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.

If an employee goes on approved leave without pay, does the employer pay the employer contribution toward SEBB benefits?: Employers will continue to pay the full employer contribution for employees who go on approved leave without pay if they have already worked 630 hours during the school year or if they are on approved FMLA.

If the school employee has not worked 630 hours and the employer no longer anticipates the school employee will work 630 hours during the school year, the school employee is no longer eligible for the employer contribution toward SEBB benefits.

When the school employee returns to work after their unpaid leave, the employer will determine whether the employee is eligible for the employer contribution toward SEBB benefits. Employees who return from approved leave without pay will establish eligibility for the employer contribution if their work schedule, had it been in effect at the start of the school year, would have resulted in the employee being anticipated to work the minimum hours to meet SEBB eligibility in the school year.

If an employee has worked 630 hours and enrolls in SEBB, and then their work schedule changes so they will work less, do they lose coverage?: No. They retain coverage until the end of the school year. Their premiums will not change, unless they have a special open enrollment event and change their coverage.

If an employee meets the eligibility requirement of working 630 hours within the school year on May 1, do we offer them coverage through August 31 (the end of the school year)?: Yes. The employee’s SEBB benefits would begin June 1 and run through August 31.

If an employee waives coverage, does the district still pay the full employer contribution?: Yes. Employees can only waive medical coverage. They cannot waive dental, vision, or other benefits. The funding rate calculation assumes a certain percentage of employees will waive medical coverage, which reduces the average amount of employer funding needed per employee.

If an employee waives medical coverage, does the district continue to pay the funding rate to the HCA?: Yes. The district pays the full funding rate for every eligible employee (when they become eligible) for the school year.

Employees can waive medical coverage but generally cannot waive other benefits for which they are eligible (dental, vision, basic life and AD&D insurance, and basic long-term disability insurance). However, dual enrollment rules do allow employees to waive SEBB medical, vision, and dental to enroll in Public Employees Benefits Board (PEBB) medical (with vision) and dental.

If an employee wants to waive medical coverage, do they use SEBB My Account or a paper form?: Employees who want to waive medical coverage can use either SEBB My Account or paper forms. If they waive medical coverage within the SEBB Program timelines, they will not be automatically enrolled into a medical plan. If they do not waive medical coverage or do not enroll in a plan within the SEBB Program’s timelines, they will default into UMP Achieve 1, and will be charged the tobacco use premium surcharge.

If an employee's spouse has a retiree policy that covers the employee, can they waive medical?: No. They can only waive SEBB medical coverage if they are enrolled in other employer-based group medical insurance, a TRICARE plan, or Medicare. Retirement policies are not employer-based, so they do not qualify.

If an employee's spouse is eligible for Medicare Part A and Part B but does not enroll in it, and the employee enrolls the spouse on their SEBB account, do they pay a spouse or state-registered domestic partner coverage premium surcharge?: No. Medicare is not employer-based group medical coverage, so the premium surcharge does not apply.

If employees don’t attest that they don’t use tobacco, will they be charged the tobacco use premium surcharge?: Yes. To avoid the tobacco use premium surcharge, employees must attest that they and their dependents do not use tobacco. For more on this, visit the Tobacco use surcharge webpage.

If employees terminate employment, does their coverage end at the end of the month?: Yes. For example, if an employee resigns in the middle of the month, the district covers them through the end of that month.