SEBB My Account
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Use this questionnaire to determine if you need to pay a premium surcharge for your spouse or state-registered domestic partner (SRDP).
If you don’t have a spouse or SRDP 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 SRDP enrolled on your 2021 SEBB medical plan, you must: