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Behavioral health comparison (SEBB) 2020
20-0179Starting in 2020, all carriers must provide information on their websites for mental health and substance abuse treatment providers’ ability to ensure timely access to care. This document includes behavioral health benefits for SEBB medical plans. When you need information about what mental health and substance use disorders are covered, you can read the SEBB medical plans’ Certificates of Coverage.
PublicationCertification of a child with a disability (PEBB) 2020
50-142After turning 26, your dependent may be eligible for enrollment under your PEBB coverage. Use this form to certify your dependent's disability and enroll them on your PEBB coverage.
FormCertification of a child with a disability (SEBB) 2020
20-0061After turning 26, your dependent may be eligible for enrollment under your SEBB coverage. Use this form to certify your dependent's disability and enroll them on your SEBB coverage.
FormContinuing eligibility for PEBB benefits during the COVID-19 outbreak
Davis Vision (SEBB) Certificate of Coverage (COC) 2020
This benefits book describes what is covered as a SEBB member under Davis vision, including vision services and specific services not covered by the plan. Finding preferred providers and how much you’ll pay, including deductibles, coinsurance, and copays.
PublicationDavis Vision (SEBB) Certificate of Coverage (COC) 2021
This benefits book describes what is covered as a SEBB member under Davis vision, including vision services and specific services not covered by the plan. Finding preferred providers and how much you’ll pay, including deductibles, coinsurance, and copays.
PublicationDavis Vision (SEBB) preauthorization requirements
Preauthorization requirements for Davis Vision plan. Preauthorization is when you seek approval from your health plan for coverage of specific services, supplies, or drugs before receiving them. Some services or treatments (except emergencies) may require preauthorization before the plan pays for them. These criteria do not imply or guarantee approval. Please check with your plan to ensure coverage. Preauthorization requirements are only valid for the month published. They may have changed from previous months and may change in future months.
PublicationDeclaration of tax status (PEBB) 2020
50-704Employees and retirees must complete and submit this form with their enrollment form when enrolling an individual on their PEBB Program coverage who does not qualify as their dependent for federal tax purposes.
FormDeclaration of tax status (SEBB) 2020
School Employees and SEBB Continuation Coverage must complete and submit this form with their enrollment form when enrolling an individual on their SEBB Program coverage who does not qualify as their dependent for federal tax purposes.
FormDelta Dental (DeltaCare and Uniform Dental Plan) (PEBB) preauthorization requirements
Preauthorization requirements for DeltaCare and Uniform Dental Plan (administered by Delta Dental of Washington). Preauthorization is when you seek approval from your health plan for coverage of specific services, supplies, or drugs before receiving them. Some services or treatments (except emergencies) may require preauthorization before the plan pays for them. These criteria do not imply or guarantee approval. Please check with your plan to ensure coverage. Preauthorization requirements are only valid for the month published. They may have changed from previous months and may change in future months.
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