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Waiving medical coverage

You can waive your enrollment in SEBB medical coverage if you are enrolled in other employer-based group medical insurance, a TRICARE plan, or Medicare.

If you waive enrollment in medical coverage, you must still enroll in dental, vision, basic life, basic accidental death and dismemberment (AD&D), and basic long-term disability (LTD) insurance. If you do not enroll in these coverages, you will be automatically enrolled.

How do I waive medical coverage?

To waive enrollment in SEBB medical, use SEBB My Account, the School Employee Enrollment form, or the School Employee Change form.

For the remainder of the 2021 plan year, if you are eligible for SEBB benefits and you waive enrollment in medical, you must still enroll in dental, vision, basic life insurance, accidental death and dismemberment (AD&D) insurance, and basic long-term disability (LTD) insurance for yourself.

If you’re a newly eligible employee, you must elect to waive enrollment in medical in SEBB My Account, or your payroll or benefits office must receive your  School Employee Enrollment form, no later than 31 days after the date you become eligible for the employer contribution toward SEBB benefits.

If you have a special open enrollment event, allowing you to waive coverage, you must elect to waive enrollment in medical using SEBB My Account, or your payroll or benefits office must receive a School Employee Change form, no later than 60 days after the event. You must also provide proof of the event that creates the special open enrollment.

What happens if I waive medical?

If you waive enrollment in SEBB medical:

  • You must still enroll in dental, vision, basic life, basic AD&D, and basic LTD insurance. If you do not enroll in these coverages, you will be automatically enrolled.
  • You cannot enroll your eligible dependents in SEBB medical coverage.
  • The premium surcharges will not apply to you.
  • You will be eligible to participate in the SmartHealth wellness program, but you will not be able to qualify for the wellness incentive.

What happens if I don't enroll?

If you are eligible for SEBB benefits, but do not enroll or waive your enrollment in SEBB medical during the SEBB Program's enrollment timelines, you will be automatically enrolled as a single subscriber in UMP Achieve 1 (for medical), Uniform Dental Plan, MetLife vision, basic life insurance, basic accidental death and dismemberment (AD&D) insurance, and basic long-term disability (LTD) insurance. Your dependents will not be enrolled. You will be charged a monthly $33 premium for medical coverage as well as a $25 tobacco use premium surcharge.

If you are automatically enrolled, you cannot change plans or enroll your eligible dependents until the next annual open enrollment unless you have a special open enrollment event that allows the change.

What if I'm eligible for SEBB benefits both as an employee and as a dependent?

You cannot enroll in medical, dental, or vision coverage under two SEBB accounts at the same time. Medical, dental, and vision coverage is limited to a single enrollment per individual. If you are an eligible employee and are also eligible as a dependent under your spouse’s, state-registered domestic partner’s, or parent’s account, you may choose one of these options:

  • Waive your enrollment in SEBB medical under your own account and instead, remain enrolled in medical under your spouse’s, state-registered domestic partner’s, or parent’s SEBB account. You must still enroll in dental, vision, basic life insurance, basic AD&D insurance, and basic LTD insurance under your own account.
  • Enroll in medical (as well as dental, vision, basic life insurance, basic AD&D insurance, and basic LTD insurance) under your own SEBB account.

How do I enroll if I previously waived medical?

If you waived enrollment in medical, you can reenroll during the next annual open enrollment (for coverage effective January 1 of the following year), or if you have a special open enrollment event that allows the change. 

What if I’m enrolled in Medicare?

For employees and their enrolled spouses or state-registered domestic partners age 65 and older or on disability, SEBB medical plans provide primary coverage, and Medicare coverage is usually secondary. You may choose to waive your enrollment in SEBB medical coverage and have Medicare as your coverage. However, you will remain enrolled in SEBB dental, vision, basic life insurance, basic AD&D insurance, and basic long-term disability insurance.

If you enroll in Medicare Part A or B, you can’t enroll in a high-deductible health plan with a health savings account (HSA).