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Meetings and materials

Get the School Employees Benefits (SEB) Board meeting schedule, along with agendas, briefing books, and minutes.

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Meeting schedule

All SEB Board meetings are held at the Health Care Authority in the Sue Crystal Conference Rooms 106A and 106B. All meetings begin at 9 a.m., unless otherwise noted.

  • January 24, 2019

  • March 7, 2019

  • April 10, 2019 - 1:00 p.m.

  • May 16, 2019

  • June 12, 2019

  • July 18, 2019

  • July 25, 2019

  • August 1, 2019

  • August 29, 2019

If you are a person with a disability and need a special accommodation, please contact Connie Bergener at 360-725-0856.

Meeting materials

2018

2017

Date

Materials

December 11

Agenda (2017-12-11)

Briefing Book (2017-12-11)

Minutes (2017-12-11)

November 6

Agenda (2017-11-06)

Briefing Book (2017-11-06)

Minutes (2017-11-06)

October 23

Agenda (2017-10-23)

Briefing Book (2017-10-23)

Minutes (2017-10-23)

Approved resolutions

Meeting date Resolution title Resolution description

Resolution number

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.
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. 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’ 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.
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.

See eligibility examples for resolution 2018-36.

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.

See eligibility example for resolution 2018-32.

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.

See eligibility example for resolution 2018-34.

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.

See eligibility example for resolution 2018-33.

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.

See eligibility examples for resolution 2018-28.

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.

See eligibility examples for resolution 2018-27.

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.

See eligibility examples for resolution 2018-26.

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.

See eligibility examples for resolution 2018-25.

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.

See eligibility examples for resolution 2018-12.

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

Location and directions

Washington State Health Care Authority
Cherry Street Plaza
Sue Crystal Center, Conference Rooms 106A and 106B
626 8th Ave. SE
Olympia, WA 98501

Directions | Printable map

Need a special accommodation?

All meetings sponsored by the Health Care Authority meet Americans with Disabilities Act (ADA) requirements.

Phone: 360-725-0856 (TRS: 711)

Contact

Email: SEBBoard@hca.wa.gov

Phone: 360-725-0856 (TRS: 711)