SEBB Continuation Coverage (COBRA)

The Health Care Authority (HCA) is responsible for verifying that all enrollees are notified of their continuation coverage rights within the required time frame. To satisfy this requirement, the HCA has assumed the responsibility for distributing continuation coverage materials, including the:

• Initial Notice of COBRA and Continuation Coverage rights
• SEBB Continuation Coverage Election Notice

Who is eligible?

Each member (employee or dependent) who loses their SEBB health plan coverage due to a qualifying event has an independent right to elect to continue medical coverage, vision coverage, dental coverage, or a combination of all three by enrolling in SEBB Continuation Coverage (COBRA) on a self-pay basis.

For example, if an employee loses their SEBB employer-based group health plan due to a qualifying event, their eligible spouse or state-registered domestic partner (SRDP) may choose continuation coverage, even if the employee does not. Either the employee or their spouse or SRDP may choose continuation coverage for any dependent children.

Qualifying events (accordion)

A qualifying event is a life event that causes loss of coverage.

Examples of qualifying events for an employee are:

• Employment ending for any reason other than gross misconduct.
• Hours of employment are reduced below the number of hours required to be eligible for the employer contribution toward SEBB benefits.

Examples of qualifying events for a spouse or state-registered domestic partner (SRDP) are:

• The spouse (the employee) dies. The surviving spouse/SRDP may qualify for SEBB COBRA or PEBB retiree insurance coverage.
• The employee's hours of employment are reduced below the number of hours required to be eligible for the employer contribution toward SEBB benefits.
• The employee's employment ends for any reason other than gross misconduct.
• The employee and spouse experience a divorce, annulment, or dissolution of marriage.
• The state-registered domestic partnership (with the employee) ends.

Examples of qualifying events for dependent children are:

• The parent (employee) dies.
• The employee's hours of employment are reduced below the number of hours required to be eligible for the employer contribution toward SEBB benefits.
• The employee's employment ends for any reason other than gross misconduct.
• Eligibility for SEBB benefits as a dependent child ends.

How do eligible SEBB members enroll?

To enroll in COBRA, the member (employee or dependent) must complete and return the SEBB Continuation Coverage (COBRA) Election/Change form along with the first premium payment to the SEBB Program.

The SEBB Program must receive the:

• Required form and supporting documentation (if applicable) no later than 60 days after SEBB benefits end or from the postmark date on the SEBB Continuation Coverage Election Notice, whichever is later.
• First premium payment, including applicable premium surcharges, are due to the HCA/SEBB Program no later than 45 days after the 60-day election period ends. Explore plan costs on the SEBB Continuation Coverage website.

Enrollment will not be processed until the completed form and first premium payment have been received (within the required time frames).

When does coverage begin?

If elected, benefits begin the first day of the month following the date SEBB benefits as an eligible employee or dependent ended.

For example, if SEBB benefits as an eligible employee or dependent end on August 31, coverage under COBRA will begin September 1.

How long does coverage last?

The maximum coverage period for COBRA can last anywhere from 12 to 36 months and is determined by the qualifying event that caused the employee or dependent to lose eligibility for the employer contribution toward SEBB benefits. In some situations, coverage under COBRA can end before the maximum coverage period.

A detailed explanation of the maximum coverage periods for each qualifying event is available on the SEBB Continuation Coverage website.

Continuing life insurance under portability or conversion

SEBB Continuation Coverage (COBRA) subscribers who are eligible and wish to continue life insurance under portability or conversion, must complete and submit the form sent to them by MetLife after their SEBB benefits were terminated. MetLife must receive the form no later than 60 days after SEBB employee life insurance ends.

Learn more about portability and conversion options for continuing life insurance.

Continuing participation in a Flexible Spending Arrangement

Employees who enroll in SEBB Continuation Coverage (COBRA) may continue their participation in a Flexible Spending Arrangement (FSA).

If an employee is eligible to continue an FSA, Navia Benefit Solutions will mail a COBRA election notice to the employee. Navia must receive the employee's election no later than 60 days from the date SEBB benefits ended, or the postmark date on Navia’s COBRA election notice, whichever is later.

Learn more about continuing participation in a Flexible Spending Arrangement on the SEBB Continuation Coverage website and in the FSA enrollment guides on Navia's website.

Related rules and policies

• WAC 182-31-090: When is an enrollee eligible to continue school employees benefits board (SEBB) benefits under Consolidated Omnibus Budget Reconciliation Act (COBRA)?
• WAC 182-31-100: What options for continuation coverage are available to school employees and their dependents during certain types of leave or when employment ends due to a layoff?
• WAC 182-31-120: What options for continuation coverage are available to school employees during their appeal of a grievance?
• WAC 182-31-130: What options for continuation coverage are available to dependents who cease to meet the eligibility criteria as described in WAC 182-31-140 or 182-30-130?