB or SEBB plan coverage or when you need to check if a provider is in network.