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.
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.
The SEBB Program provides eligibility worksheets for employers to determine and provide required notification of an employee's eligibility (or ineligibility) for the employer contribution toward SEBB benefits.
Learn about the notification requirements and access the worksheets on the Eligibility tools and worksheets webpage.
The Health Care Authority (HCA) administers the continuation coverage for COBRA and unpaid leave starting January 1, 2020. At that time, once a SEBB organization notifies the SEBB Program through SEBB My Account that a school employee has lost eligibility for SEBB benefits, HCA will mail a SEBB Continuation Coverage Election Notice booklet to the subscriber and/or any enrolled dependent who lost SEBB coverage. The subscriber and/or dependents will work directly with HCA to enroll in and pay for benefits under SEBB Continuation Coverage. They cannot enroll in continuation coverage through SEBB My Account. A paper enrollment form will be included in the SEBB Continuation Coverage Election Notice. See SEBB Continuation Coverage for more information.
Contact Outreach and Training through HCA Support to request SEBB benefits administrator training.
For the state, representatives from the Office of Financial Management (OFM) directly negotiate with a coalition of school employee unions, with staff support from the Health Care Authority (HCA).
The makeup and structure of the coalition is determined by unions that represent school employees after careful research and consideration. The coalition bargaining team currently includes representatives of: American Federation of Teachers Washington; Association of Washington Principals; Operating Engineers; Public School Employees of Washington; Service Employees International Union; Teamsters; and Washington Education Association. The spokesperson for the coalition is Shawn Lewis, with WEA.
Employees are required to provide evidence of a dependent’s eligibility within the SEBB Program’s timelines. Benefits administrators verify dependents’ eligibility for coverage.
The SEB Board has the authority to offer these kinds of insurance products and can consider offering them in the future. However, the portfolio of medical benefits offered by the SEBB Program is comprehensive and includes coverage for conditions such as cancer, critical illness, and emergency transportation. Members can select from an array of plan choices to meet different levels of coverage needs. If school districts offered these types of plans in addition to the SEBB medical plans, it would affect the state’s negotiation position when setting rates and would reduce the ability to secure the best rates possible on behalf of members.
School districts currently offer many types of accident policies, and it is not possible to determine by name alone whether the policies conflict with the SEBB Program’s authority. It appears that accident insurance policies likely conflict with the SEBB Program’s authority, but more information is needed about the exact coverage to make a final determination.
Examples of accident insurance brought to HCA’s attention have primarily included income replacement, which would conflict with the SEBB Program’s disability insurance benefit authority, or accident coverage that would conflict with the SEBB Program's accidental death and dismemberment benefit authority. Review of accident insurance plan policies is necessary to ensure they don't conflict with the SEBB Program’s authority. This review began on December 1, 2019, and each year thereafter, when SEBB organizations that elect to offer optional benefits submit their reports to HCA describing any optional benefits they are offering to school employees.
Disallowing competing benefits is in the interest of ensuring HCA has the strongest negotiation position when setting rates with SEBB Program vendors and insurers. These limitations are in place to maintain the purchasing power that comes from consolidating all eligible school employees into one statewide risk pool through the SEBB Program. If an employer helps school employees access a competing, non-SEBB Program insurance product, it would affect the risk profile of the SEBB Program population, which could affect the premiums or benefit structure of SEBB Program benefits.
Other reasons a SEBB organization cannot offer benefits authorized (but not offered) as part of the SEBB Program include:
The formula for insuring SEBB organization employees and their dependents includes an estimated rate of employee waivers. If anticipated waivers weren’t factored in, that uncertainty would need to be funded by raising the amount employers pay per employee for benefits. The state pools funds to pay for everyone enrolled in the program. Also, keep in mind that employees who waive medical will still receive other benefits.