Forms & publications

Use this form to enroll in or change your enrollment options for SEBB Continuation Coverage (COBRA) coverage.

Use this form to enroll in or change your enrollment options for SEBB Continuation Coverage (Unpaid Leave) coverage.

This is the booklet you will receive when your School Employees Benefits Board (SEBB) health coverage ends. This booklet explains how you and your dependents can continue your SEBB health coverage. To continue SEBB health coverage, you must complete the enclosed forms and follow the instructions.

Use this form to request an appeal.

This document show the 2024 monthly premiums for SEBB Continuation Coverage.

This nondiscrimination statement describes how the SEBB Program and its contracted health plans comply with applicable federal civil rights laws.

This is the 2024 SEBB Spousal plan calculator form. Use this form if you answered 'YES' to all the questions on your enrollment form and are wanting to enroll a spouse or state-registered domestic partner.

This is the 2024 Spousal plan calculator form. Use this form if you answered 'YES' to all the questions on your enrollment form and are enrolling a spouse or state-registered domestic partner.

This is the 2024 Spousal plan calculator form. Use this form if you answered 'YES' to all the questions on your enrollment form and are enrolling a spouse or state-registered domestic partner.

This is the 2024 SEBB Spousal plan calculator form. Use this form if you answered 'YES' to all the questions on your enrollment form and are wanting to enroll a spouse or state-registered domestic partner.