Current through Register Vol. 24-18, September 15, 2024
A school employee who is newly eligible or who regains
eligibility for the employer contribution toward school employees benefits
board (SEBB) benefits enrolls as described in this section.
(1) When a school employee is newly eligible
for SEBB benefits:
(a) A school employee must
complete the required forms indicating their enrollment elections, including an
election to waive enrollment provided the school employee is eligible to waive
as described in WAC
182-31-080.
The required forms must be returned to the school employee's SEBB organization
or contracted vendor. Their SEBB organization or contracted vendor must receive
the forms no later than 31 days after the school employee becomes eligible for
SEBB benefits under WAC
182-31-040.
(i) The school employee may enroll in
supplemental life insurance up to the guaranteed issue coverage amount without
evidence of insurability if the required forms are returned to the school
employee's SEBB organization or contracted vendor as required. A school
employee may apply for enrollment in supplemental life insurance over the
guaranteed issue coverage amount at any time during the calendar year by
submitting the required form to the contracted vendor for approval. For a
school employee who requests a change in their supplemental life insurance
after the election period described in this subsection, the change begins the
first day of the month following the date the contracted vendor approves the
request. A school employee may enroll in supplemental accidental death and
dismemberment (AD&D) insurance at anytime without evidence of insurability
by submitting the required form to the contracted vendor.
(ii) School employees are enrolled in
employee-paid long-term disability (LTD) insurance automatically. A school
employee may elect to reduce their employee-paid LTD insurance or decline their
employee-paid LTD insurance by returning the form to their SEBB organization. A
school employee may apply for a change in their employee-paid LTD insurance at
any time during the calendar year by submitting the required form to their SEBB
organization or the contracted vendor. For a school employee who requests a
change in their employee-paid LTD insurance after the election period described
in this subsection, the change begins the first day of the month following the
date the SEBB organization receives the required form requesting to reduce or
decline the employee-paid LTD insurance, or the day of the month the contracted
vendor approves the required form to increase the employee-paid LTD
insurance.
(iii) If the school
employee is eligible to participate in the salary reduction plan (see WAC
182-31-060)
, the school employee will automatically enroll in the premium payment plan
upon enrollment in SEBB medical allowing medical premiums to be taken on a
pretax basis. To opt out of the premium payment plan, a new school employee
must complete the required form and return it to their SEBB organization. The
form must be received by their SEBB organization no later than 31 days after
the employee becomes eligible for SEBB benefits.
(iv) If a school employee is eligible to
participate in the salary reduction plan (see WAC
182-31-060)
, the school employee may enroll in the state's medical flexible spending
arrangement (FSA) , limited purpose FSA, dependent care assistance program
(DCAP), or both an FSA and DCAP, except as limited by subsection (4) of this
section. To enroll in these SEBB benefits, the school employee must return the
required form to their SEBB organization. The form must be received by the SEBB
organization no later than 31 days after the school employee becomes eligible
for SEBB benefits.
(b)
If a newly eligible school employee's SEBB organization, or the authority's
contracted vendor in the case of life insurance and AD&D, does not receive
the school employee's required forms indicating medical, dental, vision, life
insurance, AD&D insurance, and LTD insurance elections, and the school
employee's tobacco use status attestation within 31 days of the school employee
becoming eligible, their enrollment will be as follows for those elections not
received within 31 days:
(i) A medical plan
determined by the health care authority (HCA);
(ii) A dental plan determined by the
HCA;
(iii) A vision plan determined
by the HCA;
(iv) Basic life
insurance;
(v) Basic AD&D
insurance;
(vi) Employer-paid LTD
insurance and employee-paid LTD insurance;
(vii) Dependents will not be enrolled;
and
(viii) A tobacco use premium
surcharge will be incurred as described in WAC
182-30-050(1)(b).
(2) The employer
contribution toward SEBB benefits ends according to WAC
182-31-050.
When a school employee's employment ends, participation in the salary reduction
plan ends.
(3) When a school
employee regains eligibility for the employer contribution toward SEBB
benefits, including following a period of leave as described in WAC
182-31-100(1)
or
182-31-040(4)(d),
SEBB medical, dental, and vision begin the first day of the month following the
school employee's return to work if the SEBB organization anticipates the
school employee is eligible for the employer contribution.
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Note:
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When a school employee who is called to active duty
in the uniformed services under Uniformed Services Employment and Reemployment
Rights Act (USERRA) loses eligibility for the employer contribution toward SEBB
benefits, they regain eligibility for the employer contribution toward SEBB
benefits the day they return from active duty. Employer-paid SEBB benefits will
begin the first day of the month in which they return from active duty.
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(a) A school
employee must complete the required forms indicating their enrollment
elections, including an election to waive enrollment if the school employee
chooses to waive enrollment as described in WAC
182-31-080.
The required forms must be returned to the school employee's SEBB organization
except as described in (d) of this subsection. Forms must be received by the
SEBB organization, life insurance contracted vendor, or AD&D contracted
vendor, if required, no later than 31 days after the school employee regains
eligibility except as described in (a)(i) and (b) of this subsection:
(i) A school employee who self-paid for
supplemental life insurance or supplemental AD&D coverage after losing
eligibility will maintain that level of coverage upon return;
(ii) A school employee who was eligible to
continue supplemental life insurance but discontinued that supplemental
coverage must submit evidence of insurability to the contracted vendor if they
choose to reenroll when they regain eligibility for the employer
contribution.
(b) A
school employee does not have to return a form indicating employee-paid LTD
insurance elections. Their employee-paid LTD insurance will be automatically
reinstated effective the first day of the month following the date they regain
eligibility for the employer contribution toward SEBB benefits.
(c) If a school employee's SEBB organization,
or contracted vendor accepting forms directly, does not receive the required
forms within 31 days of the school employee regaining eligibility, the school
employee's enrollment for those elections not received will be as described in
subsection (1)(b)(i) through (viii) of this section, except as described in
(a)(i) and (b) of this subsection.
(d) If a school employee is eligible to
participate in the salary reduction plan (see WAC
182-31-060)
, the school employee may enroll in the medical FSA, limited purpose FSA, DCAP,
or both an FSA and DCAP, except as limited by subsection (4) of this section.
To enroll in these SEBB benefits, the school employee must return the required
form to the contracted vendor or their SEBB organization. The contracted vendor
or school employee's SEBB organization must receive the form no later than 31
days after the school employee becomes eligible for SEBB benefits.
(4) If a school employee who is
eligible to participate in the salary reduction plan (see WAC
182-31-060)
is hired into a new position that is anticipated to be eligible for SEBB
benefits in the same year, the school employee may not resume participation in
a DCAP, a medical FSA, or a limited purpose FSA until the beginning of the next
plan year, unless the time between employments is 30days or less and within the
current plan year. The school employee must notify the new SEBB organization of
the transfer by providing the new SEBB organization the required form no later
than 31days after the school employee's first day of work with the new SEBB
organization.
(5) A school
employee will have uninterrupted coverage when moving from one SEBB
organization to another within the same month or a consecutive month if they
are eligible for the employer contribution towards SEBB benefits in the
position they are leaving and are anticipated to be eligible for the employer
contribution in the new position. SEBB benefits elections also remain the same
when a school employee has a break in employment that does not interrupt their
employer contribution toward SEBB benefits.
(6) A school employee returning to the same
SEBB organization who is anticipated to work at least 630 hours in the coming
school year, and who was receiving the employer contribution in August of the
prior school year, will receive uninterrupted coverage from one school year to
the next.
