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Am I eligible?

Your employer will determine if you are eligible for SEBB benefits based on your specific employment circumstance and whether you qualify for the employer contribution.

(For information on how eligibility is determined, see related laws and rules at the bottom of the page.)

Who is eligible?

Your employer will determine if you are eligible for SEBB benefits and your specific work circumstance.

Generally, you are eligible for SEBB benefits if you:

  • Work for a Washington State school district or charter school.
  • Are a represented employee of an educational service district.
  • Your employer anticipates you will work at least 630 hours per school year (September 1 through August 31).

Paid holidays and paid leave, such as sick, personal, and bereavement leave, count toward the required hours. Voluntary Employee Beneficiary Association (VEBA) cashout/buyout does not apply to the required hours.

Apple Health (Medicaid) and CHIP

If you're eligible, you can enroll in both SEBB benefits and Apple Health. But SEBB benefits-eligible employees cannot waive SEBB enrollment in favor of Apple Health.

Eligible dependent children can be enrolled in both SEBB benefits and Apple Health for Kids.

If your child loses or becomes eligible for Apple Health for Kids after SEBB’s annual open enrollment has ended, that creates a 60-day special open enrollment event, in which you could change the child’s SEBB coverage.

Get more details about Apple Health for adults and children.

What if I'm eligible as a subscriber and a dependent?

You cannot enroll in health plan coverage under two SEBB accounts. If you are eligible as an employee and as a dependent under your spouse’s, state-registered domestic partner’s or parent’s account, visit Waive my coverage for options available to you.

Real-world example

You and your state-registered domestic partner (SRDP) are independently eligible for SEBB insurance coverage. Since you cannot have medical, dental, and vision coverage under two accounts, you decide to waive SEBB medical for yourself and enroll as a dependent on your SRDP’s SEBB medical coverage.

I'm eligible for both SEBB and PEBB. What do I do?

You can enroll in health plans through only one program. If you enroll in both SEBB and PEBB benefits and do not take action to resolve the dual enrollment, the SEBB Program or PEBB Program will automatically enroll or disenroll you. Refer to related laws and rules at the bottom of this page.

Real-world example

You are eligible for SEBB benefits and your SRDP is eligible for PEBB benefits. Since you cannot have coverage under both programs, you decide to waive SEBB medical, dental, and vision coverage for yourself and enroll as a dependent on your SRDP's PEBB medical and dental coverage. 

How is eligibility determined?

For newly hired employees who meet the eligibility criteria, your eligibility begins on your first workday, and your benefits begin on the first day of the following month. Your first day of work typically determines when your SEBB benefits begin.

For eligibility based on:

Special rules apply for new employees who begin work on or after September 1, but not later than the first day of school. For those employees only, eligibility and benefits begin on your first day of work. If you are determined to be eligible by your employer, you are eligible on your first day of work. If you start work at any other time, your benefits begin on the first day of the following month.  

If you are not eligible for SEBB benefits at the beginning of the school year, but your work circumstance changes and your employer anticipates you will work 630 hours during the school year, you become eligible on the date your work pattern is revised. Benefits begin on the first day of the following month.

If you are not anticipated to work 630 hours at the beginning of the school year, but you do actually work 630 hours, you become eligible on the date you work your 630th hour. Benefits begin on the first day of the following month. If eligibility is established in the month of August, benefits begin on September 1 only if you are determined eligible for the employer contribution toward SEBB benefits for the school year that begins on September 1. 

If you are eligible for SEBB benefits at the beginning of the year, but your work schedule is revised so that you are no longer anticipated to work 630 hours during the school year, your eligibility for the employer contribution toward SEBB benefits ends the last day of the month in which the change in your work schedule is effective.

If you return to work from approved leave without pay, you can maintain or establish eligibility for the employer contribution toward SEBB benefits if the schedule you return to, had it been in effect at the start of the school year, would have resulted in you being anticipated to work the minimum hours to be eligible for SEBB benefits. You would regain eligibility for the employer contribution toward SEBB benefits on the day you return from approved leave without pay.

Benefits will begin on the first day of the following month. If eligibility is established in the month of August, SEBB benefits begin on September 1 only if you are determined eligible for the employer contribution toward SEBB benefits for the school year that begins on September 1.

If you are not anticipated to work 630 hours within the school year because of the time of year you are hired, but are anticipated to work at least 630 hours the next school year, you may establish eligibility for the employer contribution toward SEBB benefits if one of the following situations apply:

  • You are hired as a 9- to 10-month school employee and your employer anticipates you will work at least 17.5 compensated hours a week in six of the last eight weeks before the last day of school.
  • You are hired as a 12-month school employee and your employer anticipates you will work at least 17.5 compensated hours a week in six of the last eight weeks before the end of the school year (August 31).

If you worked at least 630 hours in each of the previous two school years and are returning to the same type of position or combination of positions with the same school district, charter school, or educational service district, you are presumed eligible for the employer contribution toward SEBB benefits at the start of the school year.

If your employer does not consider you eligible after having worked at least 630 hours the previous two school years, they must notify you in writing of the specific reasons you are not anticipated to work at least 630 hours in the current school year. You have the right to appeal the eligibility determination. The letter from your employer will have instructions on how to appeal.

All of the hours you work in your capacity as a school employee, and all hours you receive compensation from your employer during an approved leave (sick leave, personal leave, bereavement leave), are included in the hours to determine your eligibility. You cannot “stack” hours from different school districts, charter schools, or ESDs to reach eligibility.

If you were enrolled in SEBB benefits in August, you will receive uninterrupted coverage from one school year to the next when you return at the start of the next school year to the same school district, charter school, or as a represented employee of the same ESD, as long as you are still anticipated to be eligible for the employer contribution in the coming school year. 

Once enrolled in benefits, you will have uninterrupted coverage when moving from one SEBB organization to another within the same or following month, as long as you are eligible in the previous position and anticipated to be eligible for the employer contribution toward SEBB benefits in your new position.

If you are not eligible as described above, you may be eligible for some SEBB benefits if your school district, charter school, or ESD negotiated your eligibility. If you are represented, check with your union or collective bargaining agreement about eligibility.

Are my dependents eligible?

You may enroll your legal spouse, your state-registered domestic partner, your children, and your survivors. 

Learn more about dependent eligibility and survivors.

Related laws and rules

  • Chapter 182-30: Procedures.
  • Chapter 182-31: Eligible school employees.
  • WAC 182-31-040: How do school employees establish eligibility for the employer contribution toward school employees benefits board (SEBB) benefits and when do SEBB benefits begin?
  • WAC 182-30-130: What are the requirements for a school employees benefits board (SEBB) organization engaging in local negotiations regarding SEBB benefits eligibility criteria?
  • WAC 182-31-070: Is dual enrollment in school employees benefits board (SEBB) and public employees benefits board (PEBB) prohibited?