When employees may make changes
Find information for benefits administrators (BAs) about how and when employees may change their School Employees Benefits Board (SEBB) coverage. Most changes can be made during annual open enrollment or during a special open enrollment.
Annual open enrollment
During annual open enrollment each year (October 30-November 20 for 2023), employees can make changes to their SEBB benefits that will take effect January 1 of the following year.
Making changes during annual open enrollment
During open enrollment employees can:
- Change medical, dental, and vision plans.
- Add or remove eligible dependents.
- Dependent verification is required when adding dependents to coverage. Visit the Dependents page for more information.
- Waive medical coverage if already enrolled or enrolling in other employer-based group medical insurance, a TRICARE plan, or Medicare effective January 1.
- Employees may waive SEBB medical to enroll in Public Employees Benefits Board (PEBB) medical, only if they are also enrolled in PEBB dental. An employee who waives SEBB medical coverage to enroll in PEBB medical, also waives enrollment in SEBB dental and vision.
- Employees may not waive to enroll in coverage through the Health Benefit Exchange.
- Enroll in a medical plan, if medical was previously waived.
- Attest or reattest to the spouse or state-registered domestic partner (SRDP) coverage premium surcharge.
- Enroll or reenroll in an FSA or the DCAP (Medical Flexible Spending Arrangement or Limited Purpose FSA and/or the Dependent Care Assistance Program)
- Employees must reenroll during annual open enrollment each year to continue participating for the following year. Enrollment does not automatically continue from plan year to plan year.
- Enroll in or opt out of the state's premium payment plan
How do employees make changes during annual open enrollment?
Most changes can be made using Benefits 24/7 while other changes may require a form. All changes must be submitted no later than the last day of annual open enrollment (OE)
Changes that can be made in Benefits 24/7
- Change medical, vision, and/or dental plans.
- Waive medical coverage.
- Enroll in a medical plan, if previously waived.
- Add or remove eligible dependents.
- Reattest to the spouse/SRDP premium surcharge, if applicable.
Employees can submit the next year’s School Employee Change form and any required documentation to their benefits administrator (BA) instead of using Benefits 24/7. If they only need to attest to the spousal surcharge, they can submit the next year’s Premium Surcharge Attestation Change form. The next year’s enrollment forms are available on the first day of OE each year.
Once the required forms and documentation (if applicable) have been received within the required timeframes, BAs enter the changes in Benefits 24/7 on behalf of their employees.
Changes that cannot be made in Benefits 24/7
- Enroll or reenroll in an FSA or the DCAP
- Employees may use Navia's online portal or Navia’s SEBB Open Enrollment form no later than the last day of annual OE
- Online enrollment and the Open Enrollment form are only available during OE.
- BAs should follow the instructions provided on the FSA and DCAP webpage when a form is received.
- Employees may use Navia's online portal or Navia’s SEBB Open Enrollment form no later than the last day of annual OE
- Enroll in or opt out of the state's premium payment plan
- Employees must submit the SEBB Premium Payment Plan Election Change form to their BA no later than the last day of OE.
- Opting out of the state’s premium payment plan means that an employee’s premiums for SEBB medical coverage and any applicable premium surcharges will be deducted from their paycheck after federal and/or state taxes have been collected.
- Note: Employees who opt out of the state’s premium payment plan cannot enroll or remain enrolled in an FSA, DCAP, or health savings account (HSA).
Special open enrollment
Certain life events, called special open enrollment (SOE) events, allow employees to make changes outside of annual open enrollment.
Refer to the special open enrollment matrix whenever an employee is requesting to make changes outside of annual open enrollment. The matrix provides a summary of permitted election changes, which includes:
- A list of qualifying SOE events.
- Valid documents required to verify proof of the event.
- What changes are or are not allowed, according to the event.
- Required timeframes for making a change.
- When changes are effective.
Learn more about special open enrollment events for school employees.
How do employees make changes due to a special open enrollment?
Changes must be allowable, correspond to, and be consistent with the event that creates the SOE and employees must provide proof of the event (e.g., marriage or birth certificate).
Employees submit their changes, proof of the qualifying event, and dependent verification (if adding a dependent) in Benefits 24/7 or they can submit the appropriate form(s) and documents to their BA.
Generally, employees must complete this process no later than 60 days after the date of the event. Changes are effective on the first day of the month following the later of the receipt of the form or request in Benefits 24/7. However, the birth of a newborn or adoption are events which may allow other enrollment deadlines and timeframes. Learn more about adding a newborn or adopted child to coverage.
BAs verify special open enrollment events in Benefits 24/7. If a form is received, BAs must enter the employee's SOE in Benefits 24/7 before completing the verification process. To learn about entering and verifying an SOE, review Chapter 3 of the Benefits 24/7 manual.
Changes that can be made at any time
- Change employee’s or dependent’s name and/or address.
- Employees cannot update names or addresses in Benefits 24/7. They must submit their change of name or address to their BA to be updated in Benefits 24/7. This ensures that employee and dependent information remains up to date in both the SEBB organization’s payroll system and Benefits 24/7.
- To update an employee’s address in Benefits 24/7, review Chapter 3 of the Benefits 24/7 manual.
- Change of an employee’s email address or phone number.
- Employees can update their email and phone number in Benefits 24/7.
- Remove a dependent from coverage when they lose eligibility to be enrolled in SEBB benefits.
- Employees are required to remove dependents from coverage when they lose eligibility. They must make this change in Benefits 24/7 or submit the appropriate forms and documentation/proof of the event to their BA within 60 days of the last day of the month the dependent loses eligibility.
- Apply for, cancel, change coverage amounts, and update beneficiary information for supplemental life and accidental death and dismemberment (AD&D) insurance:
- Employees can make these changes using MetLife’s MyBenefits portal or by sending the MetLife Enrollment/Change form to MetLife.
- For requests to enroll in or increase supplemental life insurance after the 31-day eligibility period or outside of a special open enrollment period, MetLife must approve the request and evidence of insurability may be required.
- Reduce coverage level, decline coverage, or enroll in employee-paid long-term disability (LTD) insurance.
- Employees can make these changes using Benefits 24/7 or by using the LTD Enrollment/Change form.
- Employees requesting to enroll in or increase employee-paid LTD coverage outside of their 31-day eligibility window cannot do so using Benefits 24/7. They must complete and submit the Evidence of Insurability form to The Standard using the instructions provided on the form. See the LTD administration manual for more information.
- Start, stop, or change the employee contribution to a health savings account (HSA) by using the Employee Authorization for Payroll Deduction to Health Savings Account form.
- They can also change HSA beneficiary information using the Beneficiary Designation form.
- Make changes to the tobacco use premium surcharge attestation online using Benefits 24/7 or by using the Premium Surcharge Attestation Change form.
- Related rules and policies
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- WAC 182-30-090: When may a subscriber change health plans?
- WAC 182-30-100: When may an employee enroll or revoke an election and make a new election under the premium payment plan (FSA or DCAP)?
- WAC 182-31-080: Waiving enrollment and reenrolling in SEBB medical
- WAC 182-31-150: When may subscribers enroll or remove eligible dependents?
- SEBB Policy 45-2A: Special open enrollment matrix