11-1
|
Providing notice to a school employee
|
10/15/2020
10/1/2019 |
11-3 |
Correcting School Employees Benefits Board Organizations and contracted vendor enrollment errors |
1/1/2022
10/15/2020 |
12-1 |
Determining the first day of school for SEBB organizations |
1/1/2022
10/01/2019 |
19-1
|
Termination due to loss of eligibility
|
1/1/2023
1/1/2022
10/15/2020
10/1/2019 |
19-1A |
Addendum: Termination due to loss of eligibility of enrollment error - School employee |
1/1/2023
1/1/2022
10/15/2020
10/1/2019 |
19-1B |
Addendum: Termination due to loss of eligibility for nonpayment - Self-pay subscriber |
1/1/2023
1/1/2022
10/15/2020
10/1/2019 |
31-1 |
Verifying dependent eligibility before enrollment |
1/1/2023
1/1/2022
10/15/2020
10/1/2019 |
31-2 |
Use of premium surcharge help sheet and spousal plan calculator tools |
1/1/2023
1/1/2022
10/01/2019 |
33-1 |
Verifying legal union’s residency status |
10/15/2020
10/1/2019 |
36-1 |
Certifying eligibility for a dependent child with a disability who is age 26 or older |
1/1/2023
10/15/2020
10/1/2019 |
37-1 |
Certifying eligibility for an extended dependent child |
1/1/2023
1/1/2022
10/15/2020
10/1/2019 |
45-2 |
Special Open Enrollment (SOE) |
1/1/2024
1/1/2023
1/1/2022
10/15/2020
1/13/2020
|
45-2A |
Special open enrollment matrix: Summary of permitted election changes |
1/1/2024
1/1/2023
1/1/2022
10/15/2020
1/13/2020 |
56-1 |
Continuation coverage reinstatement for subscribers with mental or physical impairment or incapacitation |
1/1/2023
1/1/2022
10/15/2020
10/1/2019 |
56-2 |
Election period tolling for applicants with mental or physical impairment or incapacitation |
1/1/2023
1/1/2022
10/15/2020
10/1/2019 |
60-1 |
Required appeals related documents when the SEBB Program conducts a brief adjudicative proceeding |
10/1/2019 |
91-1 |
Requesting a reasonable alternative for completing wellness incentive program requirements or avoiding the tobacco use premium surcharge |
1/1/2023
10/15/2020
10/1/2019 |
91-2 |
Tobacco as it relates to religious or ceremonial use |
1/1/2023
1/1/2022
10/01/2019 |
91-3 |
Washington Wellness worksite designation program incentive requirements |
1/1/2023
1/1/2022
10/15/2020
10/1/2019 |
93-2 |
SEBB Program payment plans for continuation coverage amounts |
10/15/2020 |
94-1 |
Accessing SEBB Program salary reduction plan document |
1/1/2023
1/1/2020 |
94-2 |
Accessing SEBB Program wellness plan document |
1/1/2023
1/1/2020 |
94-3 |
Subscriber mistake - Factor test |
1/1/2023 |