FAQs for school administrators

The following frequently asked questions (FAQs) help you understand the SEBB Program and how it affects your school district, educational service district, or charter school.

Questions about corona virus and eligibility during school closures? See Information about novel coronavirus (COVID-19).

Are dependents enrolled in a plan at the same time as employees?

Dependents are enrolled in plans only after the dependent eligibility document is approved. During open enrollment, dependents will be enrolled at the same time as the employee and will be verified before the employee’s coverage begins the following January.

For new hires and during special open enrollments, there may be a difference between when the employee is enrolled and the dependent is enrolled, based on when verification is approved and the reason for the dependent’s enrollment.

Are employees able to update their own addresses in SEBB My Account?

No. Employees must notify their payroll or benefits office of address changes. They can update their email and phone number on SEBB My Account. Benefit administrators update addresses through SEBB My Account.

Are employees who aren’t considered full-time (like coaches and substitute teachers) eligible for benefits under the SEBB Program?

Yes, as long as they are employees of a school district or charter school, or are union-represented employees of an educational service district and they work or are anticipated to work 630 hours during the school year. A school year means September 1 through August 31.

Are enrollment materials available in languages other than English?

SEBB My Account, the online enrollment system, is only available in English for now. However, non-English speakers can enroll in SEBB using paper forms. Print publications and enrollment forms are available in additional languages upon request. Additional supported languages include: Amharic, Burmese, Cambodian, Chinese, Korean, Laotian, Oromo, Punjabi, Romanian, Russian, Somali, Spanish, Swahili, Tagalog, Tigrigna, Ukrainian, and Vietnamese. To request materials in supported languages, see HCA’s Language Access webpage.

Are premium surcharges deducted pretax?

Yes. Monthly medical premiums, along with applicable premium surcharges, are deducted from paychecks pretax, unless the employee arranges with their payroll or benefits office to have their premiums and applicable premium surcharges deducted posttax.

Are school board members be covered in the SEBB Program?

No, only school employees anticipated to work 630 hours or more during the school year are eligible.

Are SEBB organizations required to pay the same employer contribution regardless of the employee’s FTE, as long as they meet the 630-hour criteria?

Yes, that is correct.

Are SEBB organizations responsible for preparing Forms 1094 and 1095?

Yes. SEBB organizations are responsible for preparing Internal Revenue Service (IRS) Form 1095, providing copies of Form 1095 to certain current employees (e.g., those determined “full-time” for at least one month of the reporting year and/or those enrolled in self-insured coverage for at least one month of the report year), and certain former employees (e.g., retirees and COBRA enrollees enrolled in self-insured coverage for at least one month of the report year), and filing Form 1094 and copies of Form 1095 with the IRS. HCA provides SEBB organizations with prior-year medical enrollment data to support their preparation of Forms 1095 in early January each year. HCA provides data files that include all employee enrollment data, as well as former employee enrollment data for those former employees enrolled in self-insured coverage.  All Uniform Medical Plan coverage is “self-insured” coverage.

Note:  IRS Notice 2019-63 (Dec. 2, 2019) provided relief from certain aspects of the 2019 information-reporting requirements under Internal Revenue Code sections 6055 and 6056.

Can a school district allow payroll deductions for nonconflicting optional benefits (long-term care, travel, pet, etc.)?

Yes, school districts may offer payroll deductions for optional benefits as long as the benefits do not conflict with the SEBB Program’s authority. The limitation on payroll deductions applies to benefits that conflict with the SEBB Program’s authority (such as, but not limited to, whole life insurance, short-term disability, limited FSAs, medical indemnity plans, and cancer or other insurance types that overlap with health benefits).

Can an employee cover a retired spouse or state-registered domestic partner who is enrolled in Medicare Part A and Part B?

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.