School Employees Benefits Board (SEBB) Program FAQs

Are you a school administrator? View the FAQs for school administrators.

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. Last update: August 14, 2019.

Most recent questions

The following are answers to questions we received recently. To view questions answered prior to this update, see Questions by category.

Where can I find information about the health savings account (HSA)?

On our HSA webpage you’ll find information about the HSA, which is paired with the SEBB Program’s high-deductible health plan. The monthly HSA employer contribution amounts will be posted there on September 3.

Do employees sign up for plans based on where they live, or where they work?

All school employees will be offered a selection of plans based on their county of residence. Some school employees, including employees who live outside Washington State, may have more plan options if they work in a district that crosses county lines or is in a county that borders Idaho or Oregon.

What plans will employees be enrolled in if they don’t choose any?

If employees who are eligible for SEBB benefits do not either enroll in or waive SEBB Program medical coverage during the first annual open enrollment, they will be enrolled in the following default benefits:

  • Medical: UMP Achieve 1, with a $33 monthly premium
  • Dental: Uniform Dental Plan (no premium)
  • Vision: MetLife vision (no premium)
  • Basic life and accidental death and dismemberment (AD&D): MetLife (no premium)
  • They will be charged the $25 tobacco use premium surcharge in addition to the medical premium. Their dependents will not be enrolled. In addition, they won’t be able to change plans or enroll any eligible dependents until the next SEBB Program annual open enrollment or unless they have a special open enrollment event that allows the change, such as a marriage, birth, or adoption.

Top 10 questions

What types of benefits will be offered?

  • Medical, dental, vision, life, accidental death and dismemberment insurance, and long-term disability insurance, will be offered beginning January 1, 2020.
  • The SEB Board has authority to offer benefits that are not paid by the employer, such as the Medical Flexible Spending Arrangement, Dependent Care Assistance Program.

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

  • It depends on the plans you choose. Given the number of plans offered, it is likely that your provider will be a member of one of the covered networks.

Will my dependents be covered?

  • Spouses and state-registered domestic partners, children up to age 26, children with disabilities, and extended dependents are eligible. Learn more about dependents.

Will pooling still occur in the SEBB Program?

  • Yes, but it will happen at the state level. The state estimates how many employees will waive coverage. Factoring in the expectation that some employees will waive medical coverage allows us to offer consistent, affordable employee monthly premiums throughout the year.

Can I waive SEBB coverage?

  • You can waive SEBB medical coverage during the SEBB Program’s annual open enrollment if you are enrolled in other employer-based group medical insurance, a TRICARE plan, or Medicare.
  • However, if you are eligible for SEBB benefits, you must enroll in SEBB dental, vision, basic life and accidental death and dismemberment (AD&D) insurance, and basic long-term disability insurance, regardless of whether you waive SEBB medical coverage. See Waiving medical coverage for more about what happens if you waive medical coverage.

Will retirees participate in SEBB?

What happens if I move to another job?

  • You will have uninterrupted coverage when moving from one school district, ESD, or charter school to another within the same month or a consecutive month, if the following conditions are satisfied:
    • You were eligible for the employer contribution toward SEBB benefits in the position you are leaving; and
    • You are anticipated to be eligible for the employer contribution toward SEBB benefits in your new position.

If I enroll in SEBB Program benefits, and my spouse is enrolled in the PEBB Program, can we cover each other as dependents on each other’s account?

  • Yes. If you cover each other, your spouse’s or state-registered domestic partner’s primary coverage would be through the PEBB Program and the secondary coverage would be through the SEBB Program. Your primary coverage would be through the SEBB Program and your secondary coverage would be through the PEBB Program. In this scenario, you would not incur the monthly $50 spouse or state-registered domestic partner coverage premium surcharge.
  • However, if your spouse or state-registered domestic partner waives medical coverage and enrolls on your account (or vice versa), you would incur the monthly $50 spouse or state-registered domestic partner coverage premium surcharge in addition to your monthly premiums.

My spouse and I are both school employees eligible for SEBB. Can we put ourselves on each other’s SEBB account?

  • No. Each of you will have your own account. No one can enroll on more than one account.

What are the premium surcharges?

  • The Legislature, under Section 504 of ESSB 6032, requires school employees to pay two premium surcharges, if they apply, in addition to the medical plan premiums each month, starting January 1, 2020.
  • Tobacco use premium surcharge
    • A monthly $25 premium surcharge per account if the employee or any dependent (age 13 or older) enrolled on their SEBB medical plan uses a tobacco product.
  • Spouse or state-registered domestic partner coverage premium surcharge
    • A monthly $50 premium surcharge if the employee has a spouse or state-registered domestic partner enrolled on their SEBB medical plan, and the spouse or state-registered domestic partner has elected not to enroll in their employer-based group medical insurance that is comparable to PEBB’s Uniform Medical Plan (UMP) Classic.

Questions by category

Will pooling still occur in the SEBB Program?

  • Yes, but it will happen at the state level. The state estimates how many employees will waive coverage. Factoring in the expectation that some employees will waive medical coverage allows us to offer consistent, affordable employee monthly premiums throughout the year.

Will retirees participate in SEBB?

  • No, retirees are eligible to enroll in the PEBB Program.

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

  • Under EHB 2242, benefits 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?

  • You will continue to receive benefits from the PEBB Program through December 31, 2019. Beginning January 1, 2020, all school employees will receive benefits under the SEBB Program.
  • The SEBB Program does not affect K-12 retirees, unless the Legislature decides to change this. All K-12 retirees will continue to receive benefits through the PEBB Program.

What is the difference between the insurance plan year and the school year?

  • The insurance plan year for SEBB is a calendar year, January 1 through December 31. The school year, as defined in RCW 28A.150.203(11), is September 1 through August 31. Your benefit eligibility and coverage period are based on the school year.

What’s the difference between “fully insured” and “self-insured” plans?

  • Basically, a “fully insured” plan is offered by commercial carriers, which choose what is covered (this is called the “benefit design”). Not all fully insured plans are offered in all counties.
  • A “self-insured” plan is offered by the employer organization — in this case, Washington State. The state develops the benefit design and has more control over plan costs. Our self-insured plan is called the Uniform Medical Plan (UMP), administered by Regence. UMP will be available to all SEBB subscribers.
  • Several health care options will be offered, both fully insured and self-insured plans, with differing benefits and plan costs. Details will be available in time for open enrollment in the fall.

* New or updated August 14, 2019.

Do holiday hours count toward the 630-hour threshold?

  • For the most part, holiday hours do not count. However, holiday hours do count for new hires that happen late in the school year. See How to determine eligibility.

Can children be enrolled in Apple Health for Kids instead of the SEBB Program?

  • No. If you or your children are currently enrolled in Washington Apple Health (Medicaid) coverage, and you are eligible for SEBB Program coverage, you must enroll themselves and their children in SEBB benefits. You cannot waive SEBB medical coverage for Apple Health coverage, but you can be enrolled in both. If you are a current Apple Health client, you can apply for the Premium Payment Program, which provides reimbursement for your SEBB medical premiums. If your children are on Apple Health for Kids with premiums (CHIP), that coverage will end December 31.

Can I waive SEBB coverage?

  • You can waive SEBB medical coverage during the SEBB Program’s annual open enrollment if you are enrolled in other employer-based group medical insurance, a TRICARE plan, or Medicare.
  • However, you must enroll in SEBB dental, vision, basic life and accidental death and dismemberment (AD&D) insurance, and basic long-term disability insurance for yourself, regardless of whether you waive SEBB medical coverage.

I’m a classified employee with an uncertain schedule. Some years I work more than 630 hours a year, some years less. If I work 630 hours one year, and start receiving benefits, will I continue to get benefits the next year? *

  • That depends.
    • If your district, ESD, or charter school anticipates you will work 630 hours at the beginning of the next school year (September 1), then you will receive continual benefits.
    • If your district, ESD, or charter school does not anticipate you will work 630 hours at the beginning of the next school year, then your benefits will end on August 31.
    • If you end up working 630 hours two years in a row, and you’re returning to the same type of position(s) within the same district, ESD, or charter school, you are presumed eligible at the beginning of the third school year.
    • If your district, ESD, or charter school does not anticipate you will be eligible in the third year, they must notify you of the specific reason in writing. You would have the right to appeal that decision.

Does the SEBB Program have an employee assistance program?

  • No, but districts can pursue an employee assistance program on their own.

Who will be eligible for benefits from the SEBB Program?

  • School employees who are anticipated to work at least 630 hours during the school year are eligible.

Will my dependents be covered?

  • Spouses and state-registered domestic partners, children up to age 26, children with disabilities, and extended dependents are eligible. Learn more about dependents.

When do new employees start receiving benefits?

  • It depends on when they are hired.
    • New school employees: In September each year, new school employees who are anticipated to work 630 hours during the school year and whose first day of work is September 1 through the first day of school are eligible. They will start coverage on their first day of work.
    • Returning school employees: For school employees anticipated to work 630 hours during the school year and whose first day of work is at any other time during the school year, the effective date of coverage is the first day of the month following the day they begin work.
    • School employees hired late in the school year: School employees hired late in the school year but anticipated to work 630 hours or more the following year fall into two categories.
      • Employees hired on a nine- to 10-month basis will be eligible for SEBB benefits on their first day of work if they are anticipated to be compensated for at least 17.5 compensated hours a week in six of the last eight weeks counting backward from the week that contains the last day of school. Their benefits would begin the first of the month after they begin work.
      • Employees hired on a 12-month basis will be eligible for SEBB benefits on their first day of work if they are anticipated to be compensated for at least 17.5 compensated hours a week in six of the last eight weeks counting backward from the week that contains August 31, the last day of the school year.  Their benefits would begin the first of the month after they begin work.

What if, at the beginning of the school year, I am not anticipated to work 630 hours, but later my schedule changes, and then I am anticipated to work 630 hours?

  • You become eligible on the day you are notified of the schedule change. Your coverage begins on the first day of the following month.
    • For example, a substitute bus driver is not eligible for SEBB benefits in September because they are anticipated to work fewer than 630 hours during the school year. But in October their work schedule changes and they are then anticipated to work more than 630 hours during the school year. They become eligible the day they are notified of the change, and their coverage begins November 1.

What happens if an employee is not anticipated to reach 630 hours during the school year, but subsequently does reach 630 hours?

  • The employee becomes eligible on the day they reach 630 hours. Their coverage begins on the first day of the following month.
  • For example, a substitute teacher who is not anticipated to work 630 hours at the beginning of the school year is not eligible for the SEBB Program. However, there is more work for them than expected, and in February they reach 630 hours. They become eligible on that day. Their coverage begins March 1.

What happens when an employee hits 630 hours but is not anticipated to hit 630 hours the following year?

  • The employee would receive benefits in the school year they become eligible. Anticipated hours would be reassessed in September for the new school year. If they reach 630 hours two years in a row and return to the same type of position, they will be presumed eligible for the third year.

I work more than 630 hours during the school year. I expect to continue working in the same position next year. What happens to my benefits after August 31?

  • Your coverage will continue uninterrupted on September 1.

I’m a coach and am eligible for benefits. Am I covered past my sport’s season? What about next year?

  • If you are anticipated to work 630 hours during the school year you are eligible, and you are covered all through the school year. If you are anticipated to work 630 hours or more during the next school year, your coverage will continue without interruption.

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

  • 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. Starting in 2020, SEBB Program eligibility rules will allow only state-registered domestic partners (as defined in RCW 26.60.020) to enroll as dependents.

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

  • By law, the SEB Board establishes eligibility criteria for dependents, including legal spouses and state-registered domestic partners. To inform their decision, the SEB Board reviewed the specific reference to state-registered domestic partners in RCW 41.05.740(6)(d)(iii).

What happens if I move to another job?

  • You will have uninterrupted coverage when moving from one school district, ESD, or charter school to another within the same month or a consecutive month, if the following conditions are satisfied:
    • You were eligible for the employer contribution toward SEBB benefits in the position you are leaving; and
    • You are anticipated to be eligible for the employer contribution toward SEBB benefits in your new position.

Who will be responsible for verifying family members’ eligibility for coverage under the SEBB Program?

  • Employees are required to provide evidence of a dependent’s eligibility within the SEBB Program’s timeframe. School personnel staff will verify dependents’ eligibility for coverage. HCA staff will work with school personnel staff.

Will existing employee dependents be grandfathered?

No. Employees’ dependents will not automatically be enrolled in SEBB. Employees must enroll their eligible dependents to have them covered.

My children and I have health insurance under a group plan offered through my district, but I won’t be eligible for SEBB benefits per the 630 hour rule. Can I get any coverage through SEBB?

  • Yes. If you are eligible for coverage through your employer on December 31, 2019, but ineligible for employer-contributed SEBB benefits, you can enroll yourself and your dependents in SEBB Continuation Coverage medical, dental, and vision coverage on a self-pay basis (you pay the entire premium) for 18 months.
  • Your organization may offer benefits to employees who work more than 180 hours but fewer than 630 hours per year. See your payroll or benefits office for information.

* New or updated August 7, 2019.

Do employees sign up for plans based on where they live, or where they work? *

All school employees will be offered a selection of plans based on their county of residence. Some school employees, including employees who live outside Washington State, may have more plan options if they work in a district that crosses county lines or is in a county that borders Idaho or Oregon.

What plans will employees be enrolled in if they don’t choose any?

If employees who are eligible for SEBB benefits do not either enroll in or waive SEBB Program medical coverage during the first annual open enrollment, they will be enrolled in the following default benefits:

  • Medical: UMP Achieve 1, with a $33 monthly premium
  • Dental: Uniform Dental Plan (no premium)
  • Vision: MetLife vision (no premium)
  • Basic life and accidental death and dismemberment (AD&D): MetLife (no premium)
  • They will be charged the $25 tobacco use premium surcharge in addition to the medical premium. Their dependents will not be enrolled. In addition, they won’t be able to change plans or enroll any eligible dependents until the next SEBB Program annual open enrollment or unless they have a special open enrollment event that allows the change, such as a marriage, birth, or adoption.

What happens if employees do not select coverage during open enrollment? *

  • Employees who are eligible for SEBB benefits and do not either enroll in or waive medical coverage during the first annual open enrollment will be enrolled in the following default benefits: medical: UMP Achieve 1; dental: Uniform Dental Plan; vision: MetLife vision; blife and accidental death and dismemberment (AD&D): MetLife; basic long-term disability (LTD): The Standard.

  • Defaulted employees will be charged the $25 tobacco use premium surcharge in addition to their $33 monthly medical premium. Their dependents will not be enrolled. In addition, they won’t be able to change plans or enroll any eligible dependents until the next SEBB Program annual open enrollment or unless they have a special open enrollment event that allows the change, such as a marriage, birth, or adoption.

Are subscribers able to update their own addresses in SEBB My Account?

  • No. Subscribers must notify their payroll or benefit office of address changes. The benefit administrators will update addresses through SEBB My Account.

Does dependent verification need to be submitted before the annual open enrollment closes?

  • Yes. Documents must be submitted by 11:59 p.m., November 15, so they can be verified before January 1, 2020.

If I enroll in SEBB Program benefits, and my spouse is enrolled in the PEBB Program, can we cover each other as dependents on each other’s account?

  • Yes. If you cover each other, your spouse’s or state-registered domestic partner’s primary coverage would be through the PEBB Program and the secondary coverage would be through the SEBB Program. Your primary coverage would be through the SEBB Program and your secondary coverage would be through the PEBB Program. In this scenario, you would not incur the monthly $50 spouse or state-registered domestic partner coverage premium surcharge.
  • However, if your spouse or state-registered domestic partner waives medical coverage and enrolls on your account (or vice versa), you would incur the monthly $50 spouse or state-registered domestic partner coverage premium surcharge in addition to your monthly premiums.

Can I cover my retired spouse, who is enrolled in Medicare Part A and Part B, on my SEBB account?

  • Yes. The primary coverage would be through the SEBB Program on any claims your spouse might have. Medicare would be the secondary payer, and only pays if the SEBB plan paid less than Medicare would have paid.

If my spouse is eligible for Medicare Part A and Part B but does not enroll in it, and I enroll them on my SEBB account, do I pay a spouse or state-registered domestic partner coverage premium surcharge?

  • No. Medicare is not employer-based group medical coverage, so the premium surcharge does not apply. WAC 182-30-050 (2) says: " ‘Employer-based group health plan’ means group medical, group vision, and group dental related to a current employment relationship. It does not include medical, vision, or dental coverage available to retired employees, individual market medical or dental coverage, or government-sponsored programs such as Medicare or Medicaid.”

What if an employee doesn’t select health plans during the first annual open enrollment and is defaulted into plans that aren’t available in their area?

  • If employees do not choose medical, dental, and vision plans, they will be enrolled in default plans that are available in their area.

Can eligible employees use SEBB My Account to enroll in all of the SEBB Program’s basic and supplemental insurance benefits?

  • No.
    • Employees can enroll in medical, dental, vision, basic life AD&D, and both basic and supplemental long-term disability (LTD) insurance.
    • Employees will need to go to different websites to enroll in supplemental life and AD&D insurance, Medical Flexible Spending Arrangement (FSA), and Dependent Care Assistance Program (DCAP). The links to these respective websites will be available from within SEBB My Account.
    • A paper form will be available for employee contribution elections in health savings accounts (HSA) and provided to the district payroll or benefits office (benefits administrator).

Can I waive SEBB coverage?

  • You can waive SEBB medical coverage during the SEBB Program’s annual open enrollment if you are enrolled in other employer-based group medical insurance, a TRICARE plan, or Medicare.
  • However, if you are eligible for SEBB benefits, you must enroll in SEBB dental, vision, basic life and AD&D insurance, and basic long-term disability insurance, regardless of whether you waive SEBB medical coverage. See the Waiving medical coverage webpage for more information.

Can an employee who qualifies for Apple Health (Medicaid) waive SEBB medical coverage?

  • No. You can only waive SEBB medical coverage if you’re enrolled in other employer-based group medical insurance, a TRICARE plan, or Medicare. Apple Health (Medicaid) does not qualify. However, you can be enrolled in both SEBB benefits and Apple Health. Your SEBB benefits will be your primary health plan and will pay first for covered services. Your Apple Health coverage may pay copays, deductibles, and other services that your SEBB benefits don’t cover.

My spouse has a retiree policy that covers me. Can I waive medical?

  • No. You can only waive SEBB medical coverage if you’re enrolled in other employer-based group medical insurance, a TRICARE plan, or Medicare. Retirement policies are not employer-based, so they do not qualify.

I want to waive medical coverage. Do I use SEBB My Account or a paper form?

  • Employees who want to waive medical coverage can use either SEBB My Account or paper forms. If they waive medical coverage before the end of open enrollment, they will not default into a medical plan. If they do not waive medical coverage or do not enroll in a plan within the SEBB Program’s timelines, they will default into a medical plan chosen by the SEBB Program.

Will we use SEBB My Account for attestation?

  • Yes. Functionality will be built into SEBB My Account to attest to the tobacco use and spousal premium surcharges.

Will enrollment materials be available in languages other than English?

  • SEBB My Account, the online enrollment system, will only be available in English for now. However, non-English speakers will still be able to enroll in SEBB using paper forms. Print publications and enrollment forms will be available in additional languages upon request. Additional supported languages include: Amharic, Burmese, Cambodian, Chinese, Korean, Laotian, Oromo, Punjabi, Romanian, Russian, Somali, Spanish, Swahili, Tagalog, Tigrigna, Ukrainian, and Vietnamese. For more information visit the language access page.

Will SEBB My Account work for people who are visually impaired?

  • Yes, SEBB My Account is being developed and tested to follow the Americans with Disabilities Rehabilitation Act (ADA) Website Content Accessibility Guidelines (WCAG) 2.0. This includes making the system friendly for screen readers to read textual information.

My spouse and I are both school employees eligible for SEBB. Can we put ourselves on each other’s SEBB account?

  • No. Each of you will have your own account. No one can enroll on more than one account.

What about our children? Can they be on two accounts?

  • No. SEBB coverage is limited to a single enrollment per individual. If you and your spouse or state-registered domestic partner both enroll in coverage, you can decide which account your children go on.

Can I waive dental and/or vision coverage?

  • No. All SEBB benefits-eligible employees will be automatically enrolled in dental, vision, basic life and AD&D insurance, and basic long-term disability.

I’m waiving medical coverage. Do I have to pay the premium surcharges?

  • No. The tobacco use and spousal coverage premium surcharges do not apply if you waive medical coverage.

Can I enroll my dependents in dental and vision if they’re not enrolled in medical?

  • Yes. Dependents must be enrolled in the same health plans as the subscriber. So if the subscriber is enrolled in dental and vision coverage, their dependents can be enrolled in the same dental and vision plans. This applies whether the subscriber is enrolled in medical or waives it.

Will employees be able to enroll using paper forms?

  • School employees will be directed to enroll online using a computer, tablet, or smartphone. However, for those who cannot enroll online, paper enrollment forms will be available.

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

  • Open enrollment for SEBB Program subscribers will take place October 1 through November 15, 2019. Information about benefit options will be shared well in advance.

I am a new teacher, and I start work in August. When does my coverage start?

  • Your coverage starts on the first of the next month after you begin work. If you start work during August, your coverage would begin September 1.

I’m a new school employee and I start on September 3. School starts September 7. When does my coverage start?

  • Because you started between September 1 and the first day of school, your coverage begins on your first day of work, September 3.

I’m a new school employee and I will start work on the first day of school. When will my coverage start?

  • Because you started between September 1 and the first day of school, your coverage begins on your first day of work.

I’m a new bus driver. School starts on September 9, but I start work on September 12. When will my coverage start?

  • Your coverage begins the first day of the next month, October 1.

I want to get health coverage for my family. What do I do?

  • You can add eligible dependents to your coverage during open enrollment or during special open enrollment periods. See which dependents are eligible. You will have to provide evidence of your dependents’ eligibility within the SEBB Program’s enrollment timeframe. A list of acceptable documents and the enrollment deadlines will be available before open enrollment in fall 2019.

What is dual enrollment?

  • If you and your spouse or state-registered domestic partner are both eligible for SEBB benefits, you can't enroll on each other's accounts. We call that "dual enrollment," and it is not allowed in the SEBB Program. You need to decide which of you will cover yourselves and any eligible dependents on your medical or dental plans. You could waive medical coverage for yourself and enroll as a dependent on your spouse’s, state-registered domestic partner’s, or parent’s medical coverage. However, you must enroll in dental, basic life and AD&D insurance, and basic long-term disability insurance under your own account.

Why is dual enrollment not allowed under the SEBB Program?

  • The single-enrollment policy helps maintain the affordability of the SEBB Program’s health plans. Allowing dual enrollment would increase the cost of the SEBB Program and could result in reduced benefits or higher costs in the future.

*New or updated on August 7, 2019.

Where can I find information about the health savings account (HSA)? *

On our HSA webpage you’ll find information about the HSA, which is paired with the SEBB Program’s high-deductible health plan. The monthly HSA employer contribution amounts will be posted there on September 3.

Some people have flex plans (also referred to as Flexible Spending Arrangements [FSAs] and dependent care accounts) that overlap with the January 1 go-live date. What do these people do?

  • We encourage anyone with an FSA or dependent care account to use up all their funds by their current plan’s deadline or December 31, 2019, whichever is earlier. Doing so will minimize the risk that they will forfeit funds. It may also lessen any confusion they might experience during the switch to the SEBB Program.

Are Social Security numbers (SSN) required in SEBB My Account?

  • Yes, Social Security numbers (SSN) or Individual Tax Identification Numbers (ITIN) are required. If a dependent does not yet have an SSN or ITIN for a dependent, they can begin benefits without an SSN/ITIN, but the dependent’s record must be updated with an SSN/ITIN as soon as possible after issuance.

Is there an Accelerated Benefit Option under SEBB Program life insurance coverage?

  • Yes, the basic and supplemental life insurance plans have an accelerated benefits option. If a subscriber becomes terminally ill and is expected to die within 24 months, they can request to receive a portion of their life insurance benefit before their death. For more information, visit the Life insurance webpage.

Who is responsible for applying for life insurance portability?

  • If you are an enrolled SEBB Program subscriber and your job ends, you have the right to “port” your basic and supplemental life insurance. You do not have to show proof of insurability. You will receive forms and instructions from the carrier. You are responsible for filling out the forms and applying for portability. You must apply in writing to the insurance carrier within 60 days after the date your SEBB Program life insurance ends. For more on portability, visit the Life insurance webpage.

Is AD&D insurance portable?

  • No. AD&D insurance is not portable.

Will the basic long-term disability benefit be substantial enough to cover my expenses if I become disabled?

  • The basic long-term disability (LTD) benefit is based on a percentage of your paycheck, and the maximum amount provided by this benefit is $400 per month. The SEB Board will revisit this benefit and look for ways to improve it. Final decisions will be made in time for the first annual open enrollment, October 1 through November 15, 2019.
  • You can buy supplemental LTD insurance to ensure you are well covered. Supplemental LTD insurance with no Evidence of Insurability (EOI) will be available during the first annual open enrollment.

What are Centers of Excellence (COE)?

  • HCA contracts with providers who excel in treating certain medical conditions. Currently, the COE program offers low-to-no-cost knee and hip replacement, as well as spine care, to qualifying PEBB Uniform Medical Plan (UMP) Classic and UMP Consumer-Directed Health Plan (CDHP) members.
  • Starting January 1, 2020, the COE program will be available to employees enrolled in the SEBB Program's UMP Achieve 1, UMP Achieve 2, and UMP High Deductible. COE will be available only to subscribers of these UMP plans and those members enrolled in PEBB's CDHP plans. 
  • Premera Blue Cross administers the COE Program for UMP. To learn more, visit Premera’s COE webpage.

Does the SEBB Program have a flex plan?

How many chiropractic appointments can I get in a year?

  • It depends on the plan you choose. Plan coverages range between 16 and 60+.

Why is the SEBB Program not offering short-term disability insurance?

  • The SEBB Program was unable to offer a short-term disability benefit better than the new Paid Family Medical Leave Act (PFMLA), effective in 2020.

What types of benefits will the SEBB Program offer?

  • The SEBB Program will offer medical, dental, vision, life and AD&D insurance, and long-term disability insurance, beginning January 1, 2020.
  • The SEB Board has authority to offer benefits that are not paid by the employer, such as the Medical Flexible Spending Arrangement, Dependent Care Assistance Program, and auto and home insurance.

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

  • The number of plans offered depends on insurance carrier responses to procurements, and the types of plans and the benefit design selected by the SEB Board.

What dental benefits will be included?

  • Yes. Eligible school employees can choose from up to three dental plan options, depending on where you live:
    • Delta Dental  (DeltaCare)
    • Uniform Dental Plan
    • Willamette Dental
  • Details of deductibles, out-of-pocket maximums, coverage, premiums, and other specifics will be available in time for open enrollment in fall 2019.

Will more than one vision plan be available?

  • Yes. All eligible employees can choose between all the vision plans we offer. We are currently negotiating with three carriers: Davis Vision, EyeMed, and MetLife.

Will employees pay a monthly premium for vision and dental?

  • No. Vision and dental insurance premiums are paid for you and your eligible dependents by your employer. However, you are responsible for deductibles, copays, and coinsurance payments.

Will school employees pay a monthly premium for life and AD&D insurance, and long-term disability insurance?

  • No. Eligible school employees will receive basic life and AD&D insurance, and basic LTD insurance through employer-paid benefits.
  • Employees will also be able to purchase supplemental life and AD&D insurance, and supplemental LTD insurance for themselves and their eligible dependents.

What carriers will offer plans through SEBB?

  • Medical: The SEB Board has approved going forward with negotiations with Kaiser Permanente Northwest, Kaiser Permanente Washington, Kaiser Permanente Options, Premera Blue Cross, and Uniform Medical Plan (UMP) as administered by Regence BlueShield. Final decisions on providers will be made in summer 2019.
  • Dental: We are going forward with negotiations with Delta Dental, Willamette Dental, and Uniform Dental Plan ad administered by Delta Dental.
  • Vision: We are going forward with negotiations with Davis Vision, EyeMed, and MetLife.
  • The SEB Board may make changes to the approved benefit designs until summer 2019.

My health plan year usually ends on October 31, but SEBB Program benefits are scheduled to start January 1, 2020. What will be done to address the time between when my current benefits end in 2019 and new SEBB Program benefits begin in 2020?

  • We have heard from most carriers, who indicate they will extend coverage through December 31, 2019. If you have questions, please contact your payroll or benefits office.

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

  • It depends on the plans you choose. Given the number of plans offered, it is likely that your provider will be a member of one of the covered networks.

I live in a rural area. Will my community providers be covered under the new SEBB plans?

  • The SEB Board and HCA are working to make sure all members have access to quality health plans and providers, regardless of where they live. After the procurement process is complete, we will have more detailed information about the plans and network options that will be available.

What benefits are the SEBB Program authorized to offer?

  • Under RCW 41.05.740, the SEBB Program is authorized to offer the benefits listed below. The SEB Board will decide which of these benefits will be offered.
    • Health care coverage (medical, dental, and vision)
    • Prescription drug
    • Life insurance
    • Accidental death and dismemberment insurance
    • Liability insurance
    • Disability insurance

Are there any restrictions on additional benefits school districts, ESDs, and charter schools may offer?

  • Beginning January 1, 2020, school districts, ESDs, and charter schools may not offer any of the same benefits SEBB is authorized to offer (see list above) to any benefits-eligible employees and dependents. School districts, ESDs, and charter schools cannot offer these benefits independent from the SEBB Program, even if the SEB Board chooses not to offer them.
  • In addition, the law grants HCA exclusive authority over the salary reduction plan, so the following benefits are also excluded from being offered by school districts, ESDs, and charter schools.
    • Premium Payment Plan
    • Medical Flexible Spending Arrangement (FSA)
    • Dependent Care Assistance Program (DCAP)
    • Health Savings Account (HSA)

What optional benefits may school districts offer?

  • School districts, ESDs, and charter schools may offer some benefits, as long as they do not fall under the SEBB Program’s authority (see above). Any optional benefits that are offered by a school district, ESD, or charter school are considered an enhancement to the state’s definition of basic education, meaning the state will not contribute to their funding.
  • Optional benefits offered by school districts, ESDs, and charter schools may be paid by the employee, the employer, or both. Here are some examples of optional benefits.
    • Voluntary Employees Beneficiary Association (VEBA) plans
    • Cancer insurance
    • Travel insurance
    • Pet insurance

Will part-time employees have to pay a monthly premium for medical benefits?

  • Yes. All eligible employees will have the same premiums regardless of part- or full-time status. All eligible employees who enroll will pay a monthly premium based on the benefits they choose and whether they cover dependents.

Will part-time employees pay the same monthly premiums that full-time employees pay?

  • Yes. All employees working at least 630 hours a year who enroll in the SEBB Program will pay a monthly premium. The premium amount will depend on the medical plan you choose and whether you cover dependents.

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 eligible dependents 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 dependents 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, deductibles, 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. 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.

What are the premium surcharges?

The Legislature, under Section 504 of ESSB 6032, requires school employees to pay two premium surcharges, if they apply, in addition to the medical plan premiums each month, starting January 1, 2020.

  • Tobacco use premium surcharge
    A monthly $25 premium surcharge per account if the employee or any dependent (age 13 or older) enrolled on their SEBB medical plan uses a tobacco product.
  • Spouse or state-registered domestic partner coverage premium surcharge
    A monthly $50 premium surcharge if the employee has a spouse or state-registered domestic partner enrolled on their SEBB medical plan, and the spouse or state-registered domestic partner has elected not to enroll in their employer-based group medical insurance that is comparable to PEBB’s Uniform Medical Plan (UMP) Classic.

Are premium surcharges pre-tax?

  • Yes. Monthly medical premiums, along with applicable premium surcharges, will be deducted from paychecks pretax, unless the employee arranges with their payroll or benefits office to have their premiums and applicable premium surcharges deducted post-tax.

* New or updated June 17, 2019

What are tobacco products?

  • “Tobacco products" means any product made with or derived from tobacco that is intended for human consumption, including any component, part, or accessory of a tobacco product. This includes, but is not limited to, cigars, cigarettes, pipe tobacco, chewing tobacco, snuff, and other tobacco products. It does not include e-cigarettes or United States Food and Drug Administration (FDA)-approved prescription and over-the-counter tobacco cessation aids.

What is tobacco use?

  • Tobacco use means any use of tobacco products within the past two months. Tobacco use, however, does not include religious (as part of a formal tradition, rite, or ritual) or ceremonial (in connection with the practice of a traditional ceremony or ritual) use of tobacco.

How can I avoid paying the tobacco use premium surcharge?

  • You will not have to pay the tobacco use premium surcharge if you attest within the SEBB Program's timelines and you or any dependent (age 13 or older) enrolled on your SEBB medical coverage uses tobacco products.

Will I be charged the tobacco use premium surcharge if I fail to respond or do not attest “No” to using tobacco for all enrolled dependents?

  • Yes. To avoid paying the tobacco use premium surcharge, you must attest that you and any enrolled dependents (age 13 or older) enrolled on your SEBB medical coverage do not use tobacco products or are enrolled in a tobacco-cessation program. If the your status changes and the tobacco use surcharge no longer applies, you can re-attest at any time. For more information, visit our Tobacco use premium surcharge webpage.

Is the tobacco use premium surcharge per person?  

  • No, the tobacco use premium surcharge is per account. You will not be charged more for additional tobacco users. Find out more on our Tobacco use premium surcharge webpage. 

Does the tobacco use premium surcharge apply to my dependent who doesn’t live with me?

  • Yes. If there is at least one person (age 13 or older) enrolled on your SEBB medical coverage who uses tobacco products (whether your enrolled dependent lives with you or not), you will be charged the tobacco use premium surcharge in addition to your monthly medical premium.

Is marijuana included in the tobacco use premium surcharge? *

  • No, only tobacco products are included.

If I do not have a spouse or state-registered domestic partner enrolled on my SEBB medical coverage, do I have to attest to the spouse or state-registered domestic partner coverage premium surcharge?

  • No. The premium surcharge will not apply to you.

If I have a spouse or state-registered domestic partner enrolled on my SEBB medical coverage, what happens if I don’t attest within the HCA’s timelines?

  • You will be charged the monthly $50 premium surcharge in addition to your medical plan premium.