FAQs for school administrators

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.

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

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.

All eligible school employees must be enrolled in SEBB benefits.

An eligible employee can waive SEBB medical coverage when newly eligible or during the SEBB Program’s annual open enrollment if they are enrolled in other employer-based group medical insurance, a TRICARE plan, or Medicare.

Eligible employees who waive enrollment in medical must enroll in SEBB dental, vision, basic life and AD&D insurance, and employer-paid long-term disability insurance for themselves. However, dual enrollment prohibition rules do allow an employee to waive SEBB medical, vision, and dental to enroll in Public Employees Benefits Board (PEBB) medical (with vision) and dental (WAC 182-31-080). 

If an employee waives SEBB medical coverage:

• They cannot enroll their eligible dependents in SEBB medical coverage.
• The premium surcharges will not apply to them.
• They will be able to access SmartHealth, the online health and wellness portal but they will not be able to earn the incentives. Their spouse or state-registered domestic partner will not have SmartHealth access.
• They can reenroll later during the annual open enrollment or if they have a qualifying special open enrollment event.

Reminder that eligible employees do not pay a premium for dental or vision coverage.

As the ERB Outreach & Training team administers benefits and provides Open Enrollment training for more than 700 organizations across the SEBB and PEBB programs, we regret that we cannot support requests for each individual organization's Open Enrollment events due to resource constraints. However, we will continue to provide annual HCA-sponsored Open Enrollment events and training for the SEBB benefits administrator community.

If you would like to invite benefits carrier representatives to your event, we have compiled a list of vendor contacts for your convenience. To ensure fairness and impartiality, we request that you invite all SEBB/PEBB retiree vendors who offer benefits in your area when extending invitations to vendors.

No. HCA maintains the authority to offer cafeteria plans (as identified in IRS Section 125). This means SEBB organizations cannot offer health savings accounts (HSAs), a flexible spending arrangement (FSA), or a dependent care assistance program (DCAP).

A SEBB organization also cannot make additional employer contributions to an HSA for employees who enroll in an IRS qualified high-deductible health plan. The employer contribution is limited to the annual amount authorized by the SEBB Program and deposited into the HSA account by HCA on behalf of the SEBB organization.

HCA is aware of RCW 28A.400.370 (mandatory insurance protection for employees) and that some districts provide other work-related liability insurance coverage, such as commercial driver’s insurance for bus drivers. Historically, liability insurance administered by HCA has included at least personal auto and home insurance.

School districts can continue to offer liability insurance (including personal auto and home insurance) until at least September 1, 2020. Over the course of the next year, there could be changes to this guidance as a result of legislative action, SEB Board action, or agency rule-making processes. We will make all efforts to inform you as soon as possible of any changes ahead of the 2020–2021 school year.

No. SEBB organizations will pay the same funding rate regardless of which plan and which tier level employees select. The exception is employees who work between 180 and 630 hours and are offered SEBB benefits through locally negotiated agreements. For this group of employees only, the funding rate is different for each tier.  See “What if I work fewer than 630 hours in a school year?”

It depends. When an employee is approved for Family and Medical Leave Act (FMLA) or Paid Family Medical Leave (PFML) that is concurrent with FMLA, they remain eligible for the employer contribution and continue their benefits. Concurrent means that leave taken under approved PFML must follow and overlap with leave taken under approved FMLA.

PFML by itself (that is not concurrent with FMLA), does not allow an employee to continue benefits. However, if the employee has already worked or remains anticipated to work at least 630 hours in the school year, the employee remains eligible for the employer contribution and continues their benefits regardless of whether PFML is or is not concurrent with FMLA.

Additional guidance can be found in the C-1 and C-2 worksheets on the Eligibility tools and worksheets page.