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SEBB rules and policies
The SEBB Program follows the rules in Washington Administrative Code (WAC). Our administrative policies describe how we implement a law or rule affecting participation in SEBB Program benefits.
Stay up-to-date with SEBB Program rule making
SEBB Program law
You can find the SEBB Program's existing law in chapter 41.05 of the Revised Code of Washington (RCW).
SEBB Program rules
The SEBB Program follows the rules in Washington Administrative Code (WAC) chapters:
Below are links to the detailed rules for circumstances most common to school employees.
- How do school employees establish eligibility and when does SEBB insurance coverage begin?
- Who are eligible dependents?
- When may subscribers enroll or remove eligible dependents?
- When may subscribers change health plans?
- When do benefits end?
- SEBB appeals rules
SEBB Program policies
The SEBB Program's administrative policies describe how we implement a law or rule affecting participation in SEBB Program benefits. The statements made in these documents reflect our interpretations of the eligibility and enrollment rules.
Employee eligibility and enrollment
| Number | Title | Effective Date |
|---|---|---|
| 11-1 |
Providing a notice to a school employee and a SEBB Organization |
10/1/2019 |
| 12-1 | Determining the first day of school for SEBB Organizations | 10/1/2019 |
| 19-1 | Termination due to loss of eligibility | 10/1/2019 |
| 19-1A | Addendum - Termination due to loss of eligibility: School employee | 10/1/2019 |
| 19-1B | Addendum - Termination due to loss of eligibility or nonpayment: Self-pay subscriber | 10/1/2019 |
Dependent eligibility and enrollment
| Number | Title | Effective Date |
|---|---|---|
| 31-1 | Verifying dependent eligibility before enrollment | 10/1/2019 |
| 31-2 | Use of premium surcharge help sheet and spousal plan calculator tools | 10/1/2019 |
| 33-1 | Verifying legal union's residency status | 10/1/2019 |
| 36-1 | Certifying eligibility for a dependent child with a disability who is age 26 or older | 10/1/2019 |
| 37-1 | Certifying eligibility for an extended dependent child | 10/1/2019 |
Continuation coverage
|
Number |
Title | Effective Date |
|---|---|---|
|
56-1 |
10/1/2019 |
|
| 56-2 | Election period tolling for applicants with mental impairment or physical incapacitation | 10/1/2019 |
Appeals
|
Number |
Title | Effective Date |
|---|---|---|
| 60-1 | Required appeals related documents when the SEBB Program conducts a brief adjudicative proceeding |
10/1/2019 |
Administrative - permanent
| Number | Title | Effective Date |
|---|---|---|
| 91-1 | Requesting a reasonable alternative for completing wellness incentive program requirements or avoiding the tobacco use premium surcharge | 10/1/2019 |
| 91-2 | Tobacco as it relates to religious or ceremonial use | 10/1/2019 |
| 91-3 | Washington Wellness worksite designation program incentive requirements | 10/1/2019 |
Proposed policies
Below are SEBB Program proposed policies.
|
Number |
Title | Effective date |
|---|---|---|
| 45-2 | Special Open Enrollment (SOE) | 1/1/2020 |
|
45-2A |
Addendum - SOE matrix | 1/1/2020 |
| 94-1 | Accessing SEBB Program salary reduction plan document | 1/1/2020 |
| 94-2 | Accessing SEBB Program wellness plan document | 1/1/2020 |