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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).

Employees will have uninterrupted coverage when moving from one SEBB organization to another within the same month or a consecutive month, if the following conditions are satisfied:

  • The employee was eligible for the employer contribution toward SEBB benefits in the position they are leaving; and
  • The employee is anticipated to be eligible for the employer contribution toward SEBB benefits in their new position.

If they move to a new county, employees may need to change their medical plan. This creates a special open enrollment event.

Yes, you and your dependents can enroll in Apple Health and in the SEBB Program. See the Washington Apple Health and SEBB Program fact sheet.

School employees are encouraged to enroll online with SEBB My Account, using a computer, tablet, or smartphone. However, for those who cannot enroll online, paper enrollment forms are available from the benefits administrator.

Yes. Dependents must be enrolled in the same health plans as the subscriber. This applies whether the subscriber is enrolled in medical or waives it.

No. SEBB coverage is limited to a single enrollment per individual. If an employee and their spouse or state-registered domestic partner both enroll in the SEBB Program, they must decide which account to use to cover their children.

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.

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).

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.

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

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