School Employees Benefits Board (SEBB) Program FAQs

Staff at the Health Care Authority (HCA) are honored to be building the School Employee Benefit Board (SEBB) Program for school employees across the state. We want to answer your questions and supply you with as much information as possible. However, it is still early in the process and many questions cannot be answered at this time. As the Board makes decisions and work progresses, we will update answers, add new questions, and provide more information. Please check back for updates from time to time.

General

When will the SEBB Program begin offering benefits to school employees?

Under EHB 2242, benefits offered by the SEBB Program will be available starting January 1, 2020.

I am currently enrolled in a Public Employees Benefits Board (PEBB) health plan. What does the creation of the SEBB Program mean for me?

If you are currently enrolled in a PEBB health plan, you will continue receiving benefits from the PEBB Program until January 1, 2020. Beginning January 1, 2020, all school employees will be transferred to benefits under the SEBB Program.

The creation of the SEBB program does not affect K-12 retirees. All K-12 retirees will continue receiving benefits through the PEBB Program.

Will HCA have enough staff to meet the needs of school employees?

HCA is adding staff primarily in the Employees and Retirees Benefits (ERB) division, whose jobs will be to make the transition to SEBB as smooth as possible.  School district, educational school district (ESD), and charter school personnel will retain a very active role in assessing eligibility and aiding employees with enrollment, and ERB staff will provide training, support, and send communications to school employees ahead of the 2019 SEBB Program open enrollment to meet the needs of school employees.

How can I find out more?

As new information is available, we will post announcements and updated FAQs on the SEBB Program web page. You can also sign up to receive emails about SEB Board meetings.

Eligibility

* Updated on May 9

Who will be eligible for benefits from the SEBB Program? *

Under a new state law (RCW 41.05.740(6)(d)(ii)), an “employee must work at least 630 hours per year to qualify for coverage” under the SEBB Program. In March 2018, the SEB Board voted on dependent eligibility criteria for spouses and state-registered domestic partners, children up to age 26, children with disabilities, and extended dependents. The SEB Board will vote on other eligibility criteria in the coming months.

Will I be able to waive SEBB insurance coverage?

Information about waiving benefits will be addressed with benefits and eligibility requirements by the Board.

How does the SEBB Program’s eligibility rules for state-registered domestic partners differ from the domestic partner eligibility currently offered by some school districts?

Starting in 2020, SEBB Program domestic partner eligibility rules will allow only state-registered domestic partners (as defined in RCW 26.60.020) to enroll as dependents. Some school districts currently offer an expanded domestic partner eligibility in which employees and their significant others can sign and file a declaration (or affidavit) with their employer or benefits administrator to receive benefits.

Why is domestic partner eligibility limited to only state-registered domestic partners? *

The legislation creating the SEB Board requires the Board to establish eligibility criteria for dependents, including legal spouses and state-registered domestic partners. Some of the information reviewed by the SEB Board in making its decision included the specific reference to state-registered domestic partners in RCW 41.05.740(6)(d)(iii) and funding considerations.

Enrollment

Will districts be able to continue offering optional benefits after January 1, 2020? Must my district purchase benefits through HCA?

Under the new legislation (section 816 of EHB 2242), beginning January 1, 2020, school districts, ESDs, and charter schools shall make available basic and optional benefits through the plans offered by the Health Care Authority and the SEB Board.

Section 815, RCW 28A.400.280(3) now states that school districts are not intended to divert state basic benefit allocations for other purposes, and beginning January 1, 2020, no basic or optional benefits may be provided by employer contributions if they are not provided by the School Employees’ Benefits Board administered by the HCA and consistent with RCW 41.56.500(2).  The SEB Board will evaluate whether there will be optional benefits (such as additional life insurance) offered by the SEBB Program, but fully paid for by the employee.

When will I be able to select the benefits I want?

Open enrollment for SEBB Program subscribers will begin sometime in the fall of 2019. The exact start and end dates of open enrollment will be determined and shared well in advance of open enrollment along with information about the benefit options.

SEBB Program benefits

* Updated on May 9

What types of benefits will the SEBB Program offer? *

In March 2018, the SEB Board voted on the types of benefits that the SEBB Program would offer. Beginning January 1, 2020, the SEBB Program will offer self-insured medical and dental (similar to the Uniform Medical Plan and Uniform Dental Plan currently offered to PEBB members), fully insured dental (provided by commercial dental insurance plans), and life and accidental death and dismemberment (AD&D) insurance coverage. In addition, the SEBB Program has started procurements for fully insured medical plans (like those offered through commercial medical insurance carriers), short- and long-term disability insurance, and vision plans.

The SEB Board does not vote on benefits that are not employer paid.  These are benefits such as the Medical Flexible Spending Arrangement, Dependent Care Assistance Program, and auto and home insurance. Later this year, the SEBB Program will evaluate which benefits will be available for employees to purchase as part of their benefits package.

How many medical and dental plans will the SEBB Program offer?

The number of plans the SEBB Program will offer depends on insurance carrier responses to procurements, and the types of plans and the benefit design selected by the Board.

My health plan usually ends on October 31 each year, but SEBB Program benefits are scheduled to start January 1, 2020. What will be done to address benefits for the time between my current benefits and new SEBB Program benefits?

HCA is aware of this concern. We are currently putting information together to provide school districts, ESDs, and charter schools in advance of local procurements for the November 2018-October 2019 benefits year.

Will I be able to continue to see my current medical, dental, and vision provider?

At this time, we do not know whether or not you will be able to continue to see your current provider(s). It depends on the provider networks that insurance carriers have for plans that meet the SEBB Program benefit design requirements. HCA is in the process of gathering plan information to help the SEB Board determine benefits. HCA does not want to cause a disruption in a member’s care and is working diligently to provide as seamless of a transition as possible.

I'm undergoing a health treatment; will I be able to continue my care with my provider under the SEBB Program?

At this time, we do not know whether or not you will be able to continue to see your current provider(s). It depends on the provider networks that insurance carriers have for plans that meet the SEBB Program benefit design requirements. HCA is in the process of gathering plan information to help the SEB Board determine benefits. HCA does not want to cause a disruption in a member’s care and is working diligently to provide as seamless of a transition as possible.

I live in a rural area; will my community providers be covered under the new SEBB plan(s)?

At this time, we do not know whether or not you will be able to continue to see your current provider(s). It depends on the provider networks that insurance carriers have for plans that meet the SEBB Program benefit design requirements. HCA is in the process of gathering plan information to help the SEB Board determine benefits. HCA does not want to cause a disruption in a member’s care and is working diligently to provide as seamless of a transition as possible.

Why isn’t the SEBB Program procuring its own self-insured medical and dental plans, fully insured dental plans, or life insurance benefits? *

The legislation establishing the SEB Board directs the Board to leverage the PEBB Program’s benefits for efficiency and cost effectiveness. Also, for a January 2020 implementation, it would be challenging for the HCA to procure for all the potential benefits at the same time.

The PEBB Program’s recent procurements provide the SEB Board an opportunity to offer robust benefits for school employees, while efficiently using state resources. For example, the PEBB Program recently completed a four-year procurement for a third-party administrator for the self-insured Uniform Medical Plan. As recently as 2016, the PEBB Program also contracted with a new life insurance vendor, MetLife.

The SEB Board’s resolution also included a commitment to evaluate whether they should pursue a fully insured dental plan procurement in 2020 to consider additional or different offerings. In addition, as part of the fully insured medical procurement, the SEBB Program will look at the feasibility of Kaiser Permanente NW’s integrated medical and dental plan.

How similar do the SEBB benefits have to be compared with PEBB benefits in order to use the PEBB contracted vendors for self-insured medical and dental, fully insured dental, and life insurance?

The HCA is currently exploring how much the SEBB Program’s covered benefits, provider networks, clinical policies, etc. can differ from the PEBB Program and still use the same contracts.

Plan costs

* New or updated on May 9

What does the premium tier ratio mean for school employees? *

The premium tier ratio is the highest share of what an eligible school employee will pay for SEBB insurance coverage based on the number of eligible family members enrolled on the employee’s account.

For example, if a school employee’s SEBB medical premium is $50 per month (to cover the employee as subscriber only), the tier ratio table below shows the maximum that the school employee would pay each month to cover other eligible family members enrolled under the medical plan:

Tier category

Premium tier ratio Employee's monthly medical premium (dollar amounts are for example only)

Subscriber only

1.00

$50

($50 x 1.00)

Subscriber and child(ren)

1.75

$87.50

($50 x 1.75)

Subscriber and spouse/state-registered domestic partner

2.00

$100

($50 x 2.00)

Subscriber and spouse/state-registered domestic partner and any child(ren)

3.00

$150

($50 x 3.00)

Are my health care costs (premiums, deductible, out-of-pocket maximum, copays, and coinsurance) going to increase? *

The answer is different for everyone. It depends on what you currently pay for benefits, the type of plan you have, and whether you cover dependents. It will also depend on your future decisions about plan selection and dependent coverage under the SEBB Program. HCA will be able to share cost information and monthly premiums after contracts are in place and the SEB Board votes on benefit design decisions such as deductibles, out-of-pocket maximums, copays, and coinsurance. This will not take place until mid-2019.

SEB Board

How were the SEB Board and SEBB Program created?

The Board and SEBB Program were created by the passage of Engrossed House Bill 2242 on June 30, 2017. Sections 801 through 815 of the bill create the Board and SEBB Program, specify Board duties, and outline requirements of the SEBB Program.

What is the purpose of the Board?

The function of the Board is to design and approve insurance benefit plans for school employees and to establish eligibility criteria for participation in insurance benefit plans.

How are Board members appointed?

The Governor appoints the Board members. By law, the Board members must include:

  • Two members are from associations representing certificated employees;
  • Two members from associations representing classified employees;
  • Four members with expertise in employee health benefits policy and administration, one of which is nominated by an association representing school business officials; and
  • The director of the Health Care Authority or his or her designee. The director serves as the chair of the Board.

Who are the members of the board?

Governor Jay Inslee appointed the initial SEB Board members on September 28, 2017. SEB Board members include:

  • Position 1 – Daniel Gossett
  • Position 2 – Katy Henry
  • Position 3 – Terri House
  • Position 4 – Patricia Estes
  • Position 5 – Wayne Leonard
  • Position 6 – Pete Cutler
  • Position 7 – Alison Poulsen
  • Position 8 – Sean Corry
  • Position 9 – Louis McDermott

Learn more about the SEB Board members.

How long do Board members serve on the Board?

Initial Board members serve staggered terms not to exceed four years. After the first terms are concluded, members will be appointed to serve two-year terms.

What are the duties of the Board?

RCW 41.05.740 directs the Board to:

  • Study matters connected with providing health care coverage, disability insurance, life insurance, accidental death and dismemberment, and liability insurance;
  • Develop employee benefit plans that include comprehensive, evidence-based health care benefits;
  • Authorize premium contributions for an employee and the employee's dependents in a manner that encourages the use of cost efficient health care systems;
  • Determine the terms and conditions of employee and dependent eligibility criteria, enrollment policies, and scope of coverage;
  • Determine the terms and conditions for employing school districts, ESDS, and charter school, and individual employees to participate;
  • Establish penalties to be imposed when the employer fails to comply with established participation criteria; and
  • Participate with HCA in the preparation of specifications and selection of carriers contracted for employee benefit plan coverage and coordinate with the Public Employees Benefits Board to leverage efficient purchasing.

When does the Board meet?

The Board will meet approximately once a month. A list of the Board’s meeting dates and times through December 2018 can be found at School Employees Benefits Board (SEBB) meeting dates.

How can I get Board meeting materials?

Board meeting materials are posted to the meetings and materials page. You can also sign up for SEB Board emails.