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.

How do I waive coverage?

To waive enrollment in SEBB medical, you must use SEBB My Account, the 2020 School Employee Enrollment form, or 2020 School Employee Change form.

If you are eligible for SEBB benefits and you waive enrollment in medical, you must still enroll in dental, vision, basic life insurance and accidental death and dismemberment (AD&D) insurance, and basic long-term disability (LTD) insurance for yourself.

Waiving enrollment in medical during open enrollment

You can waive enrollment in SEBB medical during the SEBB Program’s first annual open enrollment, October 1 through midnight, November 15, 2019. You must enroll in dental, vision, basic life and accidental death and dismemberment (AD&D), and basic long-term disability insurance for yourself, regardless of whether you waive SEBB medical.

Waiving enrollment after open enrollment

You can only waive enrollment in SEBB medical outside of open enrollment if you are a newly eligible employee or have a special open enrollment event that allows you to change your medical enrollment status.

If you’re a newly eligible employee, you must elect to waive enrollment in medical on SEBB My Account, or your payroll or benefits office must receive your completed 2020 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, you must elect to waive enrollment in medical using SEBB My Account, or your payroll or benefit office must receive a completed 2020 School Employee Change form, no later than 60 days after the event.

What happens if I waive medical?

If you waive enrollment in SEBB medical:

  • 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 incentives.

What happens if I don't enroll?

If you are eligible but do not enroll or waive your enrollment in SEBB medical  during the first annual open enrollment, you will be enrolled by default 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-per-account monthly tobacco use premium surcharge.

If you are enrolled by default, 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 two SEBB accounts at the same time. 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 and be 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 and AD&D insurance, and basic LTD insurance under your own account.
  • Enroll in medical under your own SEBB account.

How do I enroll if I previously waived medical?

If you waive 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 special open enrollment event that allows the change.  

What if I’m entitled to 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 and AD&D insurance, and basic long-term disability insurance.