Change your coverage

Learn the requirements to make changes to your SEBB Continuation Coverage.

Before you make a change to your health plan

Before you make a change it is important to:

How to make changes

To make changes, like enrolling a dependent or electing a different health plan, you must complete and submit the required form(s) during the annual open enrollment or when a special open enrollment event occurs, within the timelines listed below.

To make a change during the SEBB Program’s annual open enrollment starting 2020 plan year

The SEBB Program must receive the appropriate SEBB Continuation Coverage (COBRA) Election/Change or SEBB Continuation Coverage (Unpaid Leave) Election/Change form within the timelines.

To make a change when a special open enrollment event occurs:

The SEBB Program must receive the appropriate SEBB Continuation Coverage (COBRA) Election/Change or SEBB Continuation Coverage (Unpaid Leave) Election/Change form no later than 60 days after the event that created the special open enrollment along with proof of the event that created the special open enrollment (see SEBB Program Policy Addendum 45-2A for a list of valid documents).

In most cases, the requested change will occur the first day of the month after the date of the event or the date the SEBB Program receives your required, completed enrollment form(s), whichever is later. If that day is the first of the month, the requested coverage begins on that date.

Changes you can make any time

There are some changes you can make any time during the year without a special open enrollment event.

Plan change requirements

  • You can only change medical, dental or vision plans during the SEBB Program's annual open enrollment or if a special open enrollment event occurs.
  • All eligible dependents must enroll in the same health plan as the subscriber. (Dependents can have different providers.)
  • If you have a provider you want to stay with, contact the new health plan or check the plan’s provider directory to make sure your provider is in the plan’s network.
  • You may be enrolled in only one SEBB medical, dental, or vision plan. If you and your spouse or state-registered domestic partner are both eligible subscribers, you need to choose which of you will cover yourselves and your eligible children (including adult children who are also eligible for SEBB insurance coverage as an employee). Enrolled dependents will be listed on one account, not both.

Special open enrollment

The SEBB Program allows changes outside of the SEBB Program annual open enrollment when certain events create a special open enrollment. The change must correspond to and be consistent with the event that creates the special open enrollment. You must provide proof of the event that created the special open enrollment (for example, a marriage or birth certificate).

These changes may be allowed as a special open enrollment:

If this event happens...

Add dependent

Change medical plan

Change dental/vision plan

Marriage, registering a state-registered domestic partnership as defined by Washington Administrative Code 182-31-140(2), birth, adoption, or assuming a legal obligation for total or partial support in anticipation of adoption.

Yes

Yes

Yes

Child becomes eligible as an extended dependent through legal custody or legal guardianship.

Yes

Yes

Yes

Subscriber or dependent loses eligibility for other coverage under a group health plan or through health insurance, as defined by the Health Insurance Portability and Accountability Act (HIPAA). Yes Yes Yes
Subscriber has a change in employment status that affects the subscriber’s or dependent’s eligibility for the employer contribution toward their employer-based group health plan. Yes Yes Yes
Subscriber's dependent has a change in their own employment status that affects their eligibility for the employer contribution under their employer-based group health plan. Yes Yes Yes
Subscriber or dependent has a change in enrollment under another employer-based group health insurance plan during its annual open enrollment that does not align with the SEBB Program’s annual open enrollment. Yes No No
Subscriber’s dependent moves from outside the United States to live within the United States, or from within the United States to live outside of the United States, and that change in residence resulted in the dependent losing their health insurance. Yes No No
Subscriber or dependent has a change in residence that affects health plan availability. No Yes Yes
A court order requires the subscriber or any other individual to provide insurance coverage for an eligible child of the subscriber. Yes Yes Yes
Subscriber or dependent becomes entitled to, or loses eligibility for, Medicaid or a Children’s Health Insurance Program (CHIP). Yes Yes Yes
Subscriber or a dependent becomes eligible for a state premium assistance subsidy for SEBB health plan coverage from Medicaid or a CHIP. Yes Yes Yes
Subscriber or dependent becomes entitled to Medicare or loses eligibility for Medicare. No Yes No
Subscriber’s or dependent’s current health plan becomes unavailable because the subscriber or enrolled dependent is no longer eligible for a health savings account (HSA). No Yes Yes
Subscriber or dependent experiences a disruption of care that could function as a reduction in benefits for the subscriber or their dependent for a specific condition or ongoing course of treatment (requires approval by the SEBB Program). No Yes Yes

For more details about the changes you can make during these events, see SEBB Program Policy Addendum 45-2A and refer to Washington Administrative Code (WAC) 182-30-090, 182-31-150, 182-31-080, and 182-30-100.

Switching between SEBB Continuation Coverage (COBRA) and the Marketplace

If you sign up for SEBB Continuation Coverage, you can switch to a Marketplace plan during the Marketplace’s open enrollment period or if you have another qualifying event that triggers a special enrollment period (such as marriage or birth of a child). If you cancel (terminate) SEBB Continuation Coverage early without another qualifying special open enrollment event, you will have to wait to enroll in Marketplace coverage until the next Marketplace open enrollment period. You could end up without any health plan coverage in the interim and may be charged high out-of-pocket costs if you receive health care services.

Once your SEBB Continuation Coverage expires, you will be eligible to enroll in Marketplace coverage through a special enrollment period, even if the Marketplace open enrollment period has ended.

If you sign up for Marketplace coverage instead of SEBB Continuation Coverage, you cannot switch to SEBB Continuation Coverage under any circumstances.