Individuals enrolled in Apple Health (Medicaid), Public Employees Benefits Board, and School Employees Benefits Board coverage - and those accessing behavioral health services - will not experience a disruption in care due to the federal government shutdown. In addition, health care providers will continue to be paid for the services they provide. We will continue to monitor the situation closely and share updates if anything changes.
See the updates on Benefits 24/7 stabilization efforts.
The School Employees Benefits Board (SEBB) Program provides Flexible Spending Arrangement (FSA) and Dependent Care Assistance Program (DCAP) benefits for SEBB organizations.
Navia Benefits Solutions processes claims and provides customer service for these benefits.
SEBB participating employer group employees
Employees of SEBB participating employer groups are not eligible for SEBB FSA and DCAP benefits (WAC 182-31-060).
Ready to submit payroll files and signed forms?
The SEBB Program's Flexible Spending Arrangement (FSA), Limited Purpose FSA, and Dependent Care Assistance Program (DCAP) allow eligible employees to set aside money from their paychecks on a pretax basis to pay for qualified expenses each plan year (January 1-December 31). Eligible employees who waive their SEBB medical coverage can still enroll in an FSA, Limited Purpose FSA and/or DCAP.
For a summary of these benefits, including the CBA FSA contribution, IRS maximum contributions, carryover amounts, and deadlines to submit claims and incur expenses, click on each item below.
The FSA allows employees to set aside pretax money to spend on eligible out-of-pocket medical expenses, including annual deductibles, copays, coinsurance, dental expenses and vision expenses.
Employees may use FSA funds for themselves and their qualified dependents, even if their dependents are not enrolled in a SEBB medical, dental, or vision plan.
Can an employee have an FSA, or Limited Purpose FSA with an HSA in the same plan year?
Employees cannot have both an FSA and a high deductible plan with a health savings account (HSA) or both an FSA and a Limited Purpose FSA in the same plan year. Employees can have a Limited Purpose FSA and an HSA in the same plan year.
The employee decides how much to contribute to their FSA. They may set aside a minimum annual contribution of $120 up to a maximum annual contribution of $3,200 for the 2025 plan year and $3,400 for the 2026 plan year (subject to annual IRS updates).
The amount deducted from an employee's pay is the total annual election amount divided by the number of paychecks the employee will receive during the plan year.
The full amount elected is available on the first day of the month the employee's benefits become effective.
The annual maximum contribution limit is set by the IRS. An increase to the maximum contribution limit for the following year is usually announced in late fall. If the IRS announces an increase in the maximum contribution prior to the last day of open enrollment, HCA will adopt the new maximum contribution limit for the 2026 plan year. If the IRS announces changes after HCA's annual open enrollment ends, HCA will adopt the increased maximum contribution limit for the 2027 plan year.
If all the funds in an FSA have not been spent by December 31, and the employee is still eligible to participate, they may be able to take advantage of the carryover feature.
Carryover means certain unspent funds may "carry over" into the following year without affecting annual maximums.
To receive carryover, employees must enroll in an FSA for the following plan year or have at least $120 left in their current year's balance.
Find read-world carryover examples on the FSA Enrollment Guide (2025, 2026) for school employees.
All eligible FSA expenses must be incurred by the end of the plan year, December 31.
Employees must submit all claims to Navia Benefit Solutions for reimbursement by March 31 of the following plan year.
To learn more, see the FSA Enrollment Guide (2025, 2026) and the FSA webpage for school employees.
During Collective Bargaining in 2025, an agreement was reached for an employer-paid FSA contribution. The collective bargaining agreement (CBA) states that employees whose rate of pay for the state fiscal year is $40,000 or less on June 30, are eligible to receive a $200 FSA contribution in January 2026. Although this contribution was negotiated as part of collective bargaining, employees do not need to be part of a bargaining unit to receive it.
Annual earnable compensation, as defined in Chapter 41.32 (TRS) or 41.35 (SERS) RCW, on June 30 of the previous year is $40,000 or less for a full-time equivalent position. Employees who work part-time may be eligible for this contribution if their position provides a salary of $40,000 or less as full-time. For example, if they earn $20,000 and work 20 hours per week, their full-time salary would be $40,000 and they would still qualify.
The employee or employee’s spouse or state registered domestic partner cannot be enrolled in a high-deductible health plan (HDHP) with a health savings account (HSA) and the employee must meet other eligibility criteria as described in the Health Care Coalition Agreement, including SEBB Program eligibility requirements and eligible medical plan enrollment.
Eligible employees receive this employer-paid benefit even if they do not enroll in an FSA. The contribution does not come out of the employee's paycheck.
Navia will:
HDHP plan with an HSA and/or the Limited Purpose FSA
Employees enrolling in an HDHP plan with an HSA and/or the Limited Purpose FSA for the following plan year will not receive the CBA FSA Contribution.
To learn more about the CBA FSA contribution, see the following resources:
This content is prepared for benefit administrators and union representatives to share with employees about the FSA contribution. A goal for implementing this toolkit is to align the way multiple partners (Washington State Health Care Authority’s SEBB Program, unions, and SEBB organizations) share about the FSA benefit and ensure common language. Please tailor the materials so they align with your branding or style standards and feel free to use your logo. [Suggestions are included in italics on the toolkit materials.]
The Limited Purpose FSA allows employees to set aside pretax money to spend on eligible out-of-pocket dental and vision expenses.
The Limited Purpose FSA is intended for employees who are enrolled in a high-deductible plan with a health savings account (HSA). Enrolling in a Limited Purpose FSA with a high deductible plan allows employees to save more of their HSA funds for medical expenses. However, employees can enroll in a Limited Purpose FSA even if they are not enrolled in a HDHP with an HSA.
Employees may use Limited Purpose FSA funds for themselves and their qualified dependents, even if their dependents are not enrolled in a SEBB medical, dental, or vision plan.
About employee participation
Employees may not participate in a Limited Purpose FSA and an FSA in the same plan year. Employees can participate in a Limited Purpose FSA and a HDHP with a HSA in the same plan year. It is the employee's responsibility to know which benefit to enroll in.
The employee decides how much to contribute to their Limited Purpose FSA. They may set aside a minimum annual contribution of $120 up to a maximum annual contribution of $3,200 for the 2025 plan year and $3,400 for the 2026 plan year (subject to the annual IRS update). The amount deducted from an employee's pay is the total annual election amount divided by the number of paychecks the employee will receive during the plan year.
The full amount elected is available on the first day of the month the employee's benefits become effective.
The maximum contribution limit is set by the IRS. An increase to the maximum contribution limit for the following year is usually announced in late fall. If the IRS announces an increase in the maximum contribution prior to the last day of open enrollment, HCA will adopt the new maximum contribution limit for the 2026 plan year. If the IRS announces changes after HCA's annual open enrollment ends, HCA will adopt the increased maximum contribution limit for the 2027 plan year.
If all the funds in a Limited Purpose FSA have not been spent by December 31, and the employee is still eligible to participate, they may be able to take advantage of the carryover feature.
Carryover means certain unspent funds may "carry over" into the following year without affecting annual maximums.
To receive carryover, employees must enroll in a Limited Purpose FSA for the following plan year or have at least $120 left in their current year's balance.
Find real-world carryover examples in the Limited Purpose FSA Enrollment Guide (2025, 2026).
All eligible Limited Purpose FSA expenses must be incurred by the end of the plan year, December 31.
Employees must submit all claims to Navia Benefit Solutions for reimbursement by March 31 of the following plan year.
To learn more, see the Limited Purpose FSA Enrollment Guide (2025, 2026) and the FSA webpage for school employees.
Dependent Care Assistance Program (DCAP) is an employer-sponsored benefit that allows employees to set aside money from their paycheck on a pre-tax basis to help pay for qualified child care or elder care expenses while the employee or their spouse attends school full-time, works, or looks for work. The employee is responsible for providing documentation to the IRS for tax purposes, if requested. Eligible expenses include elder day care, baby sitting, child day care, preschool and registration fees.
Participating in the DCAP and an FSA/Limited Purpose FSA
Employees may participate in a DCAP account and an FSA or a Limited Purpose FSA in the same plan year.
The employee decides how much to contribute to their DCAP account. They may set aside a minimum annual contribution of $120 up to a maximum annual contribution of:
DCAP funds are only available once they have been deposited each month. Employees may be reimbursed up to the dollar amount they have in their DCAP account at the time reimbursement is requested.
All eligible DCAP expenses must be incurred by the end of the plan year, December 31 (DCAP has no carryover feature).
Employees must submit all claims for their DCAP account to Navia Benefit Solutions for reimbursement by March 31 of the following year. Any funds remaining in the DCAP account after March 31 cannot be refunded and will be forfeited.
To learn more, see the DCAP Enrollment Guide (2025, 2026) and visit the DCAP webpage for school employees.
Employees of SEBB organizations who meet the eligibility criteria outlined in WAC 182-31-040 are eligible to participate in the FSA, Limited Purpose FSA, and DCAP (WAC 182-31-060).
Eligible employees may enroll in an FSA/Limited Purpose FSA or DCAP or make changes by submitting completed forms to their payroll or benefits office during the following timeframes (WAC 182-30-100). Employees do not enroll in an FSA/Limited Purpose FSA or DCAP benefits in Benefit 24/7. Employees cannot end participation or change their election amount once the plan year starts unless they end employment, lose eligibility, or experience an event that creates a special open enrollment (SOE)
Newly eligible employees must submit the SEBB Midyear Enrollment form (2025, 2026) no later than 31-days after becoming eligible for SEBB benefits.
These employees should complete the Midyear Enrollment form to participate for the remaining months in the year and/or the Navia Open Enrollment form to begin participation January 1 of the following year.
To enroll an FSA and/or DCAP for the following plan year, employees may use Navia's online portal or complete and submit the Navia Open Enrollment form no later than the last day of annual open enrollment (OE). Employees can follow these instructions to enroll online.
Employees must reenroll during annual open enrollment each year to continue participating for the following year. Enrollment does not automatically continue from plan year to plan year.
Outreach & Training will notify BAs in mid-December if they have any employees who elected both a high deductible plan with an HSA and an FSA during annual open enrollment. Employees will have the following options:
Employees have a one-time offer to choose one of the options above before December 29 and cannot make changes after the decision is received by HCA.
If the employee does not make a choice by December 29, they will be notified by letter that they will remain enrolled in the high deductible plan with an HSA and will be disenrolled from the FSA. However, if they qualify for carryover of funds from the previous year, the funds will be transferred to a Limited Purpose FSA.
Employees who are not enrolled in a high deductible plan with an HSA that elect both an FSA and a Limited Purpose FSA during annual OE will be enrolled in the FSA, but will not be enrolled in the Limited Purpose FSA.
Employees requesting to enroll or make a change due to a qualifying event that creates a special open enrollment (SOE) must complete and submit the SEBB Change in Status form (2025, 2026) and proof of the event no later than 60 days after the date of the event (SEBB SOE matrix - Policy 45-2A, 2025, 2026).
If there is no SOE present, requests by an employee pertaining to eligibility and/or enrollment changes in a Flexible Spending Arrangement, Limited Purpose FSA, or Dependent Care Assistance Program must go through the employing agency for an initial decision. Requests that require a decision include if the employee can cancel their FSA/Limited Purpose FSA and/or DCAP, decrease or increase their election amount, or make any other eligibility or enrollment changes to the FSA/Limited Purpose FSA or DCAP.
Requests that are not during OE or during an SOE event should be denied by the employing agency, with guidance provided to the employee that they can appeal via the steps in WAC 182-32-2050.
The rules regarding when an employee can enroll or revoke an election and make a new election under the premium payment plan, FSA, Limited Purpose FSA or DCAP are located in WAC 182-30-100.
If you have any questions about the appeals process, please contact HCA Appeals Unit at 1-800-351-6827. If you have further questions regarding your employee’s request, you may contact the SEBB Program by sending a secure message to Outreach & Training through HCA Support or call 1-800-700-1555.
Employees who enroll in an FSA/Limited Purpose FSA or DCAP and later transfer to another SEBB organization, may continue their enrollment in an FSA/Limited Purpose FSA or DCAP if:
To learn more, see the FSA/Limited Purpose FSA and DCAP enrollment guides available on Navia's Forms and Documents webpage.
An employee is no longer eligible to participate in a DCAP account when they lose eligibility for the employer contribution toward SEBB benefits. There are no continuation options available for DCAP. The employee may be eligible to continue participating in an FSA/Limited Purpose FSA: see the following section for information.
Navia debit cards will be deactivated by the last day of the month in which an employee loses eligibility. However, the employee may still submit claims for reimbursement after that date.
Employees enrolled in an FSA or Limited Purpose FSA who end employment or retire during the plan year must complete and submit the SEBB FSA/Limited Purpose FSA Termination form to their payroll or benefits office within 30 days of coverage ending.
The form requires that the employee choose one of the following options:
Stop participation: Employee declines to continue participation but retains access to their full election amount.
Continue participation: Employee may continue participation through accelerated contributions or COBRA.
Employees who terminate employment and have unspent DCAP funds, may continue to submit claims for eligible expenses as long as the expenses allow them or their spouse/state registered domestic partner to attend school full-time, look for work, or work full-time.
Expenses may be incurred through December 31 of the year the employee terminates employment. Claims may be submitted to Navia, up to the available account balance, through March 31 of the following plan year.
When BAs receive forms, they should verify that the forms have been received within the required timeframes and completed in full, including any necessary documentation, such as proof of the qualifying SOE event. An incomplete form may result in missed deductions or the employee may experience problems with accessing their FSA/Limited Purpose FSA and/or DCAP benefits.
Forms received after the enrollment window has passed
If a form is received after the enrollment window has ended, Notify the employee that they will not be enrolled and of their right to appeal through the regular appeals process. To assist in drafting a denial notice, use this sample notification letter.
For forms received timely and completed in full:
When to upload forms
During annual open enrollment, upload forms to the Navia Employer Portal on a weekly basis. Forms received after open enrollment could result in denied enrollments.
Benefits administrators use the Navia Employer Portal to securely upload monthly payroll deduction files and member forms to enroll, change status, or terminate enrollment in an FSA/Limited Purpose FSA and/or the DCAP. All payroll files and signed forms must be submitted through the portal, which allows for faster processing times and provides a confirmation email once a file has been successfully uploaded.
Employers must inform Navia’s dedicated BA help team immediately if there is a change in benefit administrator contact information. Navia will then notify HCA of the changes needed. Benefit administrators must be given approved access by Navia and HCA before logging into the SEBB portal.
For instructions on how to register for the portal and upload files:
Can SEBB organizations have more than one BA with access to the portal?
Yes.
How can BAs transfer access to a new user?
Contact Navia to have a user added or removed.
Do BAs need to use the same setup (username, password, and work email address) they have in SAW when accessing the portal?
Yes.
Can BAs add the Navia Employer Portal as a service in SAW?
Yes.
Can multiple forms be submitted at the same time when using the portal?
Yes, multiple forms can be submitted at once, up to the maximum file size allowed.
Do all of the file descriptions listed in the portal, such as “NDT Document”, apply to SEBB?
No, SEBB BAs will only upload files associated with these descriptions: “Enrollment”, “Change in Status”, or “Termination” form, or “FSA”, “HRA”, “HSA”, or “Commuter Data” file/spreadsheet.
If a BA changes districts, can they add Benefits 24/7 and Navia to their current SAW account?
BAs who change districts will need to create a new SAW account using their new work email address.
Can BAs see basic employee enrollment information in the portal?
No, the portal does not offer this functionality at this time. Navia is exploring this as an option for BAs to use in the future.
For the FSAs and DCAP, the amount deducted from an employee’s pay is the total annual election amount divided by the number of paychecks the employee will receive during the plan year (January 1-December 31). Work with Navia directly if you have employee’s that do not receive 12 paychecks per year and need to adjust the per-paycheck amount.
If an employee enrolls midyear, the amount deducted is the total annual election amount divided by the number of paychecks they will receive for the remainder of the plan year.
If an employee transfers from one SEBB organization to another, and transfers their FSA/Limited Purpose FSA/DCAP benefit, the per-paycheck deductions can increase to meet the annual contribution amount by the end of the plan year. A transfer is not a qualifying event to change FSA/Limited Purpose FSA or DCAP elections.
Ending participation or changing an election amount
Employees cannot end participation or change their election amount unless a qualifying event creates a special open enrollment.
Payroll deduction amounts must be reported to Navia each pay period using a file feed. Use the SEBB Navia consolidated file specifications to report these deductions to Navia. This file is only used to report payroll deductions; Enrollments, change in status, and terminations should be reported using the appropriate form.
Each SEBB organization will be responsible for providing a payroll file through the Navia Employer Portal. The file must:
It's important that the naming convention of the payroll files are accurate. The naming convention of the payroll files must denote the WA State SEBB three-character company code (SWB), the district-specific six-character Agency Code, and the pay date (in a specific MMDDYYY format). For example, if the district-specific Agency Code is 600A01 and the pay date is 6/30/2023, the file name should be SWB.600A01.06302023.
For instructions on how to register for the portal and upload files, visit the Training materials and recordings webpage.
The employer administrative fee for the FSA, Limited Purpose FSA, and DCAP is included in the total funding rate paid to the SEBB Program by the SEBB organization for each eligible employee.
The administration of FSA/Limited Purpose FSA and DCAP benefits is a team effort between the SEBB organization, Navia Benefit Solutions, and the Health Care Authority.
Navia Benefit Services for benefits administrators only
Phone: 425-452-3488
Email: Navia Benefits Solutions - SEBB
Navia Benefit Solutions forms submission
Email: Navia Employer Portal
Navia Benefit Solutions Customer Service for participants
Online: Navia Benefit Solutions
Phone: 425-452-3500
Toll free: 1-800-669-3539