SEB Board passes two policy resolutions

Fri, 12/14/2018

On December 13, 2018, the School Employees Benefits Board (SEB Board) approved two policy resolutions that will apply to eligible employees of school districts, educational service districts (ESDs), and charter schools, starting January 1, 2020.

The approved resolutions establish that the SEBB Program will:

  • Allow school employees eligible for the employer contribution to waive enrollment in a SEBB medical plan.
  • By default, enroll eligible school employees who don’t make timely coverage elections in employee-only medical, dental, vision, basic life, and basic long-term disability insurance.

Policy resolutions

The SEB Board approved the following policy resolutions. See page 138 of the December 13 briefing book for benefit details.

School employees may waive enrollment in medical (SEBB 2018-53)

A school employee who is eligible for the employer contribution toward SEBB benefits may waive their enrollment in a medical plan if they are enrolled in other employer-based group medical.

Default enrollment for an eligible school employee who fails to make a timely election (SEBB 2018-54)

The default election for an eligible school employee who fails to timely elect coverage will be as follows:

  • Enrollment in employee-only medical coverage;
  • Enrollment in employee-only dental coverage;
  • Enrollment in employee-only vision coverage;
  • Enrollment in basic life insurance; and
  • Enrollment in basic long-term disability insurance.

Meeting recap

The following informational items were presented to the SEB Board. To get all of the materials presented at the December 13 SEB Board meeting, view the briefing book.

  • Dave Iseminger, director of HCA’s ERB Division, discussed the major upcoming milestones leading to the January 2020 launch and the vision for 2019 open enrollment, including what communications subscribers will receive and how subscribers will find choosing their benefits and understanding their costs will be much simpler. 
  • Dave Iseminger and SEBB Procurement Manager Lauren Johnston also addressed follow-up Board questions on fully insured medical plans from the November 8 meeting, including:
    • Explaining that none of the SEBB Program’s prospective fully insured medical plans have a limit on mental or behavioral health visits;
    • Providing information on the fully insured medical plans’ utilization management for mental health and pharmacy benefits; and
    • Identifying which fully insured medical plan carriers’ pharmacy policies include step therapy for drug classifications.
  • HCA Chief Financial Officer Megan Atkinson explained some of the concepts regarding the Benefit Allocation Factor (BAF), SEBB funding rate, employer medical contributions, and employee premium contributions.
  • Molly Christie, ERB strategic plan project manager, gave the first in a series of informational presentations, Pharmacy 101, on the prescription drug market trends, including specialty drugs and manufacturer’s promotional efforts.
  • Nick Streuli, director of Legislative and Executive Operations at the Washington State Employment Security Department, explained the new state Paid Family & Medical Leave (PFML) law. PFML coverage begins January 1, 2020 for eligible employees, and provides a wage replacement benefit for up to 12 weeks after a qualifying family or medical event.
  • Justin Hahn, Washington Wellness program manager, gave a presentation on how the SEBB Program will implement the SmartHealth wellness program. He also presented two policy resolutions outlining eligibility for wellness incentives.
  • Barb Scott, ERB Policy, Rules and Compliance section manager, presented two continuation coverage policy resolutions for a potential January 7, 2018 vote.

HCA will post meeting minutes on the Meetings and materials webpage after they are approved by the Board.

Coming in January

On January 24, 2018, the SEB Board may vote on the following resolutions:

Eligibility for Participation in the SEBB Wellness Program (SEBB 2018-55)

The spouse or state-registered domestic partner of an eligible school employee may participate in SEBB wellness program activities, but is not eligible to receive an incentive payment.

Deadline for completing wellness activities (SEBB 2018-56)

Effective January 1, 2020, to receive a SEBB Wellness Incentive in the following plan year, eligible subscribers must complete SEBB Wellness Incentive Program requirements by the following deadline:

  • For subscribers enrolling in SEBB medical with an effective date in January through September, the deadline is November 30.
  • For subscribers enrolling in SEBB medical with an effective date in October through December, the deadline is December 31.

Maximum number of months that self-pay coverage is allowed (SEBB 2018-57)

The maximum number of months that a school employee may continue SEBB benefits during an approved leave of absence, by self-paying the premium and applicable premium surcharges, will be 29 months. The 29 months a school employee may self-pay for coverage under this provision includes the total months of continuation coverage allowed under the federal Consolidated Omnibus Budget Reconciliation Act (COBRA).

Continuation coverage for dependents not eligible under the SEBB Program (SEBB 2018-58)

A dependent of a SEBB-eligible school employee who is enrolled in medical, dental, or vision under a school employee’s account on December 31, 2019 who loses eligibility because they are not an eligible dependent under the SEBB Program may continue enrollment for a maximum of 36 months on a self-pay basis.

SEBB Program development continues

For more information

You can find more information on the SEBB Program webpage.