SEB Board approves dependent eligibility, benefit procurement, and benefit offerings for school employees in 2020

Thu, 03/22/2018
School employee

On March 15, 2018, the School Employees Benefits (SEB) Board voted on 11 resolutions to:

  • Establish dependent eligibility criteria;

  • Begin procurements for fully insured medical, short and long-term disability insurance, and vision benefits;
  • Beginning January 1, 2020, offer self-insured medical and dental, fully insured dental, and life and accidental death & dismemberment (AD&D) insurance benefits similar to those offered under the Public Employees Benefits Board (PEBB) Program.

As a result, HCA will move forward with recommending to the SEB Board the benefit design and coverage amounts offered for the self-insured medical and dental plans, fully insured dental plans, and life and AD&D insurance. Throughout the benefit development process, HCA will continue to work with stakeholders to ensure it considers school employees’ needs as benefits are designed.

In April, HCA will release Requests for Information (RFI) or other procurement documents to begin the procurement process for fully insured medical plans, short-term and long-term disability insurance, and vision insurance coverage. Next year, the HCA and its actuarial contractor will determine the rates (the total costs paid to the carriers) for the newly adopted benefits after the procurements are completed. The SEB Board will then vote on the employee’s share (the monthly premiums) after accounting for the state’s share.

The SEB Board meets next on April 30, 2018 to vote on resolutions presented at the March 15, 2018 meeting to establish the:

  • Coverage effective date following hire.
  • Benefit election period for new employees.
  • Premium tier structure.

Below is a summary of the 11 resolutions (with their policy resolution reference numbers) approved by the SEB Board. See the SEBB Frequently Asked Questions page for more information.

Dependent Eligibility Criteria Policy Resolutions

  • Spouse and Domestic Partner (SEBB 2018-01)Eligible school employees enrolled in SEBB benefits may enroll a dependent that satisfies one of the following criteria:
  • Dependent Child (SEBB 2018-02)Eligible school employees enrolled in SEBB benefits may enroll a child up to age 26 that satisfies one of the following criteria:
    • Children of the employee based on the establishment of a parent-child relationship as described in Revised Code of Washington (RCW) 26.26.101, except when parental rights have been terminated;
    • Children of the employee’s spouse, based on the spouse’s establishment of a parent-child relationship, except when parental rights have been terminated. The stepchild’s relationship to the employee (and eligibility as a dependent) ends on the same date the marriage with the spouse ends through divorce, annulment, dissolution, termination, or death;
    • Children of the employee’s state-registered domestic partner, based on the state-registered domestic partner’s establishment of a parent-child relationship, except when parental rights have been terminated. The child’s relationship to the employee (and eligibility as a dependent) ends on the same date the employee’s legal relationship with the state-registered domestic partner ends through divorce, annulment, dissolution, termination, or death;
    • Children for whom the employee has assumed a legal obligation for total or partial support in anticipation of adoption of the child;
    • Children specified in a court order or divorce decree for whom the employee has a legal obligation to provide support or health care coverage; and
    • Children of any age with a developmental disability or physical handicap that satisfies all of the following criteria:
      • The employee must provide proof of the disability and dependency within 60 days of the child’s attainment of age 26;
      • The employee must agree to notify the SEBB Program, in writing, no later than 60 days after the date the child is no longer eligible under this subsection.
      • A child with a developmental or physical disability who becomes self-supporting is not eligible under this subsection as of the last day of the month in which he or she becomes capable of self-support;
      • A child with a developmental or physical disability age 26 and older who becomes capable of self-support does not regain eligibility if he or she later becomes incapable of self-support;
      • The SEBB Program will, with input from the applicable contracted vendor, periodically certify the eligibility of a dependent child with a disability beginning at age 26, but no more frequently than annually after the two-year period following the child’s 26th birthday, which may require renewed proof from the employee.
  • Extended Dependent Child (SEBB 2018-03)Eligible school employees enrolled in SEBB benefits may enroll a child up to age 26 that is an extended dependent in the legal custody or legal guardianship of the employee, the employee's spouse, or the employee's state-registered domestic partner. The legal responsibility is demonstrated by a valid court order and the child's official residence with the custodian or guardian. Extended dependent child does not include a foster child unless the employee, the employee’s spouse, or the employee’s state-registered domestic partner has assumed a legal obligation for total or partial support in anticipation of adoption.

Procurement Resolutions

The School Employees Benefits Board (SEBB) Program will perform procurements for:

  • Fully insured medical plans from multiple carriers with widespread coverage offerings (SEBB 2018-04).
  • Long-term disability insurance that includes possible employer-paid and employee-paid coverage options (SEBB 2018-08).
  • Short-term disability insurance that includes employee-paid optional coverage. This benefit will not include employer-paid coverage (SEBB 2018-09).
  • A vision benefit that is not integrated into medical plans (SEBB 2018-11). The SEB Board will evaluate later whether to offer vision benefits integrated, stand alone, or a combination of both approaches.

Benefit Resolutions

Beginning January 1, 2020, the SEBB Program will offer:

  • Self-insured medical plans with features similar to the Uniform Medical Plan such as covered benefits, provider networks, clinical policies, and an integrated pharmacy benefit. Offerings are subject to final financing decisions by the state (SEBB 2018-05).
  • Fully insured dental plans similar to the fully insured dental plans offered under the Public Employees Benefits Board (PEBB) Program. In 2020, the SEB Board will evaluate whether they should pursue a fully insured dental plan procurement to consider additional or different offerings (SEBB 2018-06).
  • A self-insured dental plan with features similar to the Uniform Dental Plan such as covered benefits, clinical policies, and provider networks, subject to final financing decisions by the state (SEBB 2018-07).
  • Life insurance and accidental death and dismemberment (AD&D) insurance with coverage offerings and covered benefits similar to those offered under the PEBB Program (SEBB 2018-10).