The SEBB Program's first annual open enrollment has begun and runs through November 15. Benefit coverage will begin January 1, 2020. Find out how to enroll. Note: ALEX, the online benefits advisor, is now available.

Spousal coverage surcharge

A $50 monthly premium surcharge may apply to you if you have a spouse or state-registered domestic partner enrolled on your SEBB medical coverage.

What is the spouse or state-registered domestic partner coverage premium surcharge?

A $50 premium surcharge will be charged, in addition to your monthly medical plan premium, if you have a spouse or state-registered domestic partner enrolled on your SEBB medical coverage and they have elected not to enroll in their employer-based group medical insurance that is comparable to the PEBB Program’s Uniform Medical Plan (UMP) Classic. The comparison must be to the PEBB Program’s UMP Classic, even if you are not enrolled in that plan.

Who needs to attest?

You need to attest to this premium surcharge if you are enrolling your spouse or state-registered domestic partner on your SEBB medical coverage.

You do not need to attest if you are not enrolling your spouse or state-registered domestic partner on your SEBB medical. The premium surcharge will not apply to your account.

How do I attest?

Step one: find what to attest

Use the Premium Surcharge Attestation Help Sheet (pdf) or the online spousal plan questionnaire (2020) to determine if you must pay the surcharge.

  • You WILL NOT be charged the premium surcharge if you:
    • Answer NO to ANY of the questions in SEBB My Account, on the help sheet, or on the questionnaire, AND
    • Check NO in SEBB My Account, on your enrollment/change form, or on your Premium Surcharge Attestation Change form. (If you check YES, you will have to pay the surcharge.)
  • You WILL be charged the premium surcharge if you:
    • Answer YES to ALL of the questions on the help sheet or questionnaire. In addition, you will need to:
      • Ask your spouse or state-registered domestic partner to ask his or her employer for a 2020 Summary of Benefits and Coverage (SBC) for all medical plans that service the county of residence for your spouse or state-registered domestic partner, and have a monthly premium of $108.31 per month for the employee.
      • Use the 2020 SBC information to answer the questions in the Spousal Plan Calculator (interactive tool) or (pdf) to determine if you must pay the surcharge.

Note: If you use the interactive version of the spousal plan calculator, you must click Enable Content for the calculator to work. Do not print or submit the interactive tool.

Step two: complete your attestation

Sign into SEBB My Account and select Attestations. Answer Yes or No to the questions (1 through 6).

Check the corresponding box(es) on the appropriate enrollment/change form or complete the Premium Surcharge Attestation Change form and submit as directed on the form.

What happens if I do not attest?

If you have a spouse or state-registered domestic partner enrolled on your SEBB  medical coverage and you do not attest, you will be charged the $50 premium surcharge in addition to your monthly medical plan premium.

Do I need to attest every year?

If you plan to continue SEBB medical coverage for your spouse or state-registered domestic partner for the next year, you may need to reattest to the spousal surcharge during the SEBB Program's annual open enrollment in the fall.

How do I report a change (reattest)?

If you plan to continue SEBB medical coverage for your spouse or state-registered domestic partner for the next year, you may need to reattest to the spousal surcharge during the SEBB Program's annual open enrollment.

Step one: find out if you need to attest

Use the Premium Surcharge Help Sheet or the online spousal plan questionnaire to determine if you must pay the surcharge.

  • You WILL NOT be charged the premium surcharge if you:
    • Answer NO to ANY of the questions on the help sheet or questionnaire, AND
    • Check NO on your enrollment/change form or 2020 SEBB Premium Surcharge Attestation Change form. (If you check YES, you will have to pay the surcharge.)
  • You WILL be charged the premium surcharge if you:
    • Answer YES to ALL of the questions on the help sheet or questionnaire. In addition, you will need to:
      • Ask your spouse or state-registered domestic partner to ask his or her employer for a 2020 Summary of Benefits and Coverage (SBC) for all medical plans that service the county of residence for your spouse or state-registered domestic partner, and have a monthly premium of $108.31 per month for the employee.
      • Use the 2020 SBC information to answer the questions in the Spousal Plan Calculator to determine if you must pay the surcharge.

Note: If you use the interactive version of the spousal plan calculator, you must click Enable Content for the calculator to work. Do not print or submit the interactive tool.

Step two: complete your attestation

  • If adding a spouse or state-registered domestic partner to your SEBB medical, you must respond to the spousal coverage surcharge using SEBB My Account or the appropriate enrollment/change form.
  • If you are reporting a change, complete the 2020 SEBB Premium Surcharge Attestation Change form and submit as directed on the form.

    OR

  • Log in to SEBB My Account (only during the SEBB Program's annual open enrollment period).

When can I report a change?

You can only report a change to this surcharge in the following situations:

  • During the SEBB Program's first annual open enrollment, October 1 through November 15. 2019
  • When adding a spouse or state-registered domestic partner to your SEBB medical coverage.
  • Within 31 days of the day you regain eligibility for the employer contribution toward SEBB benefits.
  • Within 60 days of a change in your spouse’s or state-registered domestic partner’s employer-based group medical insurance.

When will my attestation change take effect?

If you submit a change that results in incurring the premium surcharge, the change is effective the first of the month after the status change. If the status change occurs on the first of the month, then the change begins on that day.

If the change results in removal of the premium surcharge, the change is effective the first day of the month after receipt of the attestation. If the status change occurs on the first of the month, then the change begins that day.