Subscribers may add their qualified domestic partner one of two ways:

1)      Provide a completed PEBB Declaration of Marriage or Qualified Domestic Partnership form, a PEBB Declaration of Tax Status form, and an enrollment/change form. The declaration has been revised to include the new criteria. If the partnership meets the declaration criteria, PEBB will add your partner to your coverage.

OR

2)      Provide a copy of a Certificate of State Registered Domestic Partnership or domestic partner registration card issued by the Washington Secretary of State’s Office for same-sex partners, a completed PEBB Declaration of Tax Status form, and a PEBB enrollment/change form.

The Declaration of Tax Status form requires the subscriber to attest whether the partner is a qualified tax dependent under the Internal Revenue Code Section 152. Even if a partner isn’t a qualified tax dependent, (s)he may still qualify for PEBB coverage. However, the state would tax the subscriber on the state’s costs for the partner’s PEBB coverage.