Partial federal government shutdown
HCA does not anticipate any immediate impacts to our services or disruption to provider payments at this time. We will continue to monitor the situation and share updates if anything changes.
HCA does not anticipate any immediate impacts to our services or disruption to provider payments at this time. We will continue to monitor the situation and share updates if anything changes.
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.
Get the School Employees Benefits (SEB) Board meeting schedule, along with agendas, briefing books, and minutes.
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All meetings begin at 9 a.m.
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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Rescinding Resolution SEBB 2023-05 | Effective January 1, 2026, resolution SEBB 2023-05, as adopted on June 1, 2023, is rescinded.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:
|
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 |
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 |
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 |
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 |
When 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 |
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:
Cost sharing for all UMP plans will be as follows:
Out of network services will not have copays and will have:
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:
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:
|
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:
|
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:
|
2021-01 |
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:
|
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:
|
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 |
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:
|
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:
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:
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:
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:
|
2019-01 |
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:
|
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:
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:
|
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:
|
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:
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:
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:
|
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:
|
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:
|
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 |
|
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:
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:
|
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.
|
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:
|
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:
|
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:
|
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:
|
2018-01 |
Washington State Health Care Authority
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