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Dependents

Find information to assist employees with benefits for their dependents.

Dependent eligibility

Eligible dependents to be enrolled in SEBB benefits include:

  • Legal Spouse. Former spouses are not eligible upon finalization of a divorce or annulment, even if a court order requires the subscriber to provide health insurance for the former spouse.

  • State-registered domestic partner, as defined in RCW 26.60.020(1) and substantially equivalent legal unions from other jurisdictions as defined in RCW 26.60.090. Former state-registered domestic partners are not eligible upon dissolution or termination of a partnership, even if a court order requires the subscriber t provide health insurance for the former partner.

  • Children through the last day of the month of their 26th birthday*. Children are defined as: 

    • Children based on establishment of a parent-child relationship as described in RCW 26.26A.100, unless parental rights have been terminated.

    • Stepchildren (not legally adopted). Children of the spouse or state-registered domestic partner. The stepchild’s relationship to the subscriber (and eligibility as a dependent) ends on the same date of the divorce, annulment, dissolution, termination, or death.

    • Children for whom the subscriber has assumed legal obligation for total or partial support in anticipation of adoption of the child.

    • Children specified in a court order or divorce decree for whom the subscriber has a legal obligation to provide health coverage.

    • Children in legal custody or legal guardianship of the subscriber or the subscriber’s spouse or state-registered domestic partner (extended dependent). The legal responsibility is demonstrated by a valid court order and the child's official residence with the custodian or guardian. Certification is required by The SEBB Program. This does not include foster children unless the employee, employee’s spouse or state-registered domestic partner has assumed legal obligation for total or partial support in anticipation of adoption.

    • * Children of any age with a developmental or physical disability that renders the child incapable of self-sustaining employment and is chiefly dependent on subscriber for support and maintenance. The disability must occur prior to age 26. Certification by The SEBB Program (with input from the applicable contracted vendor) is required once the child turns 26 years of age.

Verification of dependent eligibility

The SEBB Program:

  •  Verifies the eligibility of all dependents and will request documents from subscribers that provide evidence of a dependent's eligibility.
  • Reserves the  right to review a dependent's eligibility at any time.
  • Will remove a subscribers enrolled dependents from health plan enrollment if  the program is unable to verify a dependents eligibility.
  • And SEBB organizations will not enroll dependents into SEBB benefits if they are unable to verify a dependent's eligibility within the SEBB program enrollment timelines.

Extended dependents

If an employee is adding an extended dependent, they must submit the Extended Dependent Certification form and a copy of the court order when they upload dependent verification documents. The SEBB Program will review and make a determination to approve or deny the dependent.

Disabled dependents

If the employee is adding a dependent with disabilities, age 26 or older, the employee must submit the Certification of Dependent with a Disability form when they upload dependent verification documents.

COVID-19 extensions and exceptions to obtaining physician certification during:

Add a newborn or adopted child

If an employee wants to enroll a newborn or child whom the employee has adopted or has assumed a legal obligation for total or partial support in anticipation of adoption, the employee should submit the required forms as soon as possible to ensure timely payment of claims. If adding the child increases the premium, the required forms must be received no later than sixty days after the date of the birth, adoption, or the date the legal obligation is assumed for total or partial support in anticipation of adoption.

Newborn children may be enrolled in medical, vision, and dental coverage upon birth and adopted children may be enrolled when the school employee assumes legal obligation for total or partial support in anticipation of adoption.

  • If enrolling the newborn in medical, vision and/or dental coverage, the child's coverage will begin on the date of birth. 
  • If enrolling a newborn in supplemental life or accidental death and dismemberment insurance, coverage begins on the 14th day after birth.
  • If enrolling a newly adopted child, coverage will begin on the date of placement or the date a legal obligation is assumed in anticipation of adoption, whichever is earlier.

If the school employee previously waived medical coverage, they must enroll in medical to add an eligible dependent to medical coverage.  Coverage for the employee begins the first day of the month in which the event occurs.

The school employee can enroll an eligible spouse or state registered domestic partner due to enrolling a newborn or adopted child.  Coverage will begin the first day of the month in which the event occurs.

When a newborn or adopted child's effective date is before the 16th day of the month, the school employee will pay the full month's employee premium.  Otherwise the new premium will begin the next full calendar month.

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Enroll the newborn or adopted child in health plan coverage.

If adding the child increases the school employee premium: School employee Enrollment/Change form must be received no later than 60 days after the date of the birth, adoption, or the date the legal obligation is assumed for total or partial support in anticipation of adoption.

If adding the child does not increase the school employee premium: School employee Enrollment/Change form must be received as soon as possible to ensure timely payment of claims. If adding a state-registered domestic partner's child, the school employee must also complete and submit the Declaration of Tax Status form if the child does not qualify as their tax dependent for federal tax purposes.

School employee must wait for annual open enrollment to enroll for the next year or have a qualifying special open enrollment event.

Enroll in supplemental dependent child life or accidental death and dismemberment insurance  (14 days old to age 26)

60 days of the birth, adoption, or the date legal obligation is assumed for total or partial support in anticipation of adoption.

School employee can apply for dependent child supplemental life insurance at any time, but evidence of insurability (EOI) will be required if enrolling more than 60 days after this special open enrollment event.  Supplemental AD&D insurance never requires (EOI).

Change health plan elections, provided the school employee enrolls the child.

60 days of the birth, adoption, or the date legal obligation is assumed for total or partial support in anticipation of adoption.  The new plan effective date is the first of the month in which the event occurs.

School employee must wait for annual open enrollment to change plans for the next year or have a qualifying special open enrollment event.

Add or change their Medical Flexible Spending Arrangement (FSA) or Dependent Care Assistance Program (DCAP).

60 days of the birth, adoption, or the date legal obligation is assumed for total or partial support in anticipation of adoption.  The enrollment or change is effective the first day of the month in which the event occurs.

School employee must wait for annual open enrollment to enroll for the next year or have a qualifying special open enrollment event.