School Employees Benefits Board (SEBB) Program FAQs

Staff at the Health Care Authority (HCA) are honored to be building the School Employee Benefit Board (SEBB) Program for school employees across the state. We want to answer your questions and supply you with as much information as possible. However, it is still early in the process and many questions cannot be answered at this time. As the Board makes decisions and work progresses, we will update answers, add new questions, and provide more information. Please check back for updated from time to time.

General

When will the SEBB Program begin offering benefits to school employees?

Under EHB 2242, benefits offered by the SEBB Program will be available starting January 1, 2020.

I am currently enrolled in a Public Employees Benefits Board (PEBB) health plan. What does the creation of the SEBB Program mean for me?

If you are currently enrolled in a PEBB health plan, you will continue receiving benefits from the PEBB Program until January 1, 2020. Beginning January 1, 2020, all school employees will be transferred to benefits under the SEBB Program.

The creation of the SEBB program does not affect K-12 retirees. All K-12 retirees will continue receiving benefits through the PEBB Program.

Will HCA have enough staff to meet the needs of school employees?

HCA is adding staff primarily in the Employees and Retirees Benefits (ERB) division, whose jobs will be to make the transition to SEBB as smooth as possible.  School district, educational school district (ESD), and charter school personnel will retain a very active role in assessing eligibility and aiding employees with enrollment, and ERB staff will provide training, support, and send communications to school employees ahead of the 2019 SEBB Program open enrollment to meet the needs of school employees.

Eligibility

Who will be eligible for benefits from the SEBB Program?

Under a new state law (RCW 41.05.740(6)(d)(ii)), an “employee must work at least [630] hours per year to qualify for coverage” under the SEBB Program. In addition, the SEB Board will vote on other eligibility criteria, including dependent eligibility, in the coming months.

Will I be able to waive SEBB insurance coverage?

Information about waiving benefits will be addressed with benefits and eligibility requirements by the Board.

Enrollment

Will districts be able to continue offering optional benefits after January 1, 2020? Must my district purchase benefits through HCA?

Under the new legislation (section 816 of EHB 2242), beginning January 1, 2020, school districts, ESDs, and charter schools shall make available basic and optional benefits through the plans offered by the Health Care Authority and the SEB Board.

Section 815, RCW 28A.400.280(3) now states that school districts are not intended to divert state basic benefit allocations for other purposes, and beginning January 1, 2020, no basic or optional benefits may be provided by employer contributions if they are not provided by the School Employees’ Benefits Board administered by the HCA and consistent with RCW 41.56.500(2).  The SEB Board will evaluate whether there will be optional benefits (such as additional life insurance) offered by the SEBB Program, but fully paid for by the employee.

When will I be able to select the benefits I want?

Open enrollment for SEBB Program subscribers will begin sometime in the fall of 2019. The exact start and end dates of open enrollment will be determined and shared well in advance of open enrollment along with information about the benefit options.

SEBB Program benefits

What types of benefits will the SEBB Program offer?

The SEB Board will vote in 2018 on the types of plans and specific benefit design that the SEBB Program will offer. The benefit offerings under consideration include medical (including pharmacy), dental, vision, life, and disability insurance.

How many medical and dental plans will the SEBB Program offer?

The number of plans the SEBB Program will offer depends on insurance carrier responses to procurements, and the types of plans and the benefit design selected by the Board.

Are my health care costs (premiums, deductible, out-of-pocket maximum, copays, and coinsurance) going to increase?

The answer is different for everyone based on the plan you currently have and whether dependents are included compared to decisions the employee makes about plan selection and dependent coverage in the future. HCA will be able to share cost information and monthly premiums after contracts are in place and benefit design decisions (deductibles, out-of-pocket maximums, copays, and coinsurance) have been made by the SEB Board.

My health plan usually ends on October 31 each year, but SEBB Program benefits are scheduled to start January 1, 2020. What will be done to address benefits for the time between my current benefits and new SEBB Program benefits?

HCA is aware of this concern. We are currently putting information together to provide school districts, ESDs, and charter schools in advance of local procurements for the November 2018-October 2019 benefits year.

Will I be able to continue to see my current medical, dental, and vision provider?

At this time, we do not know whether or not you will be able to continue to see your current provider(s). It depends on the provider networks that insurance carriers have for plans that meet the SEBB Program benefit design requirements. HCA is in the process of gathering plan information to help the SEB Board determine benefits. HCA does not want to cause a disruption in a member’s care and is working diligently to provide as seamless of a transition as possible.

I'm undergoing a health treatment; will I be able to continue my care with my provider under the SEBB Program?

At this time, we do not know whether or not you will be able to continue to see your current provider(s). It depends on the provider networks that insurance carriers have for plans that meet the SEBB Program benefit design requirements. HCA is in the process of gathering plan information to help the SEB Board determine benefits. HCA does not want to cause a disruption in a member’s care and is working diligently to provide as seamless of a transition as possible.

I live in a rural area; will my community providers be covered under the new SEBB plan(s)?

At this time, we do not know whether or not you will be able to continue to see your current provider(s). It depends on the provider networks that insurance carriers have for plans that meet the SEBB Program benefit design requirements. HCA is in the process of gathering plan information to help the SEB Board determine benefits. HCA does not want to cause a disruption in a member’s care and is working diligently to provide as seamless of a transition as possible.

SEB Board

How were the SEB Board and SEBB Program created?

The Board and SEBB Program were created by the passage of Engrossed House Bill 2242 on June 30, 2017. Sections 801 through 815 of the bill create the Board and SEBB Program, specify Board duties, and outline requirements of the SEBB Program.

What is the purpose of the Board?

The function of the Board is to design and approve insurance benefit plans for school employees and to establish eligibility criteria for participation in insurance benefit plans.

How are Board members appointed?

The Governor appoints the Board members. By law, the Board members must include:

  • Two members are from associations representing certificated employees;
  • Two members from associations representing classified employees;
  • Four members with expertise in employee health benefits policy and administration, one of which is nominated by an association representing school business officials; and
  • The director of the Health Care Authority or his or her designee. The director serves as the chair of the Board.

Who are the members of the board?

Governor Jay Inslee appointed the initial SEB Board members on September 28, 2017. SEB Board members include:

  • Position 1 – Daniel Gossett
  • Position 2 – Katy Henry
  • Position 3 – Terri House
  • Position 4 – Patricia Estes
  • Position 5 – Wayne Leonard
  • Position 6 – Pete Cutler
  • Position 7 – Alison White
  • Position 8 – Sean Corry
  • Position 9 – Louis McDermott

Learn more about the SEB Board members.

How long do Board members serve on the Board?

Initial Board members serve staggered terms not to exceed four years. After the first terms are concluded, members will be appointed to serve two-year terms.

What are the duties of the Board?

RCW 41.05.740 directs the Board to:

  • Study matters connected with providing health care coverage, disability insurance, life insurance, accidental death and dismemberment, and liability insurance;
  • Develop employee benefit plans that include comprehensive, evidence-based health care benefits;
  • Authorize premium contributions for an employee and the employee's dependents in a manner that encourages the use of cost efficient health care systems;
  • Determine the terms and conditions of employee and dependent eligibility criteria, enrollment policies, and scope of coverage;
  • Determine the terms and conditions for employing school districts, ESDS, and charter school, and individual employees to participate;
  • Establish penalties to be imposed when the employer fails to comply with established participation criteria; and
  • Participate with HCA in the preparation of specifications and selection of carriers contracted for employee benefit plan coverage and coordinate with the Public Employees Benefits Board to leverage efficient purchasing.

When does the Board meet?

The Board will meet approximately once a month. A list of the Board’s meeting dates and times through December 2018 can be found at School Employees Benefits Board (SEBB) meeting dates.

How can I get Board meeting materials?

Board meeting materials are posted to the meetings and materials page. You can also sign up for SEB Board emails.