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 plan questionnaire 2020

1 2 3 4 5 6 7 8

Use this questionnaire to determine if you need to pay a premium surcharge for your spouse or state-registered domestic partner.

If you don’t have a spouse or state-registered domestic partner on your SEBB medical plan, you don’t need to complete this questionnaire. This surcharge does not apply to you.

If you have a spouse or state-registered domestic partner enrolled on your 2020 SEBB medical plan, you must:

  1. Answer YES to question 1 (the only option)
  2. YES or NO to questions 2-6

  3. Check the corresponding boxes in SEBB My Account (for school employees) or on your 2020 enrollment/change form (for SEBB Continuation Coverage members).