Employee enrollment

Information about the enrollment requirements and processes for when employees become eligible for the employer contribution toward School Employees Benefits Board (SEBB) benefits.

Providing notice of the determination of eligibility

SEBB Organizations must provide written notice of the determination of eligibility (or ineligibility) to employees upon hire and when an employee experiences a change in eligibility or work pattern. The notice should be provided within a reasonable time frame as part of the hiring process and employees must have no less than 10 calendar days after the date of notice to elect coverage. (SEBB Policy 11-1).

Learn about determining eligibility and providing required the notification using the eligibility worksheets.

Enrollment requirements

Newly eligible employees must complete and submit their enrollment elections and dependent verification (DV) documents (if applicable), no later than 31 days after becoming eligible for SEBB benefits (WAC 182-30-080).

How do newly eligible employees complete their enrollment?

Medical, dental, vision, and employee-paid long-term disability (LTD) insurance

Employees can elect medical, dental, and vision coverage for themselves and their eligible dependents, and upload dependent verification (DV) documents online using Benefits 24/7 or by submitting the appropriate School Employee Enrollment form and DV to their benefits administrator (BA).

Eligible employees will be automatically enrolled in employee-paid long-term disability (LTD) insurance at the 60-percent coverage level. They can use Benefits 24/7 or the LTD Enrollment/Change form to reduce to the 50-percent coverage level or decline employee-paid LTD at any time.

If forms (and required DV if applicable) are received within the required timeframe, BAs enter the enrollment elections in SEBB My Account on behalf of their employees.

  • Notes:
    • Employees eligible for SEBB benefits due to locally negotiated eligibility criteria are not eligible for LTD insurance
    • Eligible employees may make changes to employee-paid LTD insurance at any time. However, if they request to enroll in or increase employee-paid LTD coverage after their 31-day eligibility period, they must also complete the Evidence of Insurability form.

Learn more about the medical plans, dental plans, vision plans, and LTD insurance.

Supplemental life and accidental death and dismemberment (AD&D) insurance

Eligible employees can use MetLife’s MyBenefits portal to elect supplemental life and AD&D insurance for themselves and their eligible dependents and add beneficiaries. However, employees may choose to complete and submit the MetLife Enrollment/Change form or the Beneficiary Designation form instead. Once completed, employees should submit the form directly to MetLife using the submission instructions on the form.

  • Note: Employees may choose to elect supplemental life and AD&D insurance at any time. However, if they apply for supplemental life insurance after their 31-day eligibility period or outside of a special open enrollment period, MetLife must approve the request and evidence of insurability will be required.

Learn more about life and AD&D insurance.

Flexible Spending Arrangements (FSAs) and Dependent Care Assistance Program (DCAP)

Eligible employees may elect to participate in the Medical FSA or Limited Purpose FSA, and the DCAP by submitting the Midyear Enrollment form to their BA.

If the form is received within the required timeframe, BAs should follow the instructions provided on the FSA and DCAP webpage to process the enrollment.

What if an employee is regaining eligibility following a period of approved leave?

Enrollment requirements vary for employees who are regaining eligibility for SEBB benefits following a period of approved leave (e.g., authorized leave without pay (LWOP), Worker's compensation, etc.).

Review the D1 worksheet to learn more.

What if an employee is transferring from another SEBB organization?

Eligible employees who transfer from one SEBB employer to another without a break in benefits are not considered newly eligible and do not make new benefit elections. Their benefit elections remain the same with the new employer.

Note: A break in benefits is one full calendar month or more in which the employee does not receive the employer contribution toward SEBB coverage.

Employees enrolled in a Medical Flexible Spending Arrangement (FSA), Limited Purpose FSA, or the Dependent Care Assistance Program (DCAP) may continue participation if the employee is: 

  • Transferring from one SEBB organization to another, and
  • The time between employments is 30 days or less, and
  • Is within the current plan year.

To continue participation, the employee must submit the School Employment Transfer form to their BA at the new SEBB organization. The form must be received no later than 31 days after the employee's first day of work with the new organization.

If the employee does not meet the above criteria, participation cannot be continued until the beginning of the next plan year. 

Review the A5 worksheet to learn more.

Adding eligible dependents to coverage

Benefits administrators (BAs) should provide the E-1 worksheet and E-2 worksheet to employees who are adding dependents to SEBB benefits.

Employees adding eligible dependents to their SEBB medical, dental, and/or vision coverage must submit valid dependent verification (DV) documents before their dependents can be enrolled. Both the enrollment elections and DV must be submitted in Benefits 24/7 or received by the BA as follows:

  • When newly eligible: No later than 31 days after the date the employee becomes eligible for SEBB benefits.
  • During annual open enrollment (OE): No later than the last day of OE.
  • During a special open enrollment (SOE): Generally, no later than 60 days after the date of the event that created the SOE.

Additional forms may be required to enroll eligible dependents. Learn more on the Dependents webpage.

What if required forms and valid DV are not received within the required timeframe?

If the required forms and valid dependent verification documents are not submitted in SEBB My account or received by the BA by the deadline, dependents cannot be enrolled until the next annual OE, or an SOE occurs that allows for the enrollment of a dependent (WAC 182-31-150).

Dual enrollment

Eligible employees and dependents are limited to a single enrollment in medical, dental, and vision plans in either the SEBB Program or Public Employees Benefits Board (PEBB) Program.

If dual enrollment occurs, and no action is taken to resolve dual enrollment during an eligible enrollment period, the programs will automatically enroll or disenroll an individual as described the Dual Enrollment Q&A for BAs and WAC 182-31-170(6).

Learn about the steps to take when you encounter dual enrollment in Benefits 24/7 by reviewing Chapter 3 of the Benefits 24/7 manual.

Dual eligibility in the SEBB Program

Employees eligible for the employer contribution toward SEBB benefits under more than one employer (dual eligibility) must choose to enroll in benefits under only one employer.

What if an eligible SEBB employee is also eligible for SEBB benefits as a dependent?

Employees who are also eligible as a dependent under their spouse’s, state-registered domestic partner’s, or parent’s SEBB coverage (dual eligibility), may choose one of the following options during an eligible enrollment period:

  1. Enroll in SEBB medical under their own account as an employee, or
  2. Waive enrollment in SEBB medical under their own account and enroll in SEBB medical as a dependent, or
  3. Waive enrollment in SEBB medical under their own account if they are enrolled in other employer-based group medical, a TRICARE plan, or Medicare.

*Employees who waive SEBB medical for either of the reasons listed above must enroll in the following SEBB benefits under their own account through their employer:

  • Dental,
  • Vision,
  • Basic life insurance,
  • Basic AD&D insurance, and
  • Employer-paid LTD insurance**.
    • Eligible employees will also be enrolled in employee-paid LTD insurance* unless they decline the coverage.
    • **Employees eligible for SEBB benefits due to locally negotiated eligibility criteria are not eligible for LTD insurance.

*Note: The above requirement does not apply to employees of SEBB participating employer groups offering medical-only benefits to their eligible employees.

Learn more about waiving SEBB medical coverage.

Dual eligibility in the SEBB and PEBB Programs

Employees eligible for the employer contribution toward SEBB benefits and Public Employees Benefits Board (PEBB) benefits (dual eligibility) must choose to enroll in medical, dental, and vision under only one employer (SEBB or PEBB) and must waive these benefits with the other employer.

*Employees who are eligible for both SEBB and PEBB benefits must enroll in the following benefits under both employers:

  • Basic life insurance,
  • Basic AD&D insurance, and
  • Employer-paid LTD insurance**.
    • Eligible employees will also be enrolled in employee-paid LTD insurance* unless they decline the coverage.
    • **Employees eligible for SEBB benefits due to locally negotiated eligibility criteria are not eligible for LTD insurance.

*Note: The above requirement does not apply to employees of SEBB participating employer groups offering medical-only benefits to their eligible employees.

What if an eligible SEBB employee is also eligible for PEBB benefits as a dependent?

Employees who are also eligible for PEBB benefits as a dependent (dual eligibility), may choose one of the following options during an eligible enrollment period.

  1. Enroll in SEBB medical, dental, and vision under their own account as an employee, or
  2. Waive enrollment in SEBB medical, dental, and vision and enroll in PEBB medical (with vision) and dental as a dependent.

*Employees who waive SEBB medical for any of the reasons listed above must enroll in the following SEBB benefits under their own account through their employer:

  • Basic life insurance,
  • Basic AD&D insurance, and
  • Employer-paid LTD insurance**.
    • Eligible employees will also be enrolled in employee-paid LTD insurance* unless they decline the coverage.
    • **Employees eligible for SEBB benefits due to locally negotiated eligibility criteria are not eligible for LTD insurance.

*Note: The above requirement does not apply to employees of SEBB participating employer groups offering medical-only benefits to their eligible employees.

Learn more about waiving SEBB medical coverage.

SEBB organizations pay the employer contribution when SEBB benefits are waived.

SEBB organizations must pay the employer contribution towards SEBB benefits as required in WAC 182-30-070(4), even if the employee chooses to waive SEBB medical, dental, and vision to enroll in PEBB medical and dental coverage. This does not apply to SEBB participating medical-only employer groups.

Waiving medical coverage

Employees may waive enrollment in SEBB medical during the following timeframes if they are enrolled in other employer-based group medical (including SEBB and PEBB), a TRICARE plan, or Medicare (WAC 182-31-080):

  • When newly eligible: No later than 31 days after the date the employee becomes eligible for SEBB benefits.
  • During annual open enrollment (OE): No later than the last day of OE.
  • During a special open enrollment (SOE): No later than 60 days after the date of the event that created the SOE.

Note: If an employee waives medical coverage for themselves, their dependents cannot be enrolled in medical.

Employees who waive enrollment in SEBB medical must enroll in the following SEBB benefits:

  • Dental*,
  • Vision*,
  • Basic life insurance,
  • Basic AD&D insurance, and
  • Employer-paid LTD insurance**.
    • Eligible employees will also be enrolled in employee-paid LTD insurance* unless they decline the coverage.
    • **Employees eligible for SEBB benefits due to locally negotiated eligibility criteria are not eligible for LTD insurance.

*In addition to waiving SEBB medical, an employee may also waive enrollment in dental and vision only if they are enrolled in PEBB medical (with vision) and dental. See the dual enrollment section on this webpage for more information.

How do employees waive medical coverage?

Employees can waive SEBB medical by making their elections in Benefits 24/7 or they can submit the appropriate School Employee Enrollment form to their BA by the required deadline.

Enrolling in SEBB medical coverage after waiving

Employees who waive SEBB medical coverage, may enroll in SEBB medical during annual open enrollment or if a qualifying special open enrollment event occurs.

Learn more about when employees may make changes.

Contact

Outreach and Training
Benefits administrators contact O&T for eligibility, enrollment, or billing related questions.
1-800-700-1555
HCA Support