Washington Administrative Code › Title 182 - Health Care Authority › SCHOOL EMPLOYEES BENEFITS BOARD (SEBB) PROGRAM › Chapter 182-31 - Eligible school employees › Section 182-31-100 - What options for continuation coverage are available to school employees and their dependents during certain types of leave or when employment ends due to a layoff?

Current through Register Vol. 24-14, July 15, 2024
School employees who have established eligibility for school
				  employees benefits board (SEBB) benefits as described in WAC
				  182-31-040
				  may continue coverage for themselves and their dependents during certain types
				  of leave or when their employment ends due to a layoff.
(1) School employees who are no longer
				eligible for the employer contribution toward SEBB benefits due to an event
				described in (b)(i) through (v) of this subsection may continue coverage by
				self-paying the premium and applicable premium surcharges set by the health
				care authority (HCA) from the date eligibility for the employer contribution is
				lost:
(a) School employees may continue any
				combination of medical, dental, or vision, and may also continue life
				insur-ance and accidental death and dismemberment (AD&D) insurance. If life
				insurance or AD&D insurance is elected, both basic life and basic AD&D
				insurance must be continued. School employees who continue basic life insurance
				and basic AD&D insurance may also continue supplemental life and AD&D
				insurance;
(b) School employees in
				the following circumstances who lose their eligibility for the employer
				contribution toward SEBB benefits qualify to continue coverage under this
				subsection:
(i) School employees who are on
				authorized leave without pay;
(ii)
				School employees who are receiving time-loss benefits under workers'
				compensation;
(iii) School
				employees who are called to active duty in the uniformed services as defined
				under USERRA;
(iv) School employees
				whose employment ends due to a layoff as defined in WAC
				182-31-020;
				and
(v) School employees who are
				applying for disability retirement.
(c) The school employee's elections must be
				received by the SEBB program no later than sixty days from the date the school
				employee's SEBB health plan coverage ended or from the postmark date on the
				election notice sent by the SEBB program, whichever is later;
(d) School employees may self-pay for a
				maximum of twenty-nine months. The school employee's first premium payment and
				applicable premium surcharges are due no later than forty-five days after the
				election period ends as described in (c) of this subsection.
Premiums and applicable premium surcharges associated with
				  continuing SEBB medical, must be made to the HCA as well as premiums associated
				  with continuing SEBB dental and vision insurance coverage. Premiums associated
				  with continuing life insurance coverage or AD&D insurance coverage must be
				  made to the contracted vendor. Following the school employee's first premium
				  payment, the school employee must pay the premium amounts for SEBB insurance
				  coverage and applicable premium surcharges as premiums become due;
				  and
(e) If the school
				employee's monthly premium or applicable premium surcharges remain unpaid for
				sixty days from the original due date, the school employee's SEBB insurance
				coverage will be terminated retroactive to the last day of the month for which
				the monthly premium and applicable premium surcharges were paid as described in
				WAC
				182-30-040(1)
				(c).