Upcoming changes to dual enrollment rules and LTD

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Two important changes take effect for eligible employees beginning January 1, 2022.

  1. To comply with state law, employees and their dependents can no longer enroll in health plans under both the SEBB Program and the Public Employees Benefits Board (PEBB) Program. They may waive enrollment in SEBB medical to enroll in PEBB medical, but only if they are also enrolled in PEBB dental.
  2. All eligible employees will be automatically enrolled in an employee-paid LTD plan that covers 60 percent of their monthly predisability income (up to $16,667), with a 90-day benefit waiting period. Employees can reduce to a lower-cost 50-percent coverage level with a maximum monthly benefit of $8,333, depending on income, reduced by any deductible income, or they can decline the coverage. If an employee later decides to enroll in or increase coverage, they will have to provide evidence of insurability and be approved by the insurer.

What you need to know about dual enrollment

  • During annual open enrollment (October 25 through November 22), dual enrolled employees must choose either the SEBB Program or PEBB Program for medical, dental, and/or vision benefits for themselves and their covered dependents.
  • Employees who are enrolled in both the SEBB and PEBB Programs will receive a letter explaining what they need to do during open enrollment to update their account. The first letter will mail October 22 and a follow up reminder letter will mail November 8.
  • If the employee does not make changes to resolve the dual enrollment by November 22, the SEBB Program will enroll or disenroll them and/or their dependents per WAC 182-31-070. See the dual enrollment default matrix for details.
  • Employees may waive enrollment in SEBB medical to enroll in PEBB medical only if they are also enrolled in PEBB dental. In doing so, they also waive enrollment in SEBB dental and vision. They cannot enroll their dependents in SEBB dental and vision if they are not enrolled.
  • If the school employee’s dependent is disenrolled from PEBB dental (as an employee) to stay on the school employee’s SEBB medical, they will also be enrolled in the school employee’s SEBB dental and vision if not already enrolled.
  • Enrollment in SEBB Program life insurance, accidental death and dismemberment insurance, and long-term disability insurance is not affected by the dual enrollment rule changes.
  • The employer contribution is due to HCA each month for an employee who chooses to waive SEBB medical, dental, and vision to enroll in PEBB medical and dental.
  • The process will change for entering eligibility for some employees. We will provide more guidance on this before open enrollment begins.

What you need to know about employee-paid LTD

  • During open enrollment, employees can reduce or decline their employee-paid LTD in advance of the January 1 start date using SEBB My Account.
  • At any time after open enrollment, employees can reduce to a 50-percent coverage level or decline the employee-paid benefit by using the Long Term Disability Insurance Enrollment and Change
  • Employees who don’t reduce or decline employee-paid LTD coverage by December 31, 2021 will be enrolled at the 60-percent coverage level. Please let employees know if you have an earlier payroll deadline than December 31, 2021 for January 2022 coverage.
  • Employees already enrolled in employee-paid (formerly supplemental) LTD, will continue to be covered with 60 percent of their monthly predisability earnings.
  • Employees do not need evidence of insurability to be automatically enrolled in 60-percent coverage or to reduce to the 50-percent coverage level during open enrollment. But if they reduce or decline coverage and later decide to enroll in or increase coverage, they will have to provide evidence of insurability.
  • SEBB My Account will offer the employee three options for employee-paid LTD: 60-percent benefit, 50-percent benefit, or opt out (decline coverage). The employee will be automatically enrolled at the 60-percent coverage level unless they choose another option. We will provide more guidance on this before open enrollment begins.

Resources

To learn more, we encourage you to register today for your Pre-OE webinar.

Additional LTD resources will be sent to you in a follow-up message next week.

Questions?

Contact us through FUZE secure email or at 1-800-700-1555.