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Waiving medical coverage

You can waive your enrollment in SEBB medical coverage if you are enrolled in another 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 employer-paid long-term disability (LTD) insurance. If you do not enroll in these coverages, you will be automatically enrolled. You will also be enrolled in employee-paid LTD insurance, unless you decline this coverage.

How do I waive enrollment?

If you’re a newly eligible employee, you must elect to waive enrollment in medical coverage 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 SEBB benefits. You can also waive during an annual open enrollment.

If you have a special open enrollment event allowing you to waive coverage, you must choose 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.

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

Exception: You may waive your enrollment in a SEBB medical plan to enroll in a Public Employees Benefits Board (PEBB) medical plan if you also enroll in a PEBB dental plan. In doing so, you waive your enrollment in SEBB dental and vision. You cannot enroll in both SEBB and PEBB health plans.

What happens if I waive enrollment?

If you waive enrollment in SEBB medical:

What happens if I don't enroll or waive?

If you are eligible for SEBB benefits, but do not enroll or waive your enrollment during the SEBB Program's enrollment timelines: 

  • You will be automatically enrolled as a single subscriber in UMP Achieve 1, Uniform Dental Plan, MetLife vision, basic life insurance, basic accidental death and dismemberment (AD&D) insurance, and employer-paid long-term disability (LTD) insurance. Your dependents will not be enrolled.
  • You will be enrolled in employee-paid LTD insurance, unless you decline the coverage. 
  • You will be charged a monthly premium for medical coverage as well as a $25 tobacco use premium surcharge.
  • 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.
  • You can participate in the SmartHealth wellness program and qualify for the wellness incentive.
  • You will be removed from your spouse's, state-registered domestic partner's or your parent's coverage, if you're enrolled.

What if I'm already enrolled in SEBB coverage?

You cannot be enrolled in two SEBB accounts. If you are a newly eligible employee who is already enrolled in SEBB coverage as a dependent under your spouse’s, state-registered domestic partner’s, or parent’s account, you may choose one of these options:

  • Waive SEBB medical and stay enrolled in medical under your spouse’s, state-registered domestic partner’s, or parent’s SEBB account. Your spouse, state-registered domestic partner, or parent must remove you from their dental and vision coverage to prevent two enrollments in SEBB coverage.

OR

  • Enroll in SEBB medical under your own account. You must be removed from your spouse’s, state-registered domestic partner’s, or parent’s medical, dental, and vision accounts.

With either option, you must still enroll in dental, vision, basic life insurance, basic AD&D insurance, and employer-paid LTD insurance under your own account. You will also be enrolled in employee-paid LTD insurance, unless you decline the coverage.

How do I enroll if I previously waived medical?

If you waived enrollment, 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 dependents 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 primary coverage. However, you will remain enrolled in dental, vision, basic life insurance, basic AD&D insurance, and employer-paid LTD insurance. You will remain enrolled in employee-paid LTD insurance, unless you decline it. Learn more about Medicare and SEBB benefits while you are employed.

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).