Washington Administrative Code › Title 182 - Health Care Authority › SCHOOL EMPLOYEES BENEFITS BOARD (SEBB) PROGRAM › Chapter 182-30 - Procedures › Section 182-30-050 - What are the requirements regarding premium surcharges?

Current through Register Vol. 24-14, July 15, 2024
(1) A subscriber's account will incur a
				premium surcharge in addition to the subscriber's monthly medical premium, when
				any enrollee, thirteen years and older, engages in tobacco use.
(a) A subscriber must attest to whether any
				enrollee, thirteen years and older, enrolled in their school employees benefits
				board (SEBB) medical engages in tobacco use. The subscriber must attest as
				described in (a)(i) through (v) of this subsection:
(i) A school employee who is newly eligible
				or regains eligibility for the employer contribution toward SEBB benefits must
				complete the required form to enroll in SEBB medical as described in WAC
				182-30-080(1)
				or (3). The school employee must include
				their attestation on that form. The school employee must submit the form to
				their SEBB organization. If the school employee's attestation results in a
				premium surcharge, it will take effect the same date as SEBB medical
				begins;
(ii) If there is a change
				in the tobacco use status of any enrollee, thirteen years and older on the
				subscriber's SEBB medical, the subscriber must update their attestation on the
				required form. A school employee must submit the form to their SEBB
				organization. A subscriber on continuation coverage must submit their updated
				form to the SEBB program. The attestation change will apply as follows:
* A change that results in a premium surcharge will begin the
				  first day of the month following the status change. If that day is the first of
				  the month, the change to the surcharge begins on that day.
* A change that results in removing the premium surcharge
				  will begin the first day of the month following receipt of the attestation. If
				  that day is the first of the month, the change to the surcharge begins on that
				  day.
(iii) If a subscriber
				submits the required form to enroll a dependent, thirteen years and older, in
				SEBB medical as described in WAC
				182-31-150,
				the subscriber must attest for their dependent on the required form. A school
				employee must submit the form to their SEBB organization. A subscriber on
				continuation coverage must submit their form to the SEBB program. A change that
				results in a premium surcharge will take effect the same date as SEBB medical
				begins;
(iv) An enrollee, thirteen
				years and older, who elects to continue medical coverage as described in WAC
				182-31-090,
				must provide an attestation on the required form if they have not previously
				attested as described in (a) of this subsection. The enrollee must submit their
				form to the SEBB program. An attestation that results in a premium surcharge
				will take effect the same date as SEBB medical begins; or
(v) A school employee who previously waived
				SEBB medical must complete the required form to enroll in SEBB medical as
				described in WAC
				182-31-080(3).
				The school employee must submit their attestation on that form. A school
				employee must submit the form to their SEBB organization. An attestation that
				results in a premium surcharge will take effect the same date as SEBB medical
				begins.
Note:
A school employee who waives SEBB medical as
							 described in WAC
							 182-31-080
							 is not required to provide an attestation and no premium surcharge will be
							 applied to their account as long as the school employee remains in waived
							 status.