Changing Benefits and Deductions

Mailing Address

You can change your address on my.evergreen.edu.  When you select the Pay History and Information link you will see your current address.  If you select the Update Address link you will be able to verify the address type and make changes.  Payroll uses the Mailing Address type.

If you choose to send us an email to request the address change, please include your full legal name, Evergreen ID number (A#), and complete address including zip code.

Current Coverage - Plans, premiums, and dependents

Use the PEBB Member Coverage page to confirm your current medical and dental plans, premium amounts, and covered dependents.

Family Changes

You can add/or remove a dependent outside of open enrollment within 60 days of a qualifying event.  You will need to download the Employee/Enrollment Change form from PEBB Forms and submit it along with the required dependent verification documents to the Payroll Office. Use the PEBB Medical Benefits Comparison for a side by side comparison of the medical plans.

  • Spouse or registered domestic partner loses other coverage - Coverage will begin on the first day of the month following the date the prior coverage terminated. Proof of loss of other coverage must be provided.
  • Marriage or establishment of a Washington State registered domestic partnership - If the date of the marriage or date of the domestic partner registration is on the first day of the month the coverage will begin on that day otherwise coverage will begin on the first day of the following month.
  • Birth or placement of a child for adoption - Coverage for the newborn child will begin at birth. Coverage for a child placed for adoption will begin on the date the employee assumes legal obligation for total or partial support in anticipation of adoption of the child.
  • Divorce or dissolution of a registered domestic partnership - Coverage ends the last day of the month of the divorce, annulment, or termination of a partnership.  You must remove a former spouse or state-registered domestic partner from PEBB coverage no later than 60 days after a divorce, annulment, or termination of a partnership, even if a court order requires you to provide health insurance for him or her. To remove your spouse or partner from your coverage download the Employee/Enrollment Change form from PEBB Forms and submit it to the Payroll Office. You may continue to cover your biological children or legally adopted children. You may cover a dependent child when a court order or national medical support notice that establishes custody with the subscriber requires you to provide insurance coverage for an eligible dependent of the subscriber.

When you have family changes you may also wish to change your W-4 and beneficiary forms for life insurance and retirement. 

Other Changes

Beneficiary Changes

To change your beneficiaries, download the applicable Life Insurance Beneficiary form (PDF) and/or Department of Retirement Systems Beneficiary form. To change beneficiaries for TIAA-CREF you will need to contact them directly at TIAA-CREF.

Optional life insurance coverage

  • To increase the amount of your coverage:  Download the Life and AD&D Insurance/Enrollment Change form and the Life Insurance Evidence of Insurability form from the PEBB Forms web page.  Return the completed forms to the Payroll and Benefits office.
  • To decrease the amount of your coverage: Download the Life and AD&D Insurance/Enrollment Change form from the PEBB Forms web page.  Return the completed form to the Payroll and Benefits office.

Optional long term disability insurance

  • To enroll or decrease your waiting period:  Download the Long Term Disability Enrollment/Change form and the Long Term Disability Evidence of Insurability form from the PEBB Forms web page.  You can mail or hand deliver the completed forms to the Payroll and Benefits office.  We will mail them for you.
  • To increase your waiting period:  Download the Long Term Disability Enrollment/Change form from the PEBB Forms web page.  Turn the completed form into the Payroll and Benefits office.

Contributions to the Washington State Deferred Comp plan

The Deferral Change Request form can be downloaded at the Washington State Deferred Compensation Program/Forms web page.

TIAA-CREF supplemental retirement annuity

  • If you currently contribute to a SRA and wish to change the amount download the Salary Reduction Agreement VIP (PDF). Turn the completed form into the Payroll and Benefits office.
  • If you do not currently have a TIAA-CREF Supplemental Retirement Annuity - you can pick up the enrollment kit at the Payroll and Benefits office or request that one be mailed to you.