- Are dependents enrolled in a plan at the same time as employees?
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Dependents are enrolled in plans only after the dependent eligibility document is approved. During open enrollment, dependents will be enrolled at the same time as the employee and will be verified before the employee’s coverage begins the following January.
For new hires and during special open enrollments, there may be a difference between when the employee is enrolled and the dependent is enrolled, based on when verification is approved and the reason for the dependent’s enrollment.
- What happens to documentation for dependent verification after it’s approved or denied?
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If the dependent verification document is uploaded to Benefits 24/7 and approved, it is kept for a short while and then deleted. Some documents might be kept longer for auditing purposes. If the verification is denied, the uploaded document is kept until any appeals are completed. If a paper document is given to the benefits administrator and approved, it can be returned to the employee.
- What are the options for dependent verification?
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Here's a list of valid documents to verify dependents. New employees can upload their dependent verification documents for review via Benefits 24/7. Alternately, employees can take their paper documents to their benefits administrator for review and approval. Dependent verification documents must be approved during the SEBB Program timelines.
- Why is dependent verification required?
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The SEBB Program requires employees to provide documentation that verifies the relationship between the employee and their dependent(s) before they can be enrolled in an employee's SEBB medical, vision, and/or dental coverage.
The E-1 and E-2 worksheets, located on the Eligibility tools and worksheets page, provide guidance on the various types of allowed dependents and the type of documentation needed in order to verify the relationship with the employee.
- Is it true that the carriers participating in the SEBB Program also have to be part of the individual market exchange?
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Yes. In 2018, the Washington State Legislature passed Engrossed Substitute House Bill 2408, which calls for this participation.
- Are enrollment materials available in languages other than English?
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Benefits 24/7, the online enrollment system, is only available in English for now. However, non-English speakers can enroll in SEBB using paper forms. Print publications and enrollment forms are available in additional languages upon request. Additional supported languages include: Amharic, Burmese, Cambodian, Chinese, Korean, Laotian, Oromo, Punjabi, Romanian, Russian, Somali, Spanish, Swahili, Tagalog, Tigrigna, Ukrainian, and Vietnamese. To request materials in supported languages, see HCA’s Language Access webpage.
- If employees don’t attest that they don’t use tobacco, will they be charged the tobacco use premium surcharge?
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Yes. To avoid the tobacco use premium surcharge, employees must attest that they and their dependents do not use tobacco. For more on this, visit the Tobacco use surcharge webpage.
- What happens if employees do not select coverage?
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They are automatically enrolled into UMP Achieve 1 (medical), Uniform Dental Plan (dental), MetLife (vision), basic life, basic accidental death and dismemberment, and basic long-term disability insurance. They are charged the tobacco use premium surcharge. Their dependents are not enrolled. In addition, they cannot change plans or enroll any eligible dependents until the next SEBB Program annual open enrollment or unless they have a special open enrollment event that allows the change, such as a marriage, birth, or adoption.
- Do eligible employees who are taking FMLA or PFML get to remain enrolled in benefits?
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It depends. When an employee is approved for Family and Medical Leave Act (FMLA) or Paid Family Medical Leave (PFML) that is concurrent with FMLA, they remain eligible for the employer contribution and continue their benefits. Concurrent means that leave taken under approved PFML must follow and overlap with leave taken under approved FMLA.
PFML by itself (that is not concurrent with FMLA), does not allow an employee to continue benefits. However, if the employee has already worked or remains anticipated to work at least 630 hours in the school year, the employee remains eligible for the employer contribution and continues their benefits regardless of whether PFML is or is not concurrent with FMLA.
Additional guidance can be found in the C-1 and C-2 worksheets on the Eligibility tools and worksheets page.
- Can employees transfer benefits between districts?
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Employees will have uninterrupted coverage when moving from one SEBB organization to another within the same month or a consecutive month, if the following conditions are satisfied:
- The employee was eligible for the employer contribution toward SEBB benefits in the position they are leaving; and
- The employee is anticipated to be eligible for the employer contribution toward SEBB benefits in their new position.
If they move to a new county, employees may need to change their medical plan. This creates a special open enrollment event.