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.

How do we decide if an employee is anticipated to work 630 hours?: District administrators will decide this, based on the SEBB Program qualifications.

How will districts know how bargaining is going?: Collective bargaining law requires that the state negotiate in good faith with the union coalition. There are limits on what details can be shared away from the bargaining table. For the 2018 negotiations, OFM created a bargaining resource team to share news of the negotiations with school administrators.

I have specific questions about continuation coverage (COBRA or unpaid leave). How do I get answers?: Benefits administrators from school districts, charter schools, and ESDs can sign up for our secure messaging application, HCA Support. Your questions about continuation coverage and other topics will go directly to our Outreach and Training staff.

If an employee brings in physical dependent verification documents to their benefits administrator to verify, does the benefits administrator verify them, or should the documents be uploaded to SEBB My Account for verification?: The local benefits administrator must verify or deny it and enter that decision in SEBB My Account. The benefits administrator doesn't need to upload the document or keep it.

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.