Am I eligible?

Who is eligible?

Generally, you are eligible for SEBB benefits if you:

• Work for a Washington State school district, charter school, or educational service district (ESD), and
• Your employer anticipates you will work at least 630 hours per school year (September 1 through August 31).

Paid holidays and paid leave, such as sick, personal, and bereavement leave, count toward the required hours. Voluntary Employee Beneficiary Association (VEBA) cashout/buyout does not apply to the required hours.

Apple Health (Medicaid) and CHIP

If you're eligible, you can enroll in both SEBB benefits and Apple Health. But SEBB benefits-eligible employees cannot waive SEBB enrollment in favor of Apple Health.

Eligible dependent children can be enrolled in both SEBB benefits and Apple Health for Kids.

If your child loses or becomes eligible for Apple Health for Kids after SEBB's annual open enrollment has ended, that creates a 60-day special open enrollment event, in which you could change the child's SEBB coverage.

Get more details about Apple Health for adults and children.

What if I'm eligible as a school employee and a dependent?

You cannot enroll in health plan coverage under two SEBB accounts. If you are eligible as an employee and as a dependent under your spouse's, state-registered domestic partner's or parent's account, visit Waive my coverage for options available to you.

Real-world example

You and your state-registered domestic partner (SRDP) are independently eligible for SEBB insurance coverage. Since you cannot have medical, dental, and vision coverage under two accounts, you decide to waive SEBB medical for yourself and enroll as a dependent on your SRDP's SEBB medical coverage.

I'm eligible for both SEBB and PEBB. What do I do?

You and your dependents can enroll in health plans through only one program. If you enroll in both SEBB and PEBB benefits and do not take action to resolve the dual enrollment, the SEBB Program or PEBB Program will automatically enroll or disenroll you. Refer to related laws and rules at the bottom of this page.

Real-world example

You are eligible for SEBB benefits and your SRDP is eligible for PEBB benefits. Since you cannot have coverage under both programs, you decide to waive SEBB medical, dental, and vision coverage for yourself and enroll as a dependent on your SRDP's PEBB medical, dental, and vision coverage. 

How is eligibility determined?

For eligibility based on:

Your first day of work

For newly hired employees who the employer anticipates will work at least 630 hours during the school year, your eligibility begins on your first day of work. Your first day of work typically determines when your SEBB benefits begin.

A revision to your anticipated work or actual hours worked

If you are not eligible for SEBB benefits at the beginning of the school year, but your work circumstance changes and your employer anticipates you will work 630 hours during the school year, you become eligible on the date your work pattern is revised.

If you are not anticipated to work 630 hours at the beginning of the school year, but you do actually work 630 hours, you become eligible on the date you work your 630th hour. 

If you are eligible for SEBB benefits at the beginning of the year, but your work schedule is revised so that you are no longer anticipated to work 630 hours during the school year, your eligibility for the employer contribution toward SEBB benefits ends the last day of the month in which the change in your work schedule is effective.

Returning from approved leave

If you return to work from approved leave without pay, you can maintain or establish eligibility for the employer contribution toward SEBB benefits if the schedule you return to, had it been in effect at the start of the school year, would have resulted in you being anticipated to work the minimum hours to be eligible for SEBB benefits. You would regain eligibility for the employer contribution toward SEBB benefits on the day you return from approved leave without pay.

Date of hire late in the school year

If you are not anticipated to work 630 hours within the school year because of the time of year you are hired, but are anticipated to work at least 630 hours the next school year, you may establish eligibility for the employer contribution toward SEBB benefits as of their first working day if one of the following situations apply:

• You are hired as a 9- to 10-month school employee and your employer anticipates you will work at least 17.5 compensated hours a week in six of the last eight weeks counting backwards from the week that contains August 31st, the last day of the school year.
• You are hired as a 12-month school employee and your employer anticipates you will work at least 17.5 compensated hours a week in six of the last eight weeks counting backwards from the week that contains August 31st, the last day of the school year.

Hours worked the previous two school years

If you worked at least 630 hours in each of the previous two school years and are returning to the same type of position or combination of positions with the same school district, charter school, or educational service district, you are presumed eligible for the employer contribution toward SEBB benefits at the start of the school year.

If your employer does not consider you eligible after having worked at least 630 hours the previous two school years, they must notify you in writing of the specific reasons you are not anticipated to work at least 630 hours in the current school year. 

Work within one district, charter school, or ESD

All of the hours you work in your capacity as a school employee, and all hours you receive compensation from your employer during an approved leave (sick leave, personal leave, bereavement leave), are included in the hours to determine your eligibility. You cannot "stack" hours from different school districts, charter schools, or ESDs to reach eligibility.

Returning to the next school year with uninterrupted coverage

If you were enrolled in SEBB benefits in August, you will receive uninterrupted coverage from one school year to the next when you return at the start of the next school year to the same school district, charter school, or as a ESD, as long as you are still anticipated to be eligible for the employer contribution in the coming school year. 

Changing jobs between SEBB organizations

Once enrolled in benefits, you will have uninterrupted coverage when moving from one SEBB organization to another within the same or following month, as long as you are eligible in the previous position and anticipated to be eligible for the employer contribution toward SEBB benefits in your new position.

Employees eligible for locally negotiated benefits

If you are not eligible as described above, you may be eligible for some SEBB benefits if your school district, charter school, or ESD negotiated your eligibility. If you are represented, check with your union or collective bargaining agreement about eligibility.

School employees of an employer group

If you are a school employee who works for a tribal school or employee organization representing school employees, contact your payroll or benefits office for eligibility criteria.

Are my dependents eligible?

You may enroll your legal spouse, your state-registered domestic partner or your children. If you pass away, your dependents may be eligible to continue coverage as a survivor. 

Learn more about dependent eligibility and survivors.

Related laws and rules

• Chapter 182-30: Procedures.
• Chapter 182-31: Eligible school employees.
• WAC 182-31-040: How do school employees establish eligibility for the employer contribution toward school employees benefits board (SEBB) benefits and when do SEBB benefits begin?
• WAC 182-30-130: What are the requirements for a school employees benefits board (SEBB) organization engaging in local negotiations regarding SEBB benefits eligibility criteria?
• WAC 182-31-070: Is dual enrollment in school employees benefits board (SEBB) and public employees benefits board (PEBB) prohibited?
• WAC 182-30-080: When must a newly eligible school employee, or a school employee who regains eligibility for the employer contribution, elect school employees benefits board (SEBB) benefits and complete required forms?