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PEBB and SEBB open enrollment is Monday, October 27 through Monday, November 24, 2025.
Find information on the open enrollment page that’s right for you: PEBB retirees, PEBB employees and PEBB continuation coverage subscribers, and SEBB employees and SEBB continuation coverage subscribers.
Meetings and materials
Get the School Employees Benefits (SEB) Board meeting schedule, along with agendas, briefing books, and minutes.
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2025 meeting schedule
All meetings begin at 9 a.m.
- January 23, 2025
- March 6, 2025
- April 3, 2025
- May 8, 2025
- June 5, 2025
- June 18, 2025
- July 9, 2025
- July 16, 2025
- July 23, 2025 - Cancelled
- July 30, 2025 - Cancelled
Meeting materials
2025
| Date | Materials |
|---|---|
| July 16 | |
| July 9 | |
| June 18 | |
| June 5 | |
| May 8 | |
| April 3 | |
| March 6 | |
| January 23 |
- 2024 materials
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Date Materials July 10 June 20 June 6 May 2 April 4 March 14 January 25 - 2023 materials
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Date Materials
July 20 July 13 June 22 June 1 May 4 April 6 March 2 January 26 - 2022 materials
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Date Materials
July 21 July 7 June 23 June 2 May 5 April 7 March 3 January 27 - 2021 materials
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Date Materials
July 22 July 15 June 24 June 3 May 5 April 7 March 4 January 28
- 2020 materials
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Date
Materials July 23 July 16 June 24 June 4 May 7 April 2 March 5 January 27
Approved resolutions
- 2025 resolutions
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Meeting date Title Description Number 07/16/25 Uniform Medical Plan medical premiums The SEB Board authorizes the Uniform Medical Plan (UMP) 2026 employee premiums. 2025-09 07/16/25 Premera medical premiums The SEB Board authorizes the Premera 2026 employee premiums. 2025-08 07/16/25 Kaiser Foundation Health Plan of WA Options (KPWA-O) medical premiums The SEB Board authorizes the Kaiser Foundation Health Plan of Washington Options, Inc. 2026 employee premiums. 2025-07 07/16/25 Kaiser Foundation Health Plan of WA (KPWA) medical premiums The SEB Board authorizes the Kaiser Foundation Health Plan of Washington 2026 employee premiums.
2025-06 07/16/25 Kaiser Foundation Health Plan of the Northwest (KPNW) medical premiums The SEB Board authorizes the Kaiser Foundation Health Plan of the Northwest 2026 employee premiums.
2025-05 07/16/25 UMP hearing instruments Beginning January 1, 2026, prescribed hearing instruments in all Uniform Medical Plan (UMP) plans will be covered at 100% of the allowed amount every 36 months. Coverage for members enrolled in UMP Achieve 1 and UMP Achieve 2 is not subject to the member meeting the plan deductible. Coverage for members enrolled in UMP High Deductible is subject to the member meeting the plan deductible. 2025-04 07/16/25 Rescinding Resolution SEBB 2023-05 Effective January 1, 2026, resolution SEBB 2023-05, as adopted on June 1, 2023, is rescinded. 2025-03 06/05/25 Amending Resolution SEBB 2021-13 Amending resolution 2021-13 to read:
The SEBB Program will offer the following employer-paid LTD plan to subscribers beginning January 1, 2026:
- Benefit waiting period (the longer of):
- 90 days,
- The entire period of sick leave (excluding shared leave) for which the employee is eligible,
- The Fractionated Period of Paid Time Off (PTO) for which the employee is eligible, if your employer has a PTO plan, as those terms are defined in the policy,
- The entire period of other non-vacation salaried continuation leave for which the employee is eligible, or
- The end of Washington Paid Family and Medical Leave Law for which the employee is receiving benefits
- No choice sick leave
- Choice pension
- Maximum monthly benefit $450 (60% of $750)
2025-01 05/08/25 Amending Resolution SEBB 2024-08 Amending resolution 2024-08 to read:
Beginning January 1, 2025, diagnostic and supplemental breast exams are to be covered without member cost share to Uniform Medical Plan (UMP) members.
2025-02 - Benefit waiting period (the longer of):
- 2024 resolutions
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Meeting date Title Description Number 07/10/24 Uniform Medical Plan (UMP) 2025 medical premiums The SEB Board authorizes the Uniform Medical Plan (UMP) 2025 employee premiums. 2024-13 07/10/24 Premera 2025 medical premiums The SEB Board authorizes the Premera 2025 employee premiums. 2024-12 07/10/24 Kaiser Foundation Health Plan of Washington Options (KPWAO) 2025 medical premiums The SEB Board authorizes the Kaiser Foundation Health Plan of Washington Options, Inc. 2025 employee premiums. 2024-11 07/10/24 Kaiser Foundation Health Plan of Washington (KPWA) 2025 medical premiums The SEB Board authorizes the Kaiser Foundation Health Plan of Washington 2025 employee premiums. 2024-10 07/10/24 Kaiser Foundation Health Plan of the Northwest (KPNW) 2025 medical premiums The SEB Board authorizes the Kaiser Foundation Health Plan of the Northwest 2025 employee premiums. 2024-09 05/02/24 UMP diagnostic and supplemental breast exam coverage Beginning January 1, 2025, diagnostic and supplemental breast exams to be covered without member cost share to Uniform Medical Plan (UMP) members. UMP High Deductible members need to meet their deductible before the plan will pay any portion of the claim.
On May 5, 2025, the SEB Board amended 2024-08. Please see resolution 2025-02 for new language.
2024-08 04/04/24 Continuation coverage when a dependent of a school board member loses eligibility A dependent of a school board member who is enrolled in medical, dental, and vision who loses eligibility because they are not an eligible dependent under the SEBB Program may enroll in medical, dental, or vision for a maximum of 36 months on a selfpay basis. 2024-07 04/04/24 Continuation coverage when a term of a school board member of a school district ends A board member and their dependents who are enrolled in SEBB medical, dental, and vision who lose eligibility when the board member leaves office or their term ends may continue enrollment in SEBB medical, dental, or vision coverage for the maximum number of months allowed under COBRA. 2024-06 04/04/24 Amending SEBB 2021-08 Amending resolution 2021-08 to read:
If a school employee's dependent, who is also an employee, was auto-disenrolled from their PEBB dental and PEBB vision as a result of PEB Board Resolution PEBB 2021-04, the school employee's dependent will be automatically enrolled in the school employee's dental plan and vision plan. They will also be automatically enrolled in the school employee's dental, if they are not already enrolled.
2024-05 04/04/24 Amending SEBB 2021-07 Amending resolution 2021-07 to read:
If a school employee's dependent is enrolled in both PEBB medical and SEBB medical as a dependent and has been enrolled in PEBB benefits longer than they have been enrolled in SEBB benefits, but no action is taken to resolve the dual enrollment, the dependent will remain in PEBB benefits and will be auto-disenrolled from the school employee's SEBB medical, dental, and/or vision plans if they are enrolled.
If a school employee's dependent is not enrolled in any medical but is enrolled in both a PEBB and SEBB dental and/or vision plan as a dependent, the dependent will be kept in PEBB benefits and autodisenrolled from SEBB benefits.
Exception: If there is a National Medical Support Order or a court order in place, enrollment will be in accordance with the order.
2024-04 04/04/24 Amending SEBB 2021-05 Amending resolution 2021-05 to read:
If the school employee is enrolled in SEBB medical as a school employee and is also enrolled in PEBB medical as an employee, and the school employee has been enrolled in PEBB benefits longer than they've been enrolled in SEBB benefits, but no action is taken by the school employee to resolve their dual enrollment, they will remain in their PEBB benefits and will be autodisenrolled from their SEBB medical, SEBB dental, and SEBB vision plans. The school employee's enrollments in SEBB life, AD&D, and LTD will remain.
If a school employee is not enrolled in any medical, but is enrolled in PEBB dental, PEBB vision, SEBB dental, and SEBB vision, the school employee will be kept in PEBB benefits and auto-disenrolled from SEBB dental and SEBB vision.
2024-03 04/04/24 Amending SEBB 2021-03 Amending resolution 2021-03 to read:
An employee who waives PEBB medical and PEBB dental, and PEBB vision for SEBB medical must be enrolled in a SEBB dental and SEBB vision plan. If necessary, they will be automatically enrolled in the associated subscriber's SEBB dental and SEBB vision plans.
2024-02 04/04/24 Amending SEBB 2021-02 Amending resolution 2021-02 to read:
A school employee who is eligible for the employer contribution toward SEBB benefits may waive their enrollment in a medical plan if they are enrolled in other employer-based group medical. Exception: A school employee may waive their enrollment in a SEBB medical plan to enroll in a PEBB medical plan only if they are enrolled in a PEBB dental plan and PEBB vision plan. In doing so, the school employee also waives their enrollment in SEBB dental and SEBB vision.
2024-01 - 2023 resolutions
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Meeting date
Title
Description
Number
07/20/23 Uniform Medical Plan 2024 medical premiums The SEB Board authorizes the Uniform Medical Plan (UMP) 2024 employee premiums. 2023-12 07/20/23 Premera 2024 medical premiums The SEB Board authorizes the Premera 2024 employee premiums as presented on July 20. 2023-11 07/20/23 Kaiser Foundation Health Plan of WA Options (KPWA-O) 2024 medical premiums The SEB Board authorizes the Kaiser Foundation Health Plan of Washington Options, Inc. 2024 employee premiums. 2023-10 07/20/23 Kaiser Foundation Health Plan of WA (KPWA) 2024 medical premiums The SEB Board authorizes the Kaiser Foundation Health Plan of Washington 2024 employee premiums. 2023-09 07/20/23 Kaiser Foundation Health Plan of the Northwest (KPNW) 2024 medical premiums The SEB Board authorizes the Kaiser Foundation Health Plan of the Northwest 2024 employee premiums as presented on July 20. 2023-08 06/22/23 UMP over-the-counter COVID-19 test coverage Beginning July 1, 2023, all Uniform Medical Plan (UMP) plans will cover up to two over-the-counter COVID-19 diagnostic tests per member per month, up to $12 per test, without member cost-share.
If the Internal Revenue Service (IRS) issues future guidance that requires the deductible to be met prior to plan payment for over-the-counter COVID-19 diagnostic tests in high deductible health plans, the UMP High Deductible plan shall be amended to comply with IRS guidance.
2023-07 06/22/23 UMP High Deductible IRS plan maximum deductible For plan years beginning on or after January 1, 2024, HCA shall set the annual deductible for the UMP High Deductible health plan at the minimum annual deductible level established by the Internal Revenue Service (IRS) to qualify the plan as a high deductible health plan. 2023-06 06/01/23 UMP hearing instruments Beginning January 1, 2024, prescribed hearing instruments in all Uniform Medical Plan (UMP) plans will be covered up to $3,000 per ear with hearing loss, at least every 36 months, without member cost share. Coverage for members enrolled in UMP Achieve 1, UMP Achieve 2, and UMP Plus is not subject to the member meeting the plan deductible. Coverage for members enrolled in UMP High Deductible is subject to the member meeting the plan deductible.
On July 16, 2025, the SEB Board rescinded 2023-05. Please see resolution 2025-04 for new language.
2023-05 04/06/23 When a subscriber has a change in residence or employment location that affects medical plan availability After a change in residence or employment location, the subscriber must elect a new medical plan if a subscriber’s current medical plan is no longer available based on either residence or employment location. If they do not elect a new medical plan within the time period allowed by special open enrollment rules, the subscriber will be enrolled in a SEBB medical plan as designated by the director or designee. 2023-04 04/06/23 SEBB Continuation Coverage for a nonrepresented school employee’s dependent who is already on an ESD’s continuation coverage A dependent of a nonrepresented school employee who is continuing medical, dental, or vision coverage through an Educational Service District on December 31, 2023 may elect to continue existing enrollment to finish out their remaining months, up to the maximum number of months authorized by COBRA for a similar event, by enrolling in a medical, dental, or vision plan offered through the SEBB Program on a self-pay basis. 2023-03 04/06/23 SEBB Continuation Coverage for dependents not eligible under the SEBB Program A dependent of a SEBB eligible nonrepresented school employee of an Educational Service District who is enrolled in medical, dental, or vision under a school employee’s account on December 31, 2023 who loses eligibility because they are not an eligible dependent under the SEBB Program may continue existing enrollment for a maximum of 36 months on a self-pay basis. 2023-02 04/06/23 SEBB Continuation Coverage eligibility for nonrepresented ESD school employees not eligible for benefits under the SEBB Program A nonrepresented Educational Service District’s school employee and their dependents who are enrolled in medical, dental, or vision under a group plan offered by a SEBB Organization on December 31, 2023, who lose eligibility because the school employee is not eligible under the SEBB Program, may elect to continue existing enrollment in one or more of the following SEBB benefits: medical, dental, or vision coverage. These benefits will be provided for a maximum of 18 months on a self-pay basis. 2023-01 - 2022 resolutions
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Meeting date
Title
Description
Number
7/21/22 UMP medical premiums The SEB Board endorses the Uniform Medical Plan (UMP) employee premiums. 2022-09 7/21/22 Premera medical premiums The SEB Board endorses the Premera employee premiums. 2022-08 7/21/22 KPWA Options medical premiums The SEB Board endorses the Kaiser Foundation Health Plan of Washington Options employee premiums. 2022-07 7/21/22 KPWA medical premiums The SEB Board endorses the Kaiser Foundation Health Plan of Washington employee premiums. 2022-06 7/21/22 KPNW medical premiums The SEB Board endorses the Kaiser Foundation Health Plan of the Northwest employee premiums. 2022-05 7/21/22 UMP accumulators Beginning January 1, 2023, when a subscriber enrolled in a PEBB Program Uniform Medical Plan changes their enrollment to a SEBB Program Uniform Medical Plan during the plan year (excluding open enrollment), accumulated deductibles and out-of-pocket maximum expenses (both medical and pharmacy) will transfer.
2022-04 6/23/22 UMP High Deductible preventive care Beginning January 1, 2023, the UMP High Deductible plan will cover the drug list presented to the Board on June 2, 2022 prior to meeting the plan deductible. Thereafter, HCA may alter this drug list to allow for pre-deductible coverage based on clinical evaluation and in accordance with IRS guidance. 2022-03 6/23/22 IRS minimum deductible for high deductible health plan Beginning January 1, 2023, the deductible in the UMP High Deductible plan will be increased to $1,500 for single subscribers and $3,000 for all other tiers. 2022-02 4/7/22
School employees returning to work from
active dutyWhen a school employee who is called to active duty in the uniformed services under USERRA loses eligibility for the employer contribution toward SEBB benefits, they regain eligibility for the employer contribution toward SEBB benefits the day they return from active duty. Employer paid SEBB benefits will begin the first day of the month in which they return from active duty.
2022-01
- 2021 resolutions
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Meeting date Title Description Number 7/22/21 UMP Medical Premiums The SEB Board endorses the Uniform Medical Plan (UMP) employee premiums. 2021-22 7/22/21 Premera Medical Premiums The SEB Board endorses the Premera employee premiums. 2021-20 7/22/21 KPWAO Medical Premiums The SEB Board endorses the Kaiser Foundation Health Plan of Washington Options, Inc. employee premiums. 2021-20 7/22/21 KPWA Medical Premiums The SEB Board endorses the Kaiser Foundation Health Plan of Washington employee premiums. 2021-19 7/22/21 KPNW Medical Premiums The SEB Board endorses the Kaiser Foundation Health Plan of the Northwest employee premiums. 2021-18 7/22/21 UMP Chiropractic, Acupuncture, and Massage Benefit Design This benefit design resolution applies only if a comparable version is approved by both the PEB Board and the SEB Board.
Effective January 1, 2022, the Uniform Medical Plan (UMP) benefit design, for all UMP offerings, of the Chiropractic, Acupuncture, and Massage (CAM) benefits included in prior Board policy decisions and resolutions is rescinded and replaced with the following CAM benefit design:
Treatment limitations will be as follows:
- Chiropractic visits are limited to 24 per plan year
- Acupuncture visits are limited to 24 per plan year
- Massage visits are limited to 24 per plan year
Cost sharing for all UMP plans will be as follows:
- In network services will have a copay and neither the services nor the copay will apply toward the deductibles (except for UMP Consumer Driven Health Plan (CDHP) as described below), but the copay will apply toward the annual out of pocket maximums;
Out of network services will not have copays and will have:
- a 40% member coinsurance of the allowed amount for all UMP plans except UMP Plus, which will be a 50% member coinsurance, applies after the deductible is met and the coinsurance applies to the annual out of pocket maximum;
- no charges above the allowed amount apply toward UMP plan deductibles or the annual out of pocket maximum; and
- coverage only for Chiropractic and Acupuncture services
UMP CDHP members need to meet their deductible before the plan will pay any portion of the allowed amount for any claim, for both in network and out of network services.
2021-17 7/15/21 SEBB Continuation Coverage Eligibility for School Employees' Dependents If a school employee's dependent was auto-disenrolled from SEBB dental, SEBB vision, or both, because the school employee was auto-disenrolled from SEBB benefits to remain in PEBB benefits, the dependent may elect to enroll in SEBB dental, SEBB vision, or both. These benefits will be provided for a maximum of 36 months on a self-pay basis. 2021-16 7/15/21 UMP High Deductible Preventive Care Beginning January 1, 2022, the UMP High Deductible plan will allow coverage to treat certain chronic conditions, those presented at the July 15, 2021 SEB Board Meeting, before having to meet the plan deductible. 2021-15 6/24/21 UMP Accumulators Beginning January 1, 2022, when a subscriber enrolled in a SEBB Program Uniform Medical Plan (UMP) changes their enrollment to another SEBB Program UMP plan during the plan year (excluding Open Enrollment), the amounts accrued toward insurance accumulators (such as deductibles, out-of-pocket maximums, and benefit and visit limits) will transfer into their new UMP plan. 2021-14 4/07/21 Amending SEBB 2018-38: Employer-paid basic long-term disability Amending SEBB 2018-38 to read:
Employer-Paid Long-Term Disability Insurance The SEBB Program will offer the following Employer-Paid LTD Plan to subscribers beginning January 1, 2020:
- Benefit Waiting Period (the longer of);
- 90 days;
- The entire period of sick leave (excluding shared leave) for which the employee is eligible;
- The Fractionated Period of Paid Time Off (PTO) for which the employee is eligible, if your Employer has a PTO plan, as those terms are defined in the policy;
- The entire period of other non-vacation salaried continuation leave for which the employee is eligible; or
- The end of Washington Paid Family and Medical Leave Law for which the employee is receiving benefits
- No Choice Sick Leave
- Choice Pension
- Maximum Monthly Benefit $400 (60% of $667)
On June 5, 2025, the SEB Board amended 2021-13. Please see resolution 2025-01 for new language.
2021-13 4/07/21 Amending SEBB 2018-54: Relating to default enrollments Amending SEBB 2018-54 to read:
The default election for an eligible school employee who fails to timely elect coverage will be as follows:
- Enrollment in employee-only medical coverage;
- Enrollment in employee-only dental coverage;
- Enrollment in employee-only vision coverage;
- Enrollment in basic life insurance;
- Enrollment in employer-paid long-term disability insurance; and
- Enrollment in employee-paid long-term disability insurance at the 60% coverage level.
2021-12 4/07/21 Employee-paid long-term disability enrollment procedures All school employees who are eligible for the employer contribution towards SEBB benefits as of December 31, 2021 and not already enrolled in supplemental LTD insurance or did not make an election (reducing or declining coverage) during an enrollment period established by the Health Care Authority in 2021, will be autoenrolled in employee-paid LTD insurance at the 60% coverage level with an effective date of January 1, 2022 without Evidence of Insurability (EOI).
A school employee who becomes eligible for the employer contribution towards SEBB benefits on or after January 1, 2022 must make an election (reducing or declining coverage) during the benefit election period established in Resolution SEBB 2018-13. If the school employee fails to timely elect coverage, the school employee will be defaulted into coverage according to Resolution SEBB 2021-12 without EOI. The effective date of coverage will be according to Resolution SEBB 2020-05.
After January 1, 2022, a school employee at any time may elect to reduce employee-paid LTD to the 50% coverage plan without EOI or fully decline employee-paid LTD. The effective date of the change in coverage will be the first day of the month following the date the SEBB Organization receives the required election.
A school employee who seeks to increase coverage from the 50% coverage plan to the 60% coverage plan, or access previously declined employee-paid LTD, will be subject to evidence of insurability. The effective date of the change in coverage will be the day of the month the contracted vendor approves the required form.
Any school employee who declines employee-paid LTD insurance will remain enrolled in employer-paid LTD insurance.
2021-11 4/07/21 Employee-paid long-term disability Effective January 1, 2022, SEBB 2018-39 is rescinded and the SEBB Program will instead offer the following employee-paid LTD design:
Two separate employee-paid LTD insurance choices including: (a) coverage at 60% or (b) coverage at 50%. Both choices will have the following features:
- The following Benefit Waiting Period (the longer of):
- 90 days;
- The entire period of sick leave (excluding shared leave) for which the employee is eligible;
- The Fractionated Period of Paid Time Off (PTO) for which the employee is eligible, if your employer has a PTO plan, as those terms are defined in the policy;
- The entire period of other non-vacation salaried continuation leave for which the employee is eligible; or
- The end of Washington Paid Family and Medical Leave Law for which the employee is receiving benefits
- No Choice Sick Leave
- Choice Pension
- A Maximum Monthly Benefit of $10,000 for the 60% coverage and $8,333 for the 50% coverage
2021-10 4/07/21 Enrollment requirements when a school employee loses dependent coverage in PEBB benefits If a school employee who is eligible for the employer contribution towards SEBB benefits was enrolled as a dependent in PEBB benefits and is dropped by the PEBB subscriber, HCA will notify the school employee of their removal from the PEBB subscriber's account and that they have experienced a special enrollment event. The school employee will be required to return from waived enrollment and elect SEBB medical, SEBB dental, and SEBB vision. If the school employee's SEBB Organization does not receive the school employee's required forms indicating their medical, dental, and vision elections within sixty days of the school employee losing PEBB benefits, they will be defaulted into employee-only SEBB medical, SEBB dental, and SEBB vision. 2021-09 4/07/21 SEBB benefit automatic enrollments when PEBB benefits are auto-disenrolled If a school employee's dependent, who is also an employee who was auto-disenrolled from their PEBB dental as a result of PEBB Board Resolution PEBB 2021-04, the school employee's dependent will be automatically enrolled in the school employee's vision plan. They will also be automatically enrolled in the school employee's dental, if they are not already enrolled.
On April 4, 2024, the SEB Board amended 2021-08. Please see resolution 2024-05 for new language.
2021-08 4/07/21 Resolving dual enrollment involving a member with multiple medical enrollments as a dependent If a school employee's dependent is enrolled in both PEBB medical and SEBB medical as a dependent and has been enrolled in PEBB benefits longer than they have been enrolled in SEBB benefits, but no action is taken to resolve the dual enrollment, the dependent will remain in PEBB benefits and will be auto-disenrolled from the school employee's SEBB medical, dental, and/or vision plans if they are enrolled.
If a school employee's dependent is not enrolled in any medical but is enrolled only in PEBB dental and in SEBB vision (with or without SEBB dental) as a dependent, the dependent will be kept in SEBB benefits and auto-disenrolled from PEBB dental.
Exception: If there is a National Medical Support Order or a court order in place, enrollment will be in accordance with the order.
On April 4, 2024, the SEB Board amended 2021-07. Please see resolution 2024-04 for new language.
2021-07 4/07/21 Resolving dual enrollment involving a SEBB dependent with multiple medical enrollments If a school employee's dependent is enrolled in any SEBB benefits and the dependent is also a PEBB eligible employee who is enrolled in PEBB medical as an employee, and no action is taken by either the school employee or the dependent to resolve the dependent's dual enrollment, the dependent will remain in PEBB benefits and will be auto-disenrolled from the school employee's SEBB medical, dental, and/or vision plans in which they are enrolled. 2021-06 4/07/21 Resolving dual enrollment involving dual subscriber eligibility If the school employee is enrolled in SEBB medical as a school employee and is also enrolled in PEBB medical as an employee, and the school employee has been enrolled in PEBB benefits longer than they've been enrolled in SEBB benefits, but no action is taken by the school employee to resolve their dual enrollment, they will remain in their PEBB benefits and will be auto-disenrolled from their SEBB medical, SEBB dental, and SEBB vision plans. The school employee's enrollments in SEBB life, AD&D, and LTD will remain.
If a school employee is not enrolled in any medical, but is enrolled only in PEBB dental, SEBB dental, and SEBB vision, the school employee will be kept in SEBB benefits and auto-disenrolled from PEBB dental.
On April 4, 2024, the SEB Board amended 2021-05. Please see resolution 2024-03 for new language.
2021-05 4/07/21 Resolving dual enrollment when a school employee's only medical enrollment is in PEBB If the school employee is enrolled only in SEBB dental and SEBB vision, and is also enrolled in PEBB medical, and no action is taken to resolve their dual enrollment, the school employee will remain in their PEBB benefits and they will be auto-disenrolled from the SEBB dental and vision plans in which they are enrolled. The school employee's enrollments in SEBB life, AD&D, and LTD will remain. 2021-04 4/07/21 SEBB benefits enrollment requirements when PEBB benefits are waived An employee who waives PEBB medical and PEBB dental for SEBB medical must be enrolled in a SEBB dental and SEBB vision plan. If necessary, they will be automatically enrolled in the associated subscriber's SEBB dental and SEBB vision plans.
On April 4, 2024, the SEB Board amended 2021-03. Please see resolution 2024-02 for new language.
2021-03 4/07/21
Amending SEBB 2018-53: School employees may waive enrollment in medical
Amending SEBB 2018-53 to read:
A school employee who is eligible for the employer contribution toward SEBB benefits may waive their enrollment in a medical plan if they are enrolled in other employer-based group medical.
Exception: A school employee may waive their enrollment in a SEBB medical plan to enroll in a PEBB medical plan only if they are enrolled in a PEBB dental plan. In doing so, the school employee also waives their enrollment in SEBB dental and SEBB vision.
On April 4, 2024, the SEB Board amended 2021-02. Please see resolution 2024-01 for new language.
2021-02
4/07/21 Amending SEBB 2018-25: When the employer contribution for SEBB benefits ends Amending SEBB 2018-25 to read:
The employer contribution toward SEBB benefits ends the last day of the month in which the school year ends. The employer contribution toward SEBB benefits will end earlier than the end of the school year if one of the following occurs:
- The SEBB Organization terminates the employment relationship. In this case, 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. In this case, 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 school employee is no longer anticipated to work 630 hours during the school year. In this case, eligibility for the employer contribution ends as of the last day of the month in which the change is effective;
- The school employee who returns from approved leave without pay, who maintained or established eligibility under SEBB 2020-02, and who subsequently has a change in work pattern that, had the work pattern been in effect at the start of the school year, would not have resulted in the school employee being anticipated to work the minimum hours to meet SEBB eligibility for the employer contribution in the school year. In this case, eligibility for the employer contribution ends as of the last day of the month in which the change is effective;
- The 9- to 10-month school employee hired late in the year and eligible for the employer contribution under SEBB 2018-32, who subsequently has a change in work pattern such that the school employee is no longer anticipated to be compensated for at least 17.5 hours a week in six of the last eight weeks counting backwards from the week that contains the last day of school. In this case, eligibility for the employer contribution ends as of the last day of the month in which the change is effective;
- The 12-month school employee hired late in the year and eligible for the employer contribution under SEBB 2018-32, who subsequently has a change in work pattern such that the school employee is no longer anticipated to be compensated for at least 17.5 hours a week in six of the last eight weeks counting backwards from the week that contains August 31, the last day of the school year. In this case, eligibility for the employer contribution ends as of the last day of the month in which the change is effective; or
- The school employee hired later in the year and eligible for the employer contribution under SEBB 2018-32, who is no longer anticipated to work 630 hours the next school year. In this case, eligibility for the employer contribution ends as of the last day of the month in which the change in the anticipation occurs.
2021-01
- 2020 resolutions
-
Meeting date Title Description Number 07/23/20 UMP medical premiums The SEB Board endorses the Uniform Medical Plan employee premiums. 2020-16 07/23/20 Premera medical premiums The SEB Board endorses the Premera employee premiums. 2020-15 07/23/20 KPWAO medical premiums The SEB Board endorses the Kaiser Foundation Health Plan of Washington Options, Inc. employee premiums. 2020-14 07/23/20 KPWA medical premiums The SEB Board endorses the Kaiser Foundation Health Plan of Washington employee premiums. 2020-13 07/23/20 KPNW medical premiums The SEB Board endorses the Kaiser Foundation Health Plan of the Northwest employee premiums. 2020-12 07/23/20 Davis Vision benefit change The SEB Board endorses Davis Vision's addition, with no rate increase to the SEBB Program, of a fourth coverage tier to the:
- Progressive lens benefit for which SEBB Program members will have a $175 copay.
- Anti-reflective coating benefit for which SEBB Program members will have an $85 copay.
2020-11 05/07/20 Error correction for incorrect information If a benefits administrator or a contracted vendor provides incorrect advice regarding SEBB benefits to a school employee that they relied upon, the error will be corrected prospectively with enrollment in benefits effective the first day of the month following the date the error is identified. The Health Care Authority approves all error correction actions and determines if additional recourse, which may include retroactive enrollment, is warranted.
2020-06 05/07/20 Amending SEBB 2018-12 Amending SEBB 2018-12 to read:
For September each year, a school employee who is establishing eligibility for the employer contribution towards SEBB benefits, and whose first day of work is on or after September 1 but not later than the first day of school for the current school year as established by the SEBB Organization, the effective date of coverage is the first day of work.
For a school employee who is establishing eligibility 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 the school employee establishes eligibility for the employer contribution toward SEBB benefits.
Except that, when a school employee establishes eligibility for the employer contribution towards SEBB benefits at any time in the month of August, SEBB benefits begin September 1 only if the school employee is also determined to be eligible for the employer contribution toward SEBB benefits for the school year that begins on September 1.
2020-05 05/07/20 Amending SEBB 2019-02 Amending SEBB 2019-02 to read:
A SEBB Organization engaging in local negotiations regarding eligibility for school employees under RCW 41.05.740 (6)(e) shall negotiate within the range of anticipated to work hours described below:
- No less than 180 hours per school year; and
- Less than the threshold to meet the SEB Board's eligibility established pursuant to RCW 41.05.740(6)(d).
2020-04 04/02/20 COVID-19 enrollment timelines Beginning February 29, 2020, the date that Governor Inslee declared a state of emergency in Proclamation 20-05, any enrollment timelines established for continuation coverage subscribers will be extended to 30 days past the date the Governor terminates the state of emergency.
The Health Care Authority is authorized, during the state of emergency as described above, to extend this deadline further and extend any other enrollment deadlines as needed to meet the needs of the state and SEBB Program subscribers.
2020-08 04/02/20 COVID-19 continuation coverage eligibility Beginning February 29, 2020, the date that Governor Inslee declared a state of emergency in Proclamation 20-05, the maximum period of continuation coverage is extended until two months after the date the Governor terminates the state of emergency. 2020-07 03/05/20 Rate development procedure Beginning with the rate development process in 2020 (to set employee premium contributions for plan year 2021) and annual rate development processes thereafter, the SEB Board will not review or consider unsolicited revised rates after proposed employee premium contributions are published publicly by the Health Care Authority on its website.
2020-03 01/27/20
Benefits eligibility after returning to work Effective January 1, 2020, school employees who return from approved leave without pay will maintain or establish eligibility for the employer contribution if their work schedule, had it been in effect at the start of the school year, would have resulted in the employee being anticipated to work the minimum hours to meet SEBB eligibility in the school year. A school employee who regains eligibility under this policy establishes eligibility for the employer contribution toward SEBB benefits as of the date they returned from approved leave, and coverage will become effective the first day of the month following the employee's return to work.
2020-02 01/27/20
Inclusion of paid hours
Effective January 1, 2020, all hours for which a school employee receives compensation from a SEBB organization during an approved leave (e.g., sick leave, personal leave, bereavement leave) or a paid holiday must be included when determining how many hours a school employee is anticipated to work, or did work, in the school year.
2020-01
- 2019 resolutions
-
Meeting date Title Description Number 08/01/19 Premera medical premiums The SEB Board endorses the revised Premera employee premiums as presented at the July 25, 2019 board meeting. 2019-15 07/25/19 UMP medical premiums The SEB Board endorses the Uniform Medical Plan employee premiums. 2019-16 07/25/19 KPWAO medical premiums The SEB Board endorses the Kaiser Foundation Health Plan of Washington Options, Inc. employee premiums. 2019-14 07/25/19 KPWA medical premiums The SEB Board endorses the Kaiser Foundation Health Plan of Washington employee premiums. 2019-13 07/25/19 KPNW medical premiums The SEB Board endorses the Kaiser Foundation Health Plan of the Northwest employee premiums. 2019-12 5/16/19 Self-insured value formulary Beginning January 1, 2020, with the approval of a value formulary resolution by both the PEB Board and SEB Board, all UMP plans require the use of a value-based formulary and:
- Nonformulary drugs are covered only when medically necessary and all formulary drugs were ineffective or are not clinically appropriate for that member, and
- Multi-source brand-name drugs, including those in refill protected classes, are covered only when medically necessary and all formulary drugs have been ineffective or are clinically inappropriate for that member, and
- Members who have been taking a nonformulary drug are required to switch to the formulary drug, unless:
- They receive or have already gone through the exception process and been approved, or
- Their drug is within one of the refill-protected drug classes, which include: antipsychotics, antidepressants, antiepileptics, chemotherapy, antiretrovirals, immunosuppressives, and immunomodulatory/antiviral treatment for Hepatitis C.
2019-11 5/16/19 Error correction premium responsibilities If a SEBB organization errs and enrolls a school employee or their dependents in SEBB insurance coverage when they are not eligible and there was no fraud or intentional misrepresentation by the school employee involved, premiums and applicable premium surcharges already paid by the school employee will be refunded by the SEBB organization to the school employee. The error will be corrected prospectively with termination of benefits effective the first day of the month following the date the error is identified. 2019-10 05/16/19 Error correction recourse If a SEBB organization fails to provide notice of benefits eligibility or accurately enroll a school employee or their dependents in benefits, the error will be corrected prospectively with enrollment in benefits effective the first day of the month following the date the error is identified. The Health Care Authority approves all error correction actions and determines if additional recourse, which may include retroactive enrollment, is warranted. 2019-09 04/10/19 Terms and Conditions for RCW 41.05.740(6)(e) For school employees whose eligibility is established under RCW 41.05.740(6)(e), all SEBB Program rules within chapters 182-30, 182-31, and 182-32 WAC apply except for provisions within those rules governing benefits that are not authorized in SEBB 2019-03 to be offered to RCW 41.05.740(6)(e) employees. 2019-08 03/07/19 SEBB continuation coverage eligibility for dependents already on a SEBB Organization's continuation coverage A dependent of a school employee who is continuing medical, dental, or vision coverage through a SEBB Organization on December 31, 2019 may elect to finish out their remaining months, up to the maximum number of months authorized by COBRA for a similar event, by enrolling in a medical, dental, or vision plan offered through the SEBB Program on a self-pay basis. 2019-07 03/07/19 SEBB continuation coverage eligibility for school employees not eligible for benefits under the SEBB Program A school employee and their dependents who are enrolled in medical, dental, or vision under a group plan offered by a SEBB Organization on December 31, 2019, who lose eligibility because the school employee is not eligible under the SEBB Program, may elect to enroll in one or more of the following SEBB benefits: medical, dental, or vision coverage. These benefits will be provided for a maximum of 18 months on a self-pay basis. 2019-06 03/07/19 Employer share requirement under RCW 41.05.740(6)(e) A SEBB Organization must contribute: - The employer medical contribution (EMC) used for a RCW 41.05.740 (6)(d) school employee multiplied by the applicable tier;
- 100% of the monthly premium, for all tiers, for the dental and vision plans as selected by the school employee;
- 100% of the monthly premium for the basic life and basic AD&D benefits;
- 100% of the monthly administration fee as charged by HCA; and
- 100% of the monthly K-12 remittance fee.
Note: There is an important financial difference between employer contributions under 41.05.740(6)(d) and 41.05.740(6)(e). Under (6)(d), the employer contribution will be the same as the SEBB funding rate, regardless of what medical plan tier an employee selects (i.e. what dependents are enrolled). Under (6)(e), the employer contribution will vary for each SEBB organization, based on the medical plan tiers selected by that SEBB organization's employees.
2019-05 03/07/19 SEBB tier categories and premium tier ratios authorized under RCW 41.05.740 (6)(e) A SEBB Organization engaging in local negotiations regarding eligibility for school employees under RCW 41.05.740(6)(e) must offer the same tier categories and premium tier ratios as adopted in SEBB 2018-14. 2019-04 03/07/19 SEBB benefits authorized under RCW 41.05.740(6)(e) A SEBB Organization engaging in local negotiations regarding eligibility for school employees under RCW 41.05.740(6)(e) must offer all of, and only, the following SEBB benefits to school employees and their dependents: - Medical (includes the wellness incentive program);
- Dental;
- Vision; and
- Basic Life and Basic AD&D.
Note: The Board considered, but did not adopt, a motion to delay the vote on SEBB 2019-03 to the April 10, 2019 SEB Board meeting.
2019-03 03/07/19 Anticipated work hours eligibility range under RCW 41.05.740(6)(e) A SEBB Organization engaging in local negotiations regarding eligibility for school employees under RCW 41.05.740(6)(e) shall negotiate within the range of anticipated to work hours described below: - No less than 180 hours per school year; and
- No more than the threshold to meet the SEB Board's eligibility established pursuant to RCW 41.05.740(6)(d).
Note: The Board considered, but did not adopt, an amendment to SEBB 2019-02 that would have changed the minimum hours for eligibility to "no less than 450 hours per school year."
On May 7, 2020, the SEB Board amended 2019-02. Please see resolution 2020-04 for new language.
2019-02 03/07/19
Requirement to negotiate by group under RCW 41.05.740(6)(e)
A SEBB Organization engaging in local negotiations regarding eligibility for school employees under RCW 41.05.740(6)(e) may only negotiate by group as described below:
- The entire SEBB Organization; or
- An entire collective bargaining unit; and/or
- A group containing all nonrepresented school employees.
2019-01
- 2018 resolutions
-
Meeting date Title Description Number 01/24/19 Continuation coverage for dependents not eligible under the SEBB Program A dependent of a SEBB-eligible school employee who is enrolled in medical, dental, or vision under a school employee's account on December 31, 2019 who loses eligibility because they are not an eligible dependent under the SEBB Program may enroll in medical, dental, and vision for a maximum of 36 months on a self-pay basis. 2018-58 01/24/19 Maximum number of months that self-pay coverage is allowed The maximum number of months that a school employee may continue SEBB benefits during an approved leave of absence, by self-paying the premium and applicable premium surcharges, will be 29 months. The 29 months a school employee may self-pay for coverage under this provision includes the total months of continuation coverage allowed under the federal Consolidated Omnibus Budget Reconciliation Act (COBRA). 2018-57 01/24/19
Deadline for completing wellness activities
Effective January 1, 2020, to receive a SEBB wellness incentive in the following plan year, eligible subscribers must complete SEBB wellness incentive program requirements by the following deadline:
- For subscribers enrolling in SEBB medical with an effective date in January through September, the deadline is November 30.
- For subscribers enrolling in SEBB medical with an effective date in October through December, the deadline is December 31.
2018-56 01/24/19 Eligibility for participation in the SEBB wellness program The spouse or state-registered domestic partner of an eligible school employee may participate in the SEBB wellness program activities, but is not eligible to receive a financial incentive. 2018-55 12/13/18 Default enrollment for an eligible school employee who fails to make a timely election The default election for an eligible school employee who fails to timely elect coverage will be as follows:
- Enrollment in employee-only medical coverage;
- Enrollment in employee-only dental coverage;
- Enrollment in employee-only vision coverage;
- Enrollment in basic life insurance; and
- Enrollment in basic long-term disability insurance.
On April 7, 2021, the SEB Board amended 2018-54. Please see resolution 2021-12 for new language.
2018-54 12/13/18 School employees may waive enrollment in medical A school employee who is eligible for the employer contribution toward SEBB benefits may waive their enrollment in a medical plan if they are enrolled in other employer-based group medical.
On April 7, 2021, the SEB Board amended 2018-53. Please see resolution 2021-02 for new language.
2018-53 11/08/18 Self-insured plans treatment limits Amending SEBB 2018-20, SEBB 2018-21, and 2018-22 to change the treatment limitations as follows:
- Chiropractic visits are limited to 16 per calendar year.
- Combined physical/occupational/speech/neurodevelopmental therapy visits are limited to 80 per calendar year.
2018-52 11/08/18 Centers of Excellence The SEBB Program will offer the Uniform Medical Plan Centers of Excellence Program (COE) starting in Plan Year 2020. 2018-51 11/08/18 Fully insured medical plans (Providence Health Plan) The SEB Board endorses Providence Health Plan's proposed fully insured medical plan designs presented at the November 8, 2018, Board meeting for the purposes of rate development. 2018-50 11/08/18 Fully insured medical plans (Premera) The SEB Board endorses Premera Blue Cross's proposed fully insured medical plan designs presented at the November 8, 2018, Board meeting for the purposes of rate development. 2018-49 11/08/18 Fully insured medical plans (KPWAO) The SEB Board endorses Kaiser Foundation Health Plan of Washington Options, Inc.'s (KPWAO) proposed fully insured medical plan designs presented at the November 8, 2018, Board meeting for the purposes of rate development. 2018-48 11/08/18 Fully insured medical plans (KPWA) The SEB Board endorses Kaiser Foundation Health Plan of Washington's (KPWA) proposed fully insured medical plan designs presented at the November 8, 2018, Board meeting for the purposes of rate development. 2018-47 11/08/18 Fully insured medical plans (KPNW) The SEB Board endorses Kaiser Foundation Health Plan of the Northwest's (KPNW) proposed fully insured medical plan designs presented at the November 8, 2018, Board meeting for the purposes of rate development. 2018-46 11/08/18 Fully insured medical plans (Aetna) The SEB Board endorses Aetna's proposed fully insured medical plan designs presented at the November 8, 2018, Board meeting for purposes of rate development. 2018-45 11/08/18 Fully insured dental benefits (Willamette Dental) Beginning January 1, 2020, the SEBB Program will offer a fully insured dental plan by Willamette Dental Group, with the same covered services and exclusions, provider networks, clinical policies, and copays as the Willamette plan under the PEBB Program. 2018-44 11/08/18 Fully insured dental benefits (Delta Dental-DeltaCare) Beginning January 1, 2020, the SEBB Program will offer a fully insured dental plan by Delta Dental, with the same covered services and exclusions, provider networks, clinical policies, and copays as the DeltaCare plan under the PEBB Program. 2018-43 11/08/18 Fully insured vision plan (MetLife) Beginning January 1, 2020, the SEBB Program will offer a fully insured vision plan by MetLife as presented at the October 4, 2018, Board meeting. 2018-42 11/08/18 Fully insured vision plan (EyeMed) Beginning January 1, 2020, the SEBB Program will offer a fully insured vision plan by EyeMed as presented at the October 4, 2018, Board meeting. 2018-41 11/08/18 Fully insured vision plan (Davis Vision) Beginning January 1, 2020, the SEBB Program will offer a fully insured vision plan by Davis Vision as presented at the October 4, 2018, Board meeting. 2018-40 11/08/18 Employee-paid supplemental long-term disability The SEBB Program will offer the following employee-paid supplemental long-term disability plan design:
- Waiting period: Later of 90 days or end of state-paid family/medical leave benefit
- No choice sick leave
- Choice pension
- Maximum monthly benefit $10,000 (60% of $16,667)
2018-39 11/08/18 Employer-paid basic long-term disability The SEBB Program will offer the following employer-paid basic long-term disability plan to subscribers beginning January 1, 2020: - Waiting period: Later of 90 days or end of state-paid family/medical leave benefit
- No choice sick leave
- Choice pension
- Maximum monthly benefit $400 (60% of $667)
Members of the SEB Board expressed significant concerns regarding the employer-paid basic long-term disability plan's maximum monthly benefit. The Board expects to revisit this decision in 2019.
On April 7, 2021, the SEB Board amended 2018-38. Please see resolution 2021-13 for new language.
2018-38 11/08/18 Eligibility presumed based on hours worked the previous two school years A school employee is presumed eligible if they:
- Worked at least 630 hours in each of the previous two school years; and
- Are returning to the same type of position (teacher, paraeducator, food service worker, custodian, etc.) or combination of positions with the same SEBB organization.
A SEBB organization rebuts this presumption by notifying the school employee, in writing, of the specific reasons why the employee is not anticipated to work at least 630 hours in the current school year and how to appeal the eligibility determination.
2018-36 11/08/18 Mid-year hires anticipated to work 630 hours in the next school year A school employee who is not anticipated to work 630 hours in the current school year because of when they are hired, but is anticipated to work at least 630 hours the next school year, establishes eligibility for the employer contribution toward SEBB benefits as of their first working day if they are:
- A 9- to 10-month school employee anticipated to be compensated for at least 17.5 hours a week in six of the last eight weeks counting backwards from the week that contains the last day of school; or
- A 12-month school employee anticipated to be compensated for at least 17.5 hours a week in six of the last eight weeks counting backwards from the week that contains August 31, the last day of the school year.
2018-32 11/08/18 Dual enrollment SEBB medical, dental, and vision coverage is limited to a single enrollment per individual.
2018-15 10/04/18 Basic term life insurance and accidental death and dismemberment insurance The employer-paid life insurance provided to eligible employees beginning January 1, 2020 will be a $35,000 death by any cause benefit, and a $5,000 accidental death and dismemberment (AD&D) benefit, unless modified in a subsequent resolution by the SEB Board. 2018-30 10/04/18 Self-insured Uniform Dental Plan Beginning January 1, 2020, and subject to financing decisions, the SEBB Program will offer a self-insured plan with the same covered services and exclusions, same provider networks, and same clinical policies as the Uniform Dental Plan (UDP) in place for plan year 2020 under the Public Employees Benefits Board Program. The cost shares (deductible, out-of-pocket maximums, coinsurance for services, etc.) will be the same as the 2020 UDP benefit under the PEBB Program. 2018-37 09/17/18 Separate group vision plan The SEBB Program will offer a group vision plan(s) beginning January 1, 2020 that is separate from the medical plans. 2018-35 08/30/18 Eligibility when moving between SEBB organizations
A school employee will have uninterrupted coverage when moving from one SEBB organization to another within the same month or a consecutive month if the following conditions are satisfied:
- The employee was eligible for the employer contribution toward SEBB benefits in the position they are leaving; and
- The employee is anticipated to be eligible for the employer contribution toward SEBB benefits in their new position.
2018-34 08/30/18 Returning school employees with uninterrupted coverage
A school employee returning to the same SEBB organization who is anticipated to work at least 630 hours in the coming school year, and who was receiving the employer contribution in August of the prior school year, will receive uninterrupted coverage from one school year to the next.
2018-33 08/30/18 Supplemental term life insurance plans
Beginning January 1, 2020, the voluntary employee paid supplemental life benefit will include:
- An employee supplemental death from any cause life insurance benefit of $500,000 guaranteed issue (GI), up to a maximum of $1,000,000 with medical underwriting for amounts over $500,000;
- An employee supplemental AD&D benefit of $30,000 up to $250,000 GI;
- A spouse or state-registered domestic partner death from any cause life insurance benefit of up to 50 percent of the employee supplemental elected amount with $100,000 GI and amounts over $100,000 with medical underwriting;
- A spouse or state-registered domestic partner AD&D benefit of $30,000 up to $250,000 GI;
- A child death from any cause life insurance benefit of $10,000 up to $20,000 GI; and
- A child AD&D benefit of $10,000 up to $25,000 GI.
2018-31 08/30/18 Eligibility for the employer contribution based on stacking of hours
A school employee may establish eligibility for the employer contribution toward SEBB benefits based on stacking of hours within one SEBB organization.
2018-28 07/30/18 School employees are required to provide evidence of a dependent's eligibility to enroll the dependent - A school employee who wants to enroll his or her dependent is required to provide evidence of the dependent's eligibility. If the school employee does not submit the required evidence to verify his or her dependent's eligibility within the HCA's required timeframe, the dependent will not be enrolled.
- The school employee's next opportunity to enroll the dependent, if eligible, would be the next eligible open enrollment.
2018-29 07/30/18 SEBB eligibility for the employer contribution based on actual hours worked A school employee who is not anticipated to work 630 hours in the school year, but actually does work 630 hours, establishes eligibility for the employer contribution toward SEBB benefits as of the date the school employee worked 630 hours.
2018-27 07/30/18 SEBB eligibility for the employer contribution based on a revision to the school employee's anticipated work pattern If a school employee's work pattern is or will be revised such that he or she is now anticipated to work 630 hours for the school year, the school employee establishes eligibility for the employer contribution toward SEBB benefits as of the date the school employee is anticipated to work 630 hours for the school year.
2018-26 07/30/18 When the employer contribution for SEBB benefits ends The employer contribution toward SEBB benefits ends the last day of the month in which the school year ends. The employer contribution toward SEBB benefits will end earlier than the end of the school year if one of the following occurs:
- The SEBB organization terminates the employment relationship. In this case 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. In this case, 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 school employee is no longer anticipated to work 630 hours during the school year. In this case, eligibility for the employer contribution ends as of the last day of the month in which the change is effective.
On April 7, 2021, the SEB Board amended 2018-25. Please see resolution 2021-01 for new language.
2018-25 06/13/18 Fourth self-insured plan offering Beginning January 1, 2020, and subject to final financing decisions, the SEBB Program will offer a self-insured plan with the same covered services and exclusions, same provider networks (either or both of the PSHVN and UW ACN), and same clinical policies as the Uniform Medical Plan Plus in place for plan year 2020 under the PEBB Program. The cost shares (deductible, out-of-pocket maximums, coinsurance for services, etc.) will be the same as the UMP Plus.
2018-23 06/13/18 Third self-insured plan offering
Beginning January 1, 2020, and subject to financing decisions, the SEBB Program will offer a self-insured plan with the same covered services and exclusions, same provider networks, and same clinical policies as the Uniform Medical Plan Consumer-Directed Health Plan (CDHP) in place for plan year 2020 under the PEBB Program. The cost shares (deductible, out-of-pocket maximums, coinsurance for services, etc.) will be the same as the UMP CDHP under the PEBB Program.
2018-22 06/13/18 Second self-insured plan offering Beginning January 1, 2020, and subject to financing decisions, the SEBB Program will offer a self-insured plan with the same covered services and exclusions, same provider networks, and same clinical policies as the Uniform Medical Plan Classic in place for plan year 2020 under the PEBB Program. The cost shares (deductible, out-of-pocket maximums, coinsurance for services, etc.) will be the same as the UMP Classic under the PEBB Program, except for the following:
- Annual Deductible (medical): $750/$2,250 (single/family);
- Annual Deductible (drug): $250/$750 (single/family);
- Out-of-Pocket Maximum (medical): $3,500/$7,000 (single/family);
- Coinsurances: 20%/80% (member/plan)
2018-21 06/13/18 Self-insured plan offering Beginning January 1, 2020, and subject to financing decisions, the SEBB Program will offer a self-insured plan with the same covered services and exclusions, same provider networks, and same clinical policies as the Uniform Medical Plan Classic in place for plan year 2020 under the PEBB Program. The cost shares (deductible, out-of-pocket maximums, coinsurance for services, etc.) will be the same as the UMP Classic under the PEBB Program. 2018-20 06/13/18 Effective date of coverage for school employees eligible for the employer contribution For September each year, a school employee who is establishing eligibility for the employer contribution toward SEBB benefits, and whose first day of work is on or after September 1 but not later than the first day of school for the current school year as established by the SEBB organization, the effective date of coverage is the first day of work.
For a school employee who is establishing eligibility 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 the school employee establishes eligibility for the employer contribution toward SEBB benefits.
On May 7, 2020, the SEB Board amended 2018-12. Please see resolution 2020-05 for new language.
2018-12 05/30/18 Spousal surcharge attestation default When a subscriber has a spouse or state-registered domestic partner enrolled in medical on his or her account, the subscriber will incur a $50 monthly premium surcharge if he or she fails to attest to the applicability of the spousal surcharge within the HCA's enrollment timeframe. 2018-19 05/30/18 Tobacco surcharge attestation default A subscriber's account will incur a $25 monthly premium surcharge if he or she fails to attest that any member, age 13 years or older, enrolled in medical on his or her account does or does not engage in tobacco use within the HCA's enrollment timeframe. 2018-18 05/30/18 Definition of "tobacco use" "Tobacco use" means any use of tobacco products within the past two months. Tobacco use, however, does not include religious or ceremonial use of tobacco.
- "Religious use of tobacco" means the use of tobacco products as part of a formal tradition, rite, or ritual.
- "Ceremonial use of tobacco" means the use of tobacco products for ceremonial purposes in connections with the practice of a traditional ceremony or ritual.
2018-17 05/30/18 Definition of "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 quit aids. 2018-16 05/01/18 SEBB Program premium structure Within the premium structure for the SEBB benefit, where there is both an employer and employee premium contribution, there will be four tier categories. The premium tier ratio and employee premium contribution for each tier category will be:
- Subscriber only - 1.00
- Subscriber and any child(ren) - 1.75
- Subscriber and spouse/state-registered domestic partner - 2.00
- Subscriber and spouse/state-registered domestic partner and any child(ren) - 3.00
2018-14 05/01/18 Benefit election period A school employee's enrollment elections, including an election to waive SEBB medical if allowed, must be received no later than 31 days after the date the school employee becomes eligible for an employer contribution for SEBB benefits. 2018-13 03/15/18 Procurements for vision not integrated into medical plans The School Employees Benefits Board (SEBB) Program will perform procurements for a vision benefit that is not integrated into medical plans. The SEB Board will evaluate later whether to offer vision benefits integrated, stand alone, or a combination of both approaches. 2018-11 03/15/18 Life insurance and AD&D Beginning January 1, 2020, the SEBB Program will offer life insurance and accidental death and dismemberment (AD&D) insurance with coverage offerings and covered benefits similar to those offered under the PEBB Program. 2018-10 03/15/18 Procurements for short-term disability The School Employees Benefits Board (SEBB) Program will perform procurements for short-term disability insurance that includes employee-paid optional coverage. This benefit will not include employer-paid coverage. 2018-09 03/15/18 Procurements for long-term disability The School Employees Benefits Board (SEBB) Program will perform procurements for long-term disability insurance that includes possible employer-paid and employee-paid coverage options. 2018-08 03/15/18 Self-insured dental Beginning January 1, 2020, the SEBB Program will offer a self-insured dental plan with features similar to the Uniform Dental Plan such as covered benefits, clinical policies, and provider networks, subject to final financing decisions by the state. 2018-07 03/15/18 Fully insured dental Fully insured dental plans similar to the fully insured dental plans offered under the Public Employees Benefits Board (PEBB) Program. In 2020, the SEB Board will evaluate whether they should pursue a fully insured dental plan procurement to consider additional or different offerings. 2018-06 03/15/18 UMP-like plan Beginning January 1, 2020, the SEBB Program will offer self-insured medical plans with features similar to the Uniform Medical Plan such as covered benefits, provider networks, clinical policies, and an integrated pharmacy benefit. Offerings are subject to final financing decisions by the state.
2018-05 03/15/18 Procurements for fully insured medical plans The School Employees Benefits Board (SEBB) Program will perform procurements for:
- Fully insured medical plans from multiple carriers with widespread coverage offerings (SEBB 2018-04).
- Long-term disability insurance that includes possible employer-paid and employee-paid coverage options (SEBB 2018-08).
- Short-term disability insurance that includes employee-paid optional coverage. This benefit will not include employer-paid coverage (SEBB 2018-09).
- A vision benefit that is not integrated into medical plans (SEBB 2018-11). The SEB Board will evaluate later whether to offer vision benefits integrated, stand alone, or a combination of both approaches.
2018-04 03/15/18 Extended dependent child eligibility criteria Eligible school employees enrolled in SEBB benefits may enroll a child up to age 26 that is an extended dependent in the legal custody or legal guardianship of the employee, the employee's spouse, or the employee's state-registered domestic partner. The legal responsibility is demonstrated by a valid court order and the child's official residence with the custodian or guardian. Extended dependent child does not include a foster child unless the employee, the employee's spouse, or the employee's state-registered domestic partner has assumed a legal obligation for total or partial support in anticipation of adoption. 2018-03 03/15/18 Dependent child eligibility criteria Eligible school employees enrolled in SEBB benefits may enroll a child up to age 26 that satisfies one of the following criteria:
- Children of the employee based on the establishment of a parent-child relationship as described in Revised Code of Washington (RCW) 26.26.101, except when parental rights have been terminated;
- Children of the employee's spouse, based on the spouse's establishment of a parent-child relationship, except when parental rights have been terminated. The stepchild's relationship to the employee (and eligibility as a dependent) ends on the same date the marriage with the spouse ends through divorce, annulment, dissolution, termination, or death;
- Children of the employee's state-registered domestic partner, based on the state-registered domestic partner's establishment of a parent-child relationship, except when parental rights have been terminated. The child's relationship to the employee (and eligibility as a dependent) ends on the same date the employee's legal relationship with the state-registered domestic partner ends through divorce, annulment, dissolution, termination, or death;
- Children for whom the employee has assumed a legal obligation for total or partial support in anticipation of adoption of the child;
- Children specified in a court order or divorce decree for whom the employee has a legal obligation to provide support or health care coverage; and
- Children of any age with a developmental disability or physical handicap that satisfies all of the following criteria:
- The employee must provide proof of the disability and dependency within 60 days of the child's attainment of age 26;
- The employee must agree to notify the SEBB Program, in writing, no later than 60 days after the date the child is no longer eligible under this subsection.
- A child with a developmental or physical disability who becomes self-supporting is not eligible under this subsection as of the last day of the month in which he or she becomes capable of self-support;
- A child with a developmental or physical disability age 26 and older who becomes capable of self-support does not regain eligibility if he or she later becomes incapable of self-support;
- The SEBB Program will, with input from the applicable contracted vendor, periodically certify the eligibility of a dependent child with a disability beginning at age 26, but no more frequently than annually after the two-year period following the child's 26th birthday, which may require renewed proof from the employee.
2018-02 03/15/18 Legal spouse and domestic partner eligibility criteria Eligible school employees enrolled in SEBB benefits may enroll a dependent that satisfies one of the following criteria:
- Legal spouse
- State-registered domestic partner
2018-01
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Washington State Health Care Authority
Cherry Street Plaza
Sue Crystal Center, Conference Rooms 106A and 106B
626 8th Ave. SE
Olympia, WA 98501
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