SEBB rules and policies

The SEBB Program follows the rules in Washington Administrative Code (WAC). Our administrative policies describe how we implement a law or rule affecting participation in SEBB Program benefits.

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SEBB Program law

You can find the SEBB Program's existing law in chapter 41.05 of the Revised Code of Washington (RCW).

SEBB Program rules

The SEBB Program follows the rules in Washington Administrative Code (WAC) chapters:

Below are links to the detailed rules for circumstances most common to school employees.

SEBB Program policies

The SEBB Program's administrative policies describe how we implement a law or rule affecting participation in SEBB Program benefits. The statements made in these documents reflect our interpretations of the eligibility and enrollment rules.

Employee eligibility and enrollment

Number Title Effective Date
11-1 Providing a notice to a school employee 1/1/2023
11-3 Correcting School Employees Benefits Board Organization and contracted vendor enrollment errors 1/1/2025
12-1 Determining the first day of school for SEBB organizations 1/1/2023
19-1 Termination due to loss of eligibility or enrollment error 1/1/2025
19-1A Addendum - Termination due to loss of eligibility or enrollment error: School employee 1/1/2025
19-1B Addendum - Termination due to loss of eligibility or nonpayment: Self-pay subscriber 1/1/2025

Dependent eligibility and enrollment

Number Title Effective Date
31-1 Verifying dependent eligibility before enrollment 1/1/2024
31-2 Use of SEBB Spousal Plan Calculator 1/1/2025
33-1 Verifying legal union's residency status 1/1/2023
36-1 Certifying eligibility for a dependent child with a disability who is age 26 or older 1/1/2025
37-1 Certifying eligibility for an extended dependent child 1/1/2025

Special open enrollment

Number Title Effective Date
45-2 Special open enrollment (SOE) 9/1/2024
45-2A Addendum: special open enrollment (SOE) matrix: summary of permitted election changes 9/1/2024

Reinstatement, tolling and continuation coverage

Number Title Effective Date
56-1 Reinstatement for subscribers with mental or physical impairment or incapacitation 1/1/2025
56-2 Election period tolling for applicants with mental or physical impairment or incapacitation 1/1/2025

Appeals

Number Title Effective Date
60-1 Required appeals related documents when the SEBB Program conducts a brief adjudicative proceeding 1/1/2023

Administrative - permanent

Number Title Effective Date
90-1 Allowable mid-year termination for an employer group 1/1/2025
90-2 What authority do employer groups need before contracting with HCA for participation in SEBB for insurance coverage? 1/1/2025
90-3 Determining if an employer group requesting eligibility criteria different from SEBB Program rules shall be approved 1/1/2025
90-4 Terms and conditions set by HCA for an employer group and school employees of an employer group 1/1/2025
91-1 Requesting a reasonable alternative for completing wellness incentive program requirements or avoiding the tobacco use premium surcharge 1/1/2024
91-2 Tobacco as it relates to religious or ceremonial use 1/1/2024
91-3 Washington Wellness worksite designation program incentive requirements 1/1/2025
93-2 SEBB Program payment plans 1/1/2025
94-1 Accessing SEBB Program salary reduction plan document 1/1/2024
94-2 Accessing SEBB Program wellness plan document 1/1/2024
94-3 Subscriber mistake - Factor test 1/1/2025

Proposed policies

The proposed policies below are effective January 1, 2026. 

Number Title
11-1 Providing a notice to a school employee
11-3 Correcting School Employee Benefits Board organization and contracted vendor enrollment errors
45-2 Special open enrollment
45-2A Special open enrollment matrix: Summary of permitted election changes 
60-1 Required appeals related documents when the SEBB Program conducts a brief adjudicative proceeding
91-3 Washington wellness worksite designation program incentive requirements

Rescinded policies

The polices listed below are rescinded.

Number Title Policy effective date
11-3 Correcting School Employees Benefits Board Organizations and contracted vendor enrollment errors 1/1/2023
1/1/2022
12-1 Determining the first day of school for SEBB organizations 1/1/2022
19-1 Termination due to loss of eligibility 1/1/2024
1/1/2023
1/1/2022
19-1A Addendum: Termination due to loss of eligibility of enrollment error - School employee 1/1/2024
1/1/2023
1/1/2022
19-1B Addendum: Termination due to loss of eligibility for nonpayment - Self-pay subscriber 1/1/2024
1/1/2023
1/1/2022
31-1 Verifying dependent eligibility before enrollment 1/1/2023
1/1/2022
31-2 Use of premium surcharge help sheet and spousal plan calculator tools 1/1/2024
1/1/2023
1/1/2022
36-1 Certifying eligibility for a dependent child with a disability who is age 26 or older 1/1/2024
1/1/2023
37-1 Certifying eligibility for an extended dependent child 1/1/2024
1/1/2023
1/1/2022
45-2 Special Open Enrollment (SOE) 1/1/2024
1/1/2023
1/1/2022
45-2A Special open enrollment matrix: Summary of permitted election changes 1/1/2024
1/1/2023
1/1/2022
56-1 Continuation coverage reinstatement for subscribers with mental or physical impairment or incapacitation 1/1/2024
1/1/2023
1/1/2022
56-2 Election period tolling for applicants with mental or physical impairment or incapacitation 1/1/2024
1/1/2023
1/1/2022
91-1 Requesting a reasonable alternative for completing wellness incentive program requirements or avoiding the tobacco use premium surcharge 1/1/2023
91-2 Tobacco as it relates to religious or ceremonial use 1/1/2023
1/1/2022
91-3 Washington Wellness worksite designation program incentive requirements 1/1/2024
1/1/2023
1/1/2022
93-2 SEBB Program payment plans for continuation coverage amounts 1/1/2023
94-1 Accessing SEBB Program salary reduction plan document 1/1/2023
94-2 Accessing SEBB Program wellness plan document 1/1/2023
94-3 Subscriber mistake - Factor test 1/1/2024
1/1/2023

Salary reduction plan

Wellness plan

Related links