Most final plans and premiums announced
Medical plans, premiums, and plan service areas for Kaiser Permanente Northwest, Kaiser Permanente Washington, Kaiser Permanente WA Options, and Uniform Medical Plan were approved by the SEB Board on July 25. The Board will vote on premiums for Premera on August 1.
The final plans, premiums, and plan service areas will be provided to employees in the School Employee Initial Enrollment Guide, which will be mailed in mid-September, and available on the School employees benefits webpages beginning September 3.
Plan availability
Not all SEBB Program plans are available in all counties, but each county has at least three plans to choose from. School employees will be offered a selection of plans based on their county of residence. Some school employees, including those who live outside Washington State, may have additional plan options if they work in a district that crosses county lines or is in a county that borders Idaho or Oregon.
Approximately 90 percent of employees have six or more plan choices of the 14 total plans offered; 75 percent have nine or more; and 70 percent have 11 or more. When employees use SEBB My Account to enroll, the system will show them only the plans they can enroll in.
Default plans approved
Employees who are eligible for SEBB benefits and do not either enroll in or waive medical coverage during the first annual open enrollment will be enrolled in the following default benefits:
- Medical: UMP Achieve 1
- Dental: Uniform Dental Plan
- Vision: MetLife vision
- Basic life and accidental death and dismemberment (AD&D)
- Basic long-term disability (LTD)
Defaulted employees will be charged the $25 tobacco use premium surcharge in addition to their $33 monthly medical premium. They cannot enroll dependents, change plans, or buy supplemental life, AD&D, or LTD insurance until the next annual open enrollment, unless they have a special open enrollment event.
Eligibility timeline
As we get closer to the SEBB Program first annual open enrollment, October 1 through November 15, each SEBB organization (school district, charter school, and participating ESD) will need to complete some tasks to make sure employees can enroll successfully.
Between now and August 15, you can email mock data to our technical support team so we can test the file and report back any errors. August 16 through August 30, you can send live data test files extracted from your system, through FUZE, our secure email system. Our technical support team will respond with any errors.
Throughout August, you should make eligibility determinations for all your employees. Once you determine which employees are eligible for SEBB benefits, you’ll be ready to upload employee eligibility files between September 3 and September 10. Upload of eligibility data to SEBB My Account after September 10 may result in a delay to employees’ ability to enroll online in supplemental life/AD&D, and Medical FSA/DCAP on October 1, therefore, uploading eligibility data as soon as possible is highly encouraged. See our SEBB Program implementation timeline and SEBB Program implementation guide for details.
Tips for determining eligibility
When determining employee eligibility, here are some pointers:
- Employees anticipated to work 630 hours during the school year are eligible. It doesn’t matter whether they’re full or part-time, classified or certificated. Even though SEBB Program benefits are effective January 1, 2020, eligibility is based on the school year, September 1 through August 31.
- Hours from multiple positions within only one SEBB organization (school district, charter school, or participating ESD) count toward establishing eligibility.
- If an employee is anticipated to work 630 hours in more than one district, the employee can choose which district to participate in. Only that district pays the employer contribution.
- Paid holidays do not count toward the required hours except for circumstances when employees are hired late in the school year. View the eligibility basics infographic and fact sheet.
- You’ll need to check back two years to determine eligibility for some employees. If they worked 630 hours or more each year for the past two years, are working in the same type of position this fall, and are not anticipated to work 630 hours this school year, they are still eligible.
Read more about determining eligibility.
No authorization needed for optional benefits
In our July 3 SEBB Update, we provided a fact sheet about optional benefits. We continue to receive questions about what benefits SEBB organizations are authorized to offer outside of the SEBB Program. SEBB organizations do not need to receive authorization from the Health Care Authority (HCA) to offer optional benefits outside of the SEBB Program. The fact sheet explains the limitations regarding offering optional benefits and provides criteria to help your SEBB organization determine whether or not the benefit you wish to offer is allowable. We are developing a procedure for how to report optional benefits to the Health Care Authority, as mandated by the Legislature, and will let you know when that’s ready.
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