If you are displaced or affected by wildfire, all Washington Apple Health and PEBB/SEBB medical plans are allowing prescription refills before the refill date.
Due to COVID-19, HCA’s lobby is closed. Learn more about your customer service options.

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 corona virus (COVID-19).

New employees use SEBB My Account to enroll in their medical, dental, and vision plans, as well as basic life, basic accidental death and dismemberment (AD&D), and basic and supplemental long-term disability insurance.

Employees go to different websites to enroll in supplemental life and supplemental accidental death and dismemberment insurance, and for Medical Flexible Spending Arrangement (FSA), and Dependent Care Assistance Program (DCAP). They can access those websites from within SEBB My Account.

A paper form will be available for employee contribution elections in health savings accounts (HSA) and provided to the district benefits administrator.

The employer contribution toward SEBB benefits ends the last day of the month in which the school year ends (August 31). The employer contribution toward SEBB benefits will end earlier than the end of the school year if one of the following occurs:

  • The district, charter school, or educational service district (ESD) terminates the employment relationship. Eligibility for the employer contribution ends the last day of the month in which the employer-initiated termination notice is effective.
  • The school employee terminates the employment relationship. Eligibility for the employer contribution ends the last day of the month in which the school employee’s resignation is effective.
  • The school employee’s work pattern is revised such that the employee is no longer anticipated to work 630 hours during the school year. Eligibility for the employer contribution ends as of the last day of the month in which the change is effective.

In even-numbered years, between July 1 and October 1. Bargaining took place in 2018, effective for the 2020 and 2021 calendar years. In 2020, negotiations will take place for 2022 and 2023.

It depends on when they are hired.

  • In September each year, new school employees who are anticipated to work 630 hours during the school year and whose first day of work is from September 1 through the first day of school,  start coverage on their first day of work.
  • In general, for school employees anticipated to work 630 hours during the school year whose first day of work is at any other time during the school year, the effective date of coverage is the first day of the month following the day they begin work.
  • School employees hired late in the school year but anticipated to work 630 hours or more the following year enter into two categories.
    • Employees hired on a nine- to 10-month basis will be eligible for SEBB benefits on their first day of work if they are anticipated to work at least 17.5 compensated hours a week in six of the last eight full or partial weeks before summer break. Their benefits would begin the first of the month after they begin work.
    • Employees hired on a 12-month basis will be eligible for SEBB benefits on their first day of work if they are anticipated to work at least 17.5 compensated hours a week in six of the last eight full or partial weeks before the end of the school year (August 31). Their benefits would begin the first of the month after they begin work.

For every SEBB benefits-eligible employee, the employer will pay the funding rate, which includes the following:

  • Employer share of medical premium contribution
  • 100 percent dental premium
  • 100 percent vision premium
  • 100 percent basic life premium
  • 100 percent accidental death and dismemberment premium
  • 100 percent basic long-term disability premium
  • K-12 remittance (for retirees)
  • Administration

If new employees who are eligible for SEBB benefits do not either enroll in or waive SEBB Program medical coverage within SEBB timelines, they will be automatically enrolled in the benefits below. They will also be charged a $25-per-month tobacco use premium surcharge. This surcharge can be stopped if the employee attests that they do not use tobacco. Attestation can be done either in SEBB My Account or on a paper enrollment form.

  • Medical: UMP Achieve 1 ($33 monthly premium)
  • Dental: Uniform Dental Plan (no premium)
  • Vision: MetLife vision (no premium)
  • Basic life: MetLife (no premium)
  • Basic accidental death and dismemberment (AD&D): MetLife (no premium)
  • Basic long-term disability (LTD): The Standard (no premium)

When the Legislature created the SEBB Program in 2017, a SEBB organization’s authority to offer any benefits to their employees was removed in its  entirety beginning January 1, 2020. This meant that SEBB organizations had no authority to offer any benefits to their employees once the SEBB Program launched. However, during the 2018 session, the Legislature revised the law to allow school districts (but not educational service districts or charter schools) to offer benefits that do not conflict with the SEB Board’s authority to offer benefits.

The insurance plan year for the SEBB Program is a calendar year, January 1 through December 31. Plans run from the beginning to the end of the insurance year.

The school year, as defined in RCW 28A.150.203(11), is September 1 through August 31. Employee benefits eligibility and coverage period are based on the school year.

Dual enrollment is when a school employee is eligible to enroll in the SEBB Program and is also eligible as the spouse, state-registered domestic partner, or dependent of another eligible school employee. Dual enrollment is not allowed for medical, dental, or vision coverage. The single-enrollment policy helps maintain the affordability of the SEBB Program’s health plans.

SEBB organizations cannot endorse or make available any benefits that compete with those authorized as part of the SEBB Program. This includes but is not limited to, inviting a vendor to attend a benefits fair to endorse products that compete with any form of a benefit under the SEBB Program’s authority—even if the vendor’s product would be fully paid by the employee. It also includes providing vendors with employee contact information for marketing purposes or facilitating payroll deductions.

 

Pages