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Am I eligible?

The SEBB Program offers two types of continuation coverage: COBRA and Unpaid Leave. Both options are temporary extensions of SEBB coverage.

Continuation coverage (COBRA and Unpaid Leave) enrollment timelines and the maximum coverage period are extended during the COVID-19 state of emergency.

What continuation coverage options are available?

The SEBB Program offers two types of continuation coverage.

SEBB Continuation Coverage (COBRA)

A temporary extension of SEBB health plan coverage available to SEBB members who are qualified beneficiaries under federal Consolidated Omnibus Budget Reconciliation Act (COBRA) rules.

The Health Care Authority (HCA) also extends SEBB Continuation Coverage (COBRA) to state-registered domestic partners and their children. Coverage may be temporarily extended only if the SEBB member experiences a qualifying event.

SEBB Continuation Coverage (Unpaid Leave)

A temporary extension of SEBB insurance coverage for employees who lose eligibility for the employer contribution toward SEBB benefits due to specific types of leave, such as active duty in the uniformed services and authorized leave without pay.

What is a qualified beneficiary? A qualified beneficiary is a covered employee, the employee’s covered spouse, and covered dependent children during a period of continuation coverage.

Am I eligible?

For COBRA

Each person who loses their SEBB health plan coverage due to a qualifying event has an independent election right under SEBB Continuation Coverage (COBRA).

Real-world example

An employee loses their SEBB employer-based group health plan due to a qualifying event, their spouse or state-registered domestic partner (SRDP) may choose continuation coverage, even if the employee does not. Either the employee or the spouse may choose continuation coverage for any dependent children.

For Unpaid Leave

Employees who lose their SEBB employer-based group health plan due to a qualifying event may choose SEBB Continuation Coverage (Unpaid Leave) for themselves and their dependents. The employee must choose this coverage for dependents to have coverage. Dependents do not have independent election rights.

Qualifying events

A qualifying event is a life event that causes loss of coverage. See related laws and rules at the bottom of this page for more information. 

Employee

  • Your employment ended for any reason other than gross misconduct.
  • Your hours of employment were reduced below the number of hours required to be eligible for the employer contribution toward SEBB benefits.

Spouse

State-registered domestic partner (SRDP)

Dependent children

  • Your parent (the employee) died.
  • Your parent’s hours of employment were reduced.
  • Your parent’s employment ended for any reason other than gross misconduct.
  • Your eligibility for SEBB health plan coverage as a dependent child ended.

SRDP's child

  • Your parent’s SRDP (the employee) died.
  • Your parent’s SRDP’s hours of employment are reduced.
  • Your parent’s SRDP’s employment ends for any reason other than gross misconduct.
  • Your eligibility for SEBB health plan coverage as a dependent child ended.
  • You are on authorized leave without pay from your school district, educational service district, or charter school.
  • Your employment ends due to a layoff.
  • You are appealing a grievance action.
  • You are receiving time-loss benefits under workers’ compensation.
  • You are applying for disability retirement.
  • You are called to active duty in the uniformed services, as defined under Uniformed Services Employment and Reemployment Rights Act (USERRA).

How long does coverage last?

Your maximum coverage period is determined by the qualifying event that caused you to lose SEBB coverage. In some situations, coverage can end before the maximum coverage period. See related laws and rules at the bottom of the page for more information.

Eligible member

  • Employee
  • Spouse
  • State-registered domestic partner
  • Children

Maximum continuation coverage (COBRA) period

18 months

Additional months of coverage may be available under SEBB Continuation Coverage (Unpaid Leave).

Note: In certain circumstances, qualified beneficiaries eligible for 18 months of SEBB Continuation Coverage (COBRA) may become eligible for an extension. A disability extension provides an additional 11 months of coverage (for a total maximum of 29 months). An extension due to a second qualifying event provides an additional 18 months of coverage (for a total maximum of 36 months). 

Eligible member

  • Employee
  • Spouse
  • State-registered domestic partner
  • Children

Maximum continuation coverage (COBRA) period

Up to 36 months, measured from the date of the employee's Medicare enrollment

Eligible member

Employee

Note: Employee must enroll to cover dependents. Dependents do not have independent election rights under SEBB Continuation Coverage (Unpaid Leave).

Maximum continuation coverage (Unpaid Leave) period

29 months

An employee who is no longer eligible for SEBB Continuation Coverage (Unpaid Leave), but who has not used the maximum number of months allowed under SEBB Continuation Coverage (COBRA), may continue medical, dental, vision, or all three for the remaining months allowed under COBRA.

Eligible member

Employee

Note: Employee must enroll to cover dependents. Dependents do not have independent election rights under SEBB Continuation Coverage (Unpaid Leave).

Maximum continuation coverage (Unpaid Leave) period

29 months

An employee who is no longer eligible for SEBB Continuation Coverage (Unpaid Leave), but who has not used the maximum number of months allowed under SEBB Continuation Coverage (COBRA), may continue medical, dental, vision, or all three for the remaining months allowed under COBRA.

Eligible member

Employee

Note: Employee must enroll to cover dependents. Dependents do not have independent election rights under SEBB Continuation Coverage (Unpaid Leave).

Maximum continuation coverage (Unpaid Leave) period

29 months

An employee who is no longer eligible for SEBB Continuation Coverage (Unpaid Leave), but who has not used the maximum number of months allowed under SEBB Continuation Coverage (COBRA), may continue medical, dental, vision, or all three for the remaining months allowed under COBRA.

Eligible member

Employee

Note: Employee must enroll to cover dependents. Dependents do not have independent election rights under SEBB Continuation Coverage (Unpaid Leave).

Maximum continuation coverage (Unpaid Leave) period

29 months

An employee who is no longer eligible for SEBB Continuation Coverage (Unpaid Leave), but who has not used the maximum number of months allowed under SEBB Continuation Coverage (COBRA), may continue medical, dental, vision, or all three for the remaining months allowed under COBRA.

Eligible member

Employee

Note: Employee must enroll to cover dependents. Dependents do not have independent election rights under SEBB Continuation Coverage (Unpaid Leave).

Maximum continuation coverage (Unpaid Leave) period

29 months

An employee who is no longer eligible for SEBB Continuation Coverage (Unpaid Leave), but who has not used the maximum number of months allowed under SEBB Continuation Coverage (COBRA), may continue medical, dental, vision, or all three for the remaining months allowed under COBRA.

Eligible member

Employee

Note: Employee must enroll to cover dependents. Dependents do not have independent election rights under SEBB Continuation Coverage (Unpaid Leave).

Maximum continuation coverage (Unpaid Leave) period

29 months

If the grievance is upheld and the employee has not used the maximum number of months allowed under SEBB Continuation Coverage (COBRA), they may continue medical, dental, vision, or all three for the remaining months allowed under COBRA.

Eligible member

  • Spouse
  • State-registered domestic partner
  • Children

Maximum continuation coverage (Unpaid Leave) period

36 months

PEBB retiree insurance coverage may also be available in certain cases.

Eligible member

  • Spouse
  • State-registered domestic partner
  • Stepchildren

Maximum continuation coverage (COBRA) period

36 months

Eligible member

  • Children

Maximum continuation coverage (COBRA) period

36 months

 Are there other options?

Yes. You and your dependents may have other coverage options through the Health Insurance Marketplace, Medicaid, or other group health plan coverage (such as a spouse’s plan).

Related laws and rules

Contact

The SEBB Program
Phone: 1-800-200-1004 
(TRS: 711)
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