If new employees who are eligible for SEBB benefits do not either enroll in or waive SEBB Program medical coverage within SEBB timelines, they will be automatically enrolled in the benefits below. They will also be charged a $25-per-month tobacco use premium surcharge. This surcharge can be stopped if the employee attests that they do not use tobacco. Attestation can be done either in Benefits 24/7 or on a paper enrollment form.

• Medical: UMP Achieve 1
• Dental: Uniform Dental Plan (no premium)
• Vision: MetLife vision (no premium)
• Basic life: MetLife (no premium)
• Basic accidental death and dismemberment (AD&D): MetLife (no premium)
• Basic long-term disability (LTD): The Standard (no premium)

No. The tobacco use and spouse or state-registered domestic partner coverage premium surcharges do not apply if medical coverage is waived.

No. They can only waive SEBB medical coverage if they are enrolled in other employer-based group medical insurance, a TRICARE plan, or Medicare. Retirement policies are not employer-based, so they do not qualify.

The formula for insuring SEBB organization employees and their dependents includes an estimated rate of employee waivers. If anticipated waivers weren’t factored in, that uncertainty would need to be funded by raising the amount employers pay  per employee for benefits. The state pools funds to pay for everyone enrolled in the program. Also, keep in mind that employees who waive medical will still receive other benefits.

Yes. Dependents must be enrolled in the same health plans as the subscriber. This applies whether the subscriber is enrolled in medical or waives it.

All eligible school employees must be enrolled in SEBB benefits.

An eligible employee can waive SEBB medical coverage when newly eligible or during the SEBB Program’s annual open enrollment if they are enrolled in other employer-based group medical insurance, a TRICARE plan, or Medicare.

Eligible employees who waive enrollment in medical must enroll in SEBB dental, vision, basic life and AD&D insurance, and employer-paid long-term disability insurance for themselves. However, dual enrollment prohibition rules do allow an employee to waive SEBB medical, vision, and dental to enroll in Public Employees Benefits Board (PEBB) medical (with vision) and dental (WAC 182-31-080).

If an employee waives SEBB medical coverage:

• They cannot enroll their eligible dependents in SEBB medical coverage.
• The premium surcharges will not apply to them.
• They will be able to access SmartHealth, the online health and wellness portal but they will not be able to earn the incentives. Their spouse or state-registered domestic partner will not have SmartHealth access.
• They can reenroll later during the annual open enrollment or if they have a qualifying special open enrollment event.

Reminder that eligible employees do not pay a premium for dental or vision coverage.

No. Medicare is not employer-based group medical coverage, so the premium surcharge does not apply.

Yes. The primary coverage would be through the SEBB Program on any claims the spouse or state-registered domestic partner might have. Medicare would be the secondary payer, and only pays if the SEBB plan pays less than Medicare would have paid.

If employees do not choose medical, dental, and vision plans, they will be automatically enrolled in UMP Achieve 1 (medical), Uniform Dental Plan (dental) and MetLife (vision). These plans are available in all Washington counties.

No. SEBB coverage is limited to a single enrollment per individual. If an employee and their spouse or state-registered domestic partner both enroll in the SEBB Program, they must decide which account to use to cover their children.