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Dear Benefits Administrators,
This is our third and final message to provide some extra guidance about enrollment topics we typically receive questions about at the start of the new school year. Today’s message is regarding when a school employee transfers from one SEBB organization to another.
Transferring school employees
When a school employee moves from one SEBB organization to another, benefits may continue without interruption if the employee:
- Is eligible for the employer contribution toward SEBB benefits in the position they are leaving, and
- Is anticipated to be eligible for the employer contribution toward SEBB benefits in the new position, and
- Moves to their new SEBB organization within the same month or a consecutive month.
Claiming an employee in Benefits 24/7
When adding an employee in Benefits 24/7, you may be asked to "claim" an employee record. This means the system has found an existing account for the employee from a previous employer. However, claiming the record does not necessarily mean the employee will be treated as a transfer by Benefits 24/7.
Benefits 24/7 generally treats an employee as a transfer when the employee moves between SEBB organizations within the same month or consecutive months. Employees treated as transfers typically will not see an enrollment wizard in their Benefits 24/7 dashboard.
If Benefits 24/7 identifies a break in employment of one full calendar month or longer, the employee will not be treated as a transfer and will need to complete the newly eligible enrollment wizard.
Benefit elections
Employees identified in Benefits 24/7 as a “transfer” will get uninterrupted coverage and do not make new benefit elections when transferring between SEBB organizations.
The exception is when the employee’s current medical plan is no longer available, such as moving to a county where that health plan is not offered. In those situations, the employee may select a new available health plan. In this circumstance, the employee will need to submit an SOE change request.
Transfer employees may make benefit changes during the annual open enrollment period for changes effective January 1.
Returning the following school year – not a transfer
Benefits continue uninterrupted from one school year to the next when the employee:
- Is enrolled in SEBB benefits at the end of the current school year,
- Is anticipated to work at least 630 hours during the next school year, and
- Continues employment with the same SEBB organization.
Returning eligible employees will not see an enrollment wizard in Benefits 24/7 at the start of the new school year, but they may make changes during annual open enrollment.
Employees moving between SEBB and PEBB employers – not a transfer
Although both programs are administered by HCA, PEBB and SEBB are separate benefit programs.
Employees that move from a PEBB employer to a SEBB employer (or vice versa) are not considered transfers for benefits purposes. They will be “newly eligible” employees and asked to complete the newly eligible wizard in Benefits 24/7.
The previous employer should terminate the employee’s coverage and should not term the employee as a transfer. SEBB and PEBB eligibility rules are different, so the new employer must determine eligibility under the rules for the applicable program.
Important reminder
If a school employee has already established eligibility and is entitled to maintain employer-paid benefits through August 31, do not terminate coverage early simply because the employee has accepted a position with another SEBB organization beginning in September.
For example, if an eligible employee notifies you in June that they will begin working for another school district in September, they can remain eligible for employer-paid coverage through the end of the current school year. Terminating the employee's benefits effective the end of June will cause a break in coverage and the employee will not be recognized in Benefits 24/7 as a “transfer” when claimed by their new employer.
Common transfer scenarios
Please review this list of common transfer scenarios for additional guidance associated with this topic.
If you're unsure
If you are uncertain whether an employee will be eligible for employer-paid coverage with their new SEBB organization, process the employee’s termination using the appropriate termination reason and effective date. The receiving SEBB organization will determine eligibility and claim the employee’s account, if applicable.
Want to learn more?
For additional information about eligibility and other SEBB benefits topics, register for our August 7 Benefits Webinar. During the webinar, we’ll review key eligibility rules, recent updates, and answer common questions to help you confidently administer SEBB benefits.
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