Benefit Changes Under SEBB
All existing health plans through Highline Public Schools will terminate effective December 31, 2019.
Starting in the 2019-20 school year, all Washington State K-12 school employees will begin receiving health insurance and benefits through the statewide School Employees Benefits Board (SEBB) Program.
The SEBB Program will replace the health and insurance benefits Highline Public Schools currently provides. The first SEBB Program open enrollment is October 1–November 15, 2019. Benefits begin January 1, 2020. All benefit changes are contingent on the legislature enacting SEBB as expected.
The SEBB offerings will be similar to what is currently offered in Highline. Below is a summary of similarities and differences of benefit offerings, program eligibility and how health insurance will be funded.
As with your plans now, the monthly premium costs for SEBB medical plans will be based on the plan you choose, while vision, life, long-term disability and dental will be covered 100% through Highline Public Schools.
For more information, please review the SEBB Benefits Fact Sheet.
|Most bargaining units have a flat $50,000 policy rate and a voluntary option to purchase additional coverage.||SEBB will offer a flat $35,000 and $5,000 Accidental Death & Dismemberment (AD&D) policy. You will have the option to purchase additional coverage based on your needs.|
Long Term Disability (LTD)
|Depending on your bargaining unit, Highline’s minimum LTD coverage is 60% of the first $5,833 of monthly earnings, or a maximum monthly benefit of $3,500.||Under SEBB, coverage will be 60% of the first $667 of monthly income, or a maximum monthly benefit of $400. A voluntary buy-up option will be available.|
|Staff can purchase frames every 12 months. Our current plan also allows you to purchase frames at wholesale prices. We cannot speak to the market places available for use with SEBB vision benefits.||SEBB will offer three options: Davis Vision, MetLife and EyeMed. You will be able to choose a carrier based on your needs. You can purchase frames every 24 months.|
Our existing plan through UCCI is an incentive plan. The first year, you start at 70/70/50 coverage, with a 10% increase each year when you receive preventative services annually.
Under our current Highline plan, crowns are considered a basic service and are covered at 70-100%.
SEBB will offer two fully insured carriers: DeltaCare and Willamette. Both carriers are Dental Maintenance Organizations (DMO) which means you can only go to designated providers. Both will offer copays and no annual maximum limits. This is similar to what we currently offer with Willamette.
Additionally, SEBB will offer a Preferred Provider Organization (PPO) through Delta Dental. This will provide a larger network. The plan will consist of a $50 deductible with 100% coverage for preventative services, 80% coverage for basic services and 50% coverage for major services (100/80/50).
Crown services will be considered a major service and be covered at 50% under this SEBB dental option. Depending on the provider, crowns will range anywhere from $600-$1,000.
SEBB medical costs and plan options have not been finalized. Review a comparison of medical plans under consideration. Review a comparison of the SEBB Health Maintenance Organization (HMO) coverage to our HMO through Kaiser.
The plans under consideration have the same average value of covered benefits as those offered to state employees.
What Makes SEBB So Different From What We Have Now?
Beyond coverage, there are three significant differences to be aware of when we switch to SEBB. Here are three commonly asked questions that address these differences.
- Who is eligible for coverage?
- How will health insurance be paid for?
- Why are we making these changes?
All school employees who work at least 630 hours during the school year are eligible for full benefits under the new plan. Currently, we offer full benefits to staff who work 1,440 hours and prorated coverage below that. Learn more about SEBB eligibility.
Eligible dependents include:
Currently, each full-time employee is allocated a certain amount for monthly premiums based on bargaining group. When one employee doesn’t use their full allocation, the funds are returned to the “pool” for other members in the pool to use. Under the new plan, this process is eliminated. Essentially, the pooling happens upfront at a state level and is reflected in the rates.
Employees will pay a monthly premium based on the benefits they choose and whether they cover dependents. The Healthcare Authority (HCA) will share cost information and monthly premiums after contracts are in place and the SEB Board votes on benefit design decisions such as deductibles, out-of-pocket maximums, copays, and coinsurance. This will not take place until mid-2019.
State law mandates all medical plans offered through the SEBB meet a three to one ratio for medical premiums. This means an employee covering a full family will not pay more than three times the amount as a single employee in premiums for the same plan.