Washington Administrative Code › Title 182 - Health Care Authority › SCHOOL EMPLOYEES BENEFITS BOARD (SEBB) PROGRAM › Chapter 182-30 - Procedures › Section 182-30-090 - When may a subscriber change health plans?

Current through Register Vol. 24-14, July 15, 2024
A subscriber may change health plans at the following
				  times:
(1)
During the annual
				open enrollment:
A subscriber may change health plans during the school
				employees benefits board (SEBB) annual open enrollment period. The subscriber
				must submit the required enrollment forms to change their health plan. A school
				employee submits the enrollment forms to their SEBB organization. A subscriber
				on continuation coverage submits the enrollment forms to the SEBB program. The
				required enrollment forms must be received no later than the last day of the
				annual open enrollment. Enrollment in the new health plan will begin January
				1st of the following year.
(2)
During a special open enrollment:
A subscriber may revoke their
				health plan election and make a new election outside of the annual open
				enrollment if a special open enrollment event occurs. A special open enrollment
				event must be an event other than a school employee gaining initial eligibility
				for SEBB benefits as described in WAC
				182-31-040 or regaining
				eligibility for SEBB benefits as described in WAC
				182-30-080. The change in
				enrollment must be allowable under Internal Revenue Code (IRC) and Treasury
				regulations, and correspond to and be consistent with the event that creates
				the special open enrollment for the subscriber, the subscriber's dependent, or
				both.
A subscriber may not change their health plan during a
				  special open enrollment if their state registered domestic partner or state
				  registered domestic partner's child is not a tax dependent. A subscriber may
				  change their health plan as described in subsection (1) of this section.
To make a health plan change, a subscriber must submit the
				  required enrollment forms. The forms must be received no later than 60 days
				  after the event occurs. A school employee submits the enrollment forms to their
				  SEBB organization. A subscriber on continuation coverage submits the enrollment
				  forms to the SEBB program. In addition to the required forms, a subscriber must
				  provide evidence of the event that created the special open enrollment. New
				  health plan coverage will begin the first day of the month following the later
				  of the event date or the date the form is received. If that day is the first of
				  the month, the change in enrollment begins on that day. If the special open
				  enrollment is due to the birth, adoption, or assumption of legal obligation for
				  total or partial support in anticipation of adoption of a child, health plan
				  coverage will begin the month in which the birth, adoption, or assumption of
				  legal obligation for total or partial support in anticipation of adoption
				  occurs. If the special open enrollment is due to the enrollment of an extended
				  dependent or a dependent with a disability, the change in health plan coverage
				  will begin the first day of the month following the later of the event date or
				  the eligibility certification. Any one of the following events may create a
				  special open enrollment:
(a)
				Subscriber acquires a new dependent due to:
(i) Marriage or registering a state
				registered domestic partnership;
(ii) Birth, adoption, or when the subscriber
				has assumed a legal obligation for total or partial support in anticipation of
				adoption; or
(iii) A child becoming
				eligible as an extended dependent through legal custody or legal
				guardianship.