SEBB rules and policies

The SEBB Program follows the rules in Washington Administrative Code (WAC). Our administrative policies describe how we implement a law or rule affecting participation in SEBB Program benefits.

Stay up-to-date with SEBB Program rule making

SEBB Program law

You can find the SEBB Program's existing law in chapter 41.05 of the Revised Code of Washington (RCW).

SEBB Program rules

The SEBB Program follows the rules in Washington Administrative Code (WAC) chapters:

Below are links to the detailed rules for circumstances most common to school employees.

SEBB Program policies

The SEBB Program's administrative policies describe how we implement a law or rule affecting participation in SEBB Program benefits. The statements made in these documents reflect our interpretations of the eligibility and enrollment rules.

Employee eligibility and enrollment

Number Title Effective Date
11-1

Providing a notice to a school employee

1/1/2023

11-3 Correcting School Employees Benefits Board Organization and contracted vendor enrollment errors

1/1/2025

1/1/2023

12-1 Determining the first day of school for SEBB organizations

1/1/2023

19-1

Termination due to loss of eligibility or enrollment error

1/1/2025

1/1/2024

19-1A Addendum - Termination due to loss of eligibility or enrollment error: School employee

1/1/2025

1/1/2024

19-1B Addendum - Termination due to loss of eligibility or nonpayment: Self-pay subscriber

1/1/2025

1/1/2024

Dependent eligibility and enrollment

Number Title Effective Date
31-1 Verifying dependent eligibility before enrollment

1/1/2024

31-2 Use of SEBB Spousal Plan Calculator

1/1/2025

1/1/2024

33-1 Verifying legal union's residency status 1/1/2023
36-1 Certifying eligibility for a dependent child with a disability who is age 26 or older

1/1/2025

1/1/2024

37-1 Certifying eligibility for an extended dependent child

1/1/2025

1/1/2024

Special open enrollment

Number

Title Effective Date

45-2

Special open enrollment (SOE)

9/1/2024

45-2A Addendum: special open enrollment (SOE) matrix: summary of permitted election changes

9/1/2024

Reinstatement, tolling and continuation coverage

Number

Title Effective Date

56-1

Continuation coverage reinstatement for subscribers with mental or physical impairment or incapacitation

1/1/2025

1/1/2024

56-2 Election period tolling for applicants with mental or physical impairment or incapacitation

1/1/2025

1/1/2024

Appeals

Number

Title Effective Date
60-1 Required appeals related documents when the SEBB Program conducts a brief adjudicative proceeding

1/1/2023

Administrative - permanent

Number Title Effective Date
90-1 Allowable mid-year termination for an employer group 1/1/2025
90-2 What authority do employer groups need before contracting with HCA for participation in SEBB for insurance coverage? 1/1/2025
90-3 Determining if an employer group requesting eligibility criteria different from SEBB Program rules shall be approved 1/1/2025
90-4 Terms and conditions set by HCA for an employer group and school employees of an employer group 1/1/2025
91-1 Requesting a reasonable alternative for completing wellness incentive program requirements or avoiding the tobacco use premium surcharge

1/1/2024

91-2 Tobacco as it relates to religious or ceremonial use

1/1/2024

91-3 Washington Wellness worksite designation program incentive requirements

1/1/2025

1/1/2024

93-2

SEBB Program payment plans for continuation coverage accounts

1/1/2025

1/1/2023

94-1 Accessing SEBB Program salary reduction plan document

1/1/2024

94-2 Accessing SEBB Program wellness plan document

1/1/2024

94-3 Subscriber mistake - Factor test

1/1/2025

1/1/2024

Proposed policies

There are currently no proposed policies.

Rescinded policies

The polices listed below are rescinded.

Number

Title

Policy effective date

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

 SEBB Program salary reduction plan

SEBB wellness plan