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FAQs for school administrators

The following frequently asked questions (FAQs) help you understand the SEBB Program and how it affects your school district, educational service district, or charter school.

We will update this page periodically.  

Last updated November 14, 2018.

Can implementation of the SEBB Program be delayed for one year?

The Legislature, the SEB Board, and the Health Care Authority (HCA) are committed to having everything in place for implementation on January 1, 2020. There is no consideration of delaying implementation.

Can school districts, ESDs, and charter schools opt out?

No. The SEBB Program applies to all school districts, educational service districts, and charter schools within Washington.

Is HCA adding additional staff to support this?

Yes. HCA is adding staff primarily in the Employees and Retirees Benefits (ERB) Division, whose jobs will be to make the transition to the SEBB Program as smooth as possible. Personnel in school districts, educational service districts, and charter schools will retain a very active role in assessing eligibility and aiding employees with enrollment. ERB staff will provide training and support. Additionally, ERB will provide information to school employees ahead of the October 2019 open enrollment to assist them in making benefit selections.

Is the Legislature aware of the amount of workload districts will need to undertake for dependent verification?

HCA is working with the Legislature to address the anticipated workload needs resulting from dependent verification requirements.

How will HCA communicate information to school districts, ESDs, charter schools, and interested people?

Information is available on our website, including:

We will continue to add information as it becomes available.

You can also sign up to receive email updates on:

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.

Will employees working 630 hours or more be fully funded by the state?

This depends on the outcome of the 2019 legislative session.

How will the discrepancy in funding between headcount, FTE, and staffing reality be resolved?

Benefits are funded by the Legislature on an FTE basis. However, to help bridge the difference between FTE and headcount, the “benefit allocation factor” was approved in collective bargaining. The benefit allocation factor (1.02 for certificated employees and 1.43 for classified employees) is multiplied by the FTE to arrive at the allocation.

Will districts be responsible for any difference between state-funded FTE benefits and district headcount-based benefits?

Districts will likely pay any difference. The amount of funding provided in the state budget for SEBB Program benefits won’t be known until the 2019–21 biennial budget is enacted.

Will SEBB funding be tied to prototypical school funding?

SEBB Program funding is anticipated to be calculated using the prototypical model. However, the Legislature may make adjustments.

Will the Legislature make any adjustments to address discrepancies between headcount and FTE?

Benefits are funded by the Legislature on an FTE basis. To help bridge the difference between FTE and headcount, the collective bargaining agreement includes a “benefit allocation factor.” The benefit allocation factor (1.02 for certificated employees and 1.43 for classified employees) is multiplied by the FTE to arrive at the allocation.

What will the funding source be for the school districts going forward? 

The state will provide funding on an FTE basis with a benefit allocation factor applied (see above). Funding will still come from the state, and we do not yet know what funding will be required from the district. Employees will also be responsible for a portion of their medical premium.

How will the funding rate account for job shares?

If two individuals sharing one job are each anticipated to work more than 630 hours, they will both be eligible for SEBB Program benefits. The district will be required to pay the employer’s share of the benefit costs for each eligible employee.

Can the district choose how to move money around to fund two employees for one FTE?

It is beyond the scope of HCA to direct how districts choose to fund employee benefits.

Will the school district, ESD, or charter school be required to pay the same amount of the medical premium and all the complete premium for employee dental, vision, LTD, life and AD&D, regardless of the employee’s FTE, as long as they meet the 630 hour criteria?

Yes, that is correct.

Will part-time school 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.

If a substitute qualifies for coverage mid-year and declines benefits, does the district have to pay the premium cost to HCA?

The SEB Board is developing policies to address this type of situation.

If an employee meets the eligibility requirement of working 630 hours within the school year on May 1, do we offer them coverage through August 31 (the end of the school year)?

Yes. The employee’s SEBB benefits would begin June 1 and run through August 31.

Will districts still pay the K-12 retiree remittance?

Yes. As long as K-12 retirees remain in the PEBB Program, districts will continue to pay the K-12 remittance that supports them. 

Why do school districts pay an employer contribution for employees who waive SEBB Program coverage?

The formula for insuring school district, ESD, and charter school employees and their dependents includes an estimated rate of employee waivers. If anticipated waivers weren’t factored in, that uncertainty would need to be funded by raising the amount employees pay for their benefits. The state pools funds to pay for everyone enrolled in the program. Also, keep in mind that employees who waive medical will still receive other benefits.

Why is the Legislature passing funding through the districts for SEBB benefits rather than providing it directly to HCA?

State funding for K-12 benefits is currently distributed to districts as part of general apportionment. In order to provide funding directly to HCA, the Legislature would need to restructure the K-12 benefit funding process in the budget bill, and HCA would still need to work with the districts to collect employee premium contributions and funding for any eligible staff not covered by the state funding. This funding model for SEBB Program benefits is similar to the PEBB Program benefits model, where state funds are distributed to state agencies and higher education institutions to forward to HCA along with employee premium contributions.

Will districts receive money or funded FTEs to implement the system of record and data transfer required for SEBB?

We don’t anticipate additional funding from the Legislature. However, HCA will provide technical assistance to support the transition to the SEBB Program. 

Will there be funding parity between PEBB and SEBB?

Funding parity was addressed by the Legislature in Engrossed Substitute Senate Bill 6241, which intended for insurance benefit allocations for school employees to be no less than rates for state employees. The amount of funding provided for PEBB Program and SEBB Program benefits will be addressed during standard legislative operating budget processes.

Will school districts, ESDs, and charter schools have to pay the reduction in employee premiums based on the wellness incentives?

If the Legislature approves the reduction, it will appropriate funds to cover the costs of wellness incentives.

Who is doing the “contributing” in RCW 41.56 and 41.59?

The contributions referred to in these laws is supplied by the state; the state will negotiate directly with a coalition of union representatives to determine what the employer contribution will be. As part of the budget process, the Legislature determines whether to fund the negotiated agreement as part of the 2019 legislative session.

RCW 41.56.500 (3) states: “Employee bargaining shall be initiated after July 1, 2018, over the dollar amount to be contributed for school employee health benefits beginning January 1, 2020, on behalf of each employee for health care benefits.”

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.

How do current PEBB rules inform the SEB Board’s policy decisions?

The SEB Board makes policy decisions entirely separate from PEBB Program rules. However, HCA does use its understanding of various issues that it has developed in administering the PEBB Program to help inform the SEB Board in its decision-making process.

When do new employees start receiving benefits?

It depends on when they are hired.

  • 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 for the SEBB Program. They will start coverage on their first day of work.
  • 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 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 work at least 17.5 compensated hours a week in six of the last eight full or partial weeks before summer break. 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 work at least 17.5 compensated hours a week in six of the last eight full or partial weeks before the end of the school year (August 31). Their benefits would begin the first of the month after they begin work.

Who will track the hours of an employee who works multiple jobs in a school district to determine their eligibility for benefits?

School personnel staff will track part-time employees’ hours for all positions they fill within the district.

How do we track employees who work across multiple school districts?

Only hours worked within the same school district will count toward the 630 hours. School employees cannot add together hours from multiple districts. Only hours from one district can count toward eligibility.

If an employee works for more than one school district, how will we know if they are dual enrolled in benefits under the SEBB Program?

HCA’s system of record only allows employees to be enrolled once, within a single district.

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 are notified of the schedule change. Their 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 she is anticipated to work fewer than 630 hours during the school year. But in October her work schedule changes and she is then anticipated to work more than 630 hours during the school year. She becomes eligible the day she is notified of the change, and her coverage begins November 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.

Are employees who aren’t considered full-time (like coaches, substitute teachers, etc.) eligible for benefits under the SEBB Program?

Yes, as long as they work or are anticipated to work 630 hours for a school district, educational service district, or charter school during the school year. A school year means September 1 through August 31.

What happens when an employee reaches 630 hours but decides not to bid or take shifts for the rest of the year? Do districts still provide benefits?

Yes. Districts will provide benefits to any employee who works or is anticipated to work 630 hours within the school year.

When does employee eligibility for coverage through the SEBB Program end?

The employer contribution toward SEBB benefits ends the last day of the month in which the school year ends (August 31). The employer contribution toward SEBB benefits will end earlier than the end of the school year if one of the following occurs:

  • The district, ESD, or charter school terminates the employment relationship. Eligibility for the employer contribution ends the last day of the month in which the employer-initiated termination notice is effective.
  • The school employee terminates the employment relationship. Eligibility for the employer contribution ends the last day of the month in which the school employee’s resignation is effective.
  • The school employee’s work pattern is revised such that the employee is no longer anticipated to work 630 hours during the school year. Eligibility for the employer contribution ends as of the last day of the month in which the change is effective.

If an employee meets the eligibility requirement of working 630 hours within the school year on May 1, do we offer them coverage through August 31 (the end of the school year)?

Yes. The employee’s SEBB benefits would begin June 1 and run through August 31.

If a school employee begins working full time on May 13 and is anticipated to work the next school year, when would their benefits begin?

It depends on how many hours they work during the current school year.

  • If the employee is anticipated to work at least 17.5 compensated hours a week in six of the last eight weeks before summer break (for 9- and 10-month appointees) or before August 31 (for 12-month appointees) they would start receiving benefits on June 1.
  • If the employee is not anticipated to work 17.5 compensated hours a week as noted in the first example, they would be eligible to start benefits on September 1 of the following school year.

What about transfers between districts?

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.

Will HCA create all open enrollment materials, benefit summaries, enrollment forms, etc., or will districts be able to create their own materials for open enrollment?

Yes. The SEBB Program will create open enrollment materials — including benefit summaries, enrollment forms, website content, email messages, flyers, posters, articles, and other communications. We’ll depend on the districts to distribute much of the information to ensure that all eligible school employees receive consistent information and follow the same processes.

We are developing information for administrators preparing for this change and for all school employees regarding open enrollment.

Will HCA attend all benefit fairs during OE?

HCA staff will not be able to attend benefits fairs at more than 300 school districts, educational service districts, and charter schools during open enrollment. However, HCA staff are looking into other ways to reach employees before and during open enrollment to make sure they — and their employers' payroll and business office staff — have the information needed to take action.

More information will be available closer to the SEBB Program’s first open enrollment in fall 2019, for coverage starting January 1, 2020.

What is “dual enrollment”?

If a school employee is eligible to enroll in the SEBB Program and is also eligible as the spouse, state-registered domestic partner or dependent of another school employee, we call that “dual enrollment.” Dual enrollment is not allowed in the SEBB Program. If an employee and their spouse or state-registered domestic partner are both eligible for SEBB benefits, they need to decide which will cover themselves and any eligible dependents on their medical, dental, and vision plans. An employee could waive medical coverage for themselves and enroll as a dependent on their spouse’s, state-registered domestic partner’s, or parent’s medical coverage. However, they must enroll in dental, basic life and AD&D, and basic long-term disability insurance under their 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.

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

Employees are required to provide evidence of their dependents' eligibility within the HCA’s timeframe. School personnel staff will verify dependents' eligibility for coverage. HCA staff will work with school personnel staff on how to do this.

Will existing employees be grandfathered?

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

Will school personnel staff be required to verify special open enrollment events for employees?

Yes. More information on special open enrollment will be included in open enrollment materials.

Our nonrepresented and admin groups currently have employer-paid life insurance of twice their salary. Will the listed new amount of $35,000 apply to all employees, with no additional employer-paid life insurance allowed?

Yes, that is correct.

Who will track the hours of an employee who works multiple jobs in a school district to determine their eligibility for benefits?

School personnel staff will track part-time employees’ hours for all positions they fill within the district.

How do we track employees who work across multiple school districts?

Only hours worked within the same school district will count toward the 630 hours. School employees cannot add together hours from multiple districts. Only hours from one district can count toward eligibility.

If an employee works for more than one school district, how will we know if they are dual enrolled in benefits under the SEBB Program?

HCA’s system of record only allows employees to be enrolled once, within a single district.

What about transfers between districts?

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.

When the SEBB Program becomes effective on January 1, 2020, will the amount met toward employees’ deductibles in 2019 carry over?

No. Current plans should run until the end of 2019. January 1, 2020 will begin a new plan year and deductibles will start over.

Is there a request for proposal (RFP) date for dental?

Not at the moment. The SEB Board voted to not pursue a competitive solicitation for dental services starting January 1, 2020, but instead to leverage the current PEBB Program dental benefits. The procurements process for other benefits is ongoing, and the most current RFPs are posted on HCA’s Bids and contracts page. The procurements for disability, group vision, and fully insured group medical have all closed.

Is it true that the carriers participating in the SEBB Program also have to be part of the individual market exchange?

Yes. In 2018, the Washington State Legislature passed Engrossed Substitute House Bill 2408, which calls for this participation.

Of the six apparently successful bidders (ASBs) for the SEBB Program fully insured medical carriers, how many also currently provide PEBB insurance?

Kaiser Foundation Health Plan of the Northwest and Kaiser Foundation Health Plan of Washington currently offer PEBB insurance. The other ASBs are Aetna, Kaiser Foundation Health Plan of Washington Options, Premera Blue Cross, and Providence Health Plan.

Is HCA looking at a third-party administrator for a fully insured plan?

No. Typically, fully insured health care plans do not have a third-party administrator (TPA). TPAs are used to perform administrative services on behalf of an employer that sponsors a self-insured health plan.