When eligibility for benefits ends

Find information regarding employees and their covered dependents when the employment relationship is terminated.

When eligibility ends for the employer contribution

The employer contribution toward School Employees Benefits Board (SEBB) benefits ends the last day of the month in which the school year ends (WAC 182-31-050). However, the employer contribution will end earlier than the end of the school year under the following circumstances:

If the...	...then eligibility for the employer contribution will end on...
SEBB organization terminates the employment relationship.	The last day of the month in which the employer-initiated termination notice is effective.
School employee terminates the employment relationship.	The last day of the month in which the school employee's resignation is effective.
School employee's work pattern is revised such that the school employee is no longer anticipated to work six-hundred thirty hours during the school year.	The last day of the month in which the change is effective.
School employee returns from approved leave without pay and maintained or established eligibility as described in WAC 182-31-040 (4)(d), who subsequently has a change in work pattern that, had the work pattern been in effect at the start of the school year, would not have resulted in the school employee being anticipated to work the minimum hours to meet SEBB eligibility for the employer contribution in the school year.	The last day of the month in which the change is effective.
Nine-to-ten-month school employee, hired late in the year and eligible for the employer contribution as described in WAC 182-31-040 (4)(c)(i), who subsequently has a change in work pattern such that the school employee is no longer eligible under the criteria described in WAC 182-31-040 (4)(c)(i).	The last day of the month in which the change is effective.
Twelve-month school employee, hired late in the year and eligible for the employer contribution as described in WAC 182-31-040 (4)(c)(ii), who subsequently has a change in work pattern such that the school employee is no longer eligible under the criteria described in WAC 182-31-040 (4)(c)(ii).	The last day of the month in which the change is effective.
School employee hired later in the year and eligible for the employer contribution as described in WAC 182-31-040 (4)(c), who is no longer anticipated to work six hundred thirty hours the next school year.	The last day of the month in which the change in the anticipation occurs.

If the SEBB organization deducted the employee's portion of the premium for SEBB benefits from their pay after the employee was no longer eligible for the employer contribution, SEBB benefits end the last day of the month for which the employee premiums were deducted.

COBRA

An employee or their dependent who loses eligibility for the employer contribution towards SEBB benefits and who qualifies for continuation coverage under the federal Consolidated Omnibus Budget Reconciliation Act (COBRA) may continue coverage for all or any combination of medical, dental, or vision by self-paying the premium and applicable premium surcharges set by the health care authority (HCA) (WAC 182-31-090).

PEBB retiree insurance

Retiring employees may choose to elect PEBB retiree coverage, if eligible (WAC 182-12-171).

SEBB organization requirements

The SEBB organization must...	...no later than...	...or this will happen
Complete the C-3 worksheet.	30 days after the date employment ends or as soon as the employee's termination effective date is known.	Eligibility errors may occur, and the employee will not receive the required notice and information provided in the worksheet.
Terminate the employee's SEBB insurance coverage in Benefits 24/7. See SEBB Policy Addendum 19-1A (Termination due to loss of eligibility or enrollment error: School employee) for more information.	Immediately after the date employment ends or as soon as the employee's termination effective date is known.	The Continuation Coverage Election Notice will be delayed, resulting in increased employer cost for coverage, insurance coverage enrollment delays, and possible payment hardships.

HCA will send the employee the Continuation Coverage Election Notice in the mail after the employee coverage has been terminated in Benefits 24/7. This can take up to 14 days after the insurance coverage has been terminated.

Information for employees

Employees who have...	...may...	...no later than
A spouse or state-registered domestic partner (SRDP) also covered by SEBB benefits	Enroll under the spouse or SRDP medical, dental and or vision coverage as a dependent.	60 days after the date the employee's coverage ended.
SEBB life insurance	Apply for portability or conversion of coverage through MetLife.	60 days after the date the employee's life insurance ends.
A spouse or SRDP also covered by SEBB benefits	Transfer their supplemental life insurance to their spouses or SRDP's SEBB coverage, up to the eligible limits, without evidence of insurability. The spouse or SRDP must contact MetLife to initiate the process.	60 days after the date the employee's life insurance ends.
A Medical Flexible Spending Arrangement (FSA) through Navia Benefit Solutions	Apply for Continuation Coverage through Navia Benefit Solutions to extend their period of coverage, so they may claim expenses incurred after employment ends.	60 days after the date the employee's coverage ends.
A spouse or SRDP also covered by SEBB benefits	Enroll in or change their election for a Medical FSA	60 days after the date the employee's coverage ends.

Employees applying to enroll in COBRA

Employees applying for COBRA must...	...no later than...	... or this will happen
Complete the Continuation Coverage (COBRA) election/change form.	60 days after the mailing date on the Continuation Coverage Election Notice.	SEBB insurance coverage will end on the last day of the month in which the employee lost eligibility for the employer contribution.
Mail or hand-deliver the Continuation Coverage (COBRA) election/change form to the Health Care Authority (HCA). The mailing and physical address is provided on the form.	60 days after the mailing date on the Continuation Coverage Election Notice.	Lose the right to continue coverage.
Make first payment to HCA for continuation coverage.	45 days after the date the coverage is elected.	Lose the right to continue coverage.

Employees applying to enroll in PEBB retiree coverage

Employees applying for PEBB retiree coverage must...	...no later than...	...or this will happen
Complete the PEBB Retiree Election form to enroll in or defer retiree coverage	60 days after their employer-paid, COBRA, or Continuation Coverage (Unpaid leave) ends.	The employee may lose the right to enroll in or defer PEBB retiree insurance coverage in the future.
Mail, hand-deliver, or fax the Retiree Election form to the HCA. The mailing address is provided on the form. The fax number is 360-725-0771	60 days after the employer-paid, COBRA or Continuation Coverage (Unpaid leave) ends.	The employee may lose the right to enroll in or defer PEBB retiree insurance coverage in the future.
Make the first full payment to HCA (if not electing pension deduction from the Department of Retirement Systems (DRS).	45 days after the 60-day election period ends.	The employee will not be enrolled in retiree coverage and may lose the right to enroll in or defer retiree insurance coverage in the future.

Employees retiring under Department of Retirement Systems (DRS) plans must contact DRS about retirement eligibility.

Contact

Outreach and Training
Benefits administrators contact O&T for eligibility, enrollment, or billing related questions.
Phone: 1-800-700-1555
Secure messaging: HCA Support

The SEBB Program
Employees and dependents may contact the SEBB Program to discuss their SEBB Continuation Coverage and PEBB Retiree Insurance options.
Phone: 1-800-200-1004 (toll-free) Monday through Friday, 8 a.m. to 4:30 p.m., or
Send a secure message: Employees need to set up an account to protect their privacy and sensitive health information.

The Department of Retirement Systems (DRS)
Employees retiring under plans administered by the Department of Retirement Systems must contact DRS for information about retirement eligibility.
Online: www.drs.wa.gov
Phone: 1-800-547-6657