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 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 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 FSA, or a limited
purpose FSA until the beginning of the next plan year, unless the time between
employments is 30 days 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 31 days 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.
