This section describes the terms and conditions for a school employees benefits board (SEBB) organization that is engaging in local negotiations regarding eligibility for school employees as described in RCW
41.05.740 (6)(e).
(1) A SEBB organization must provide a current ratified collective bargaining agreement (CBA) and information on all eligible school employees under the CBA to the health care authority (HCA) by the start of the school year.
(2) A SEBB organization must offer all of, and only, the following SEBB benefits to employees and their dependents:
(a) Medical (includes the wellness incentive);
(b) Dental;
(c) Vision;
(d) Basic life;
(e) Basic accidental death and dismemberment (AD&D) insurance.
(3) A SEBB organization must provide an employer contribution as described below:
(a) The subscriber-only employer medical contribution (EMC) amount for school employees eligible under RCW
41.05.740 (6)(d) multiplied by the premium tier ratio associated with the enrollment tier selected by the school employee;
(b) One hundred percent of the cost for the school employee dental plan multiplied by the enrollment tier selected by the school employee;
(c) One hundred percent of the cost for the school employee vision plan multiplied by the enrollment tier selected by the school employee;
(d) One hundred percent of the cost for basic life and accidental death and dismemberment (AD&D) insurance;
(e) One hundred percent of the cost of the administrative fee charged by the HCA; and
(f) One hundred percent of the monthly K-12 remittance for deposit in the retired school employees' subsidy account.
(4) A SEBB organization providing SEBB benefits as described in this section may do so by group as described in (a) through (d) of this subsection:
(a) The entire SEBB organization;
(b) A entire collective bargaining unit;
(c) A group containing all nonrepresented school employees; or
(d) A combination of (b) and (c) of this subsection.
(5) A SEBB organization must establish a threshold of anticipated work hours no less than 180 hours but less than the minimum hours to meet SEBB eligibility under WAC
182-31-040 within a school year.
(6) All of the rules in chapters
182-30, 182-31, and
182-32 WAC apply, except for all rules governing SEBB benefits that are not available to school employees whose eligibility is established under this section. The following benefits are not available to school employees whose eligibility is established under this section:
(a) Long-term disability (LTD);
(b) Medical flexible spending arrangement (FSA) or limited purpose FSA;
(c) Dependent care assistance program (DCAP);
(d) Supplemental life insurance; and
(e) Supplemental accidental death and dismemberment insurance.
(7) If a school employee waives medical under this section, there is no requirement to send the employer contribution to the HCA as required in WAC
182-30-070(4).
(8) Eligibility determinations must align with the SEBB program's status as a governmental plan under Section 3(32) of the Employee Retirement Income Security Act of 1974 (ERISA) as amended. This means the SEBB organization may only consider school employees whose services are substantially all in the performance of essential governmental functions, but not in the performance of commercial activities, whether or not those activities qualify as essential governmental functions to be eligible.
(9) A SEBB organization providing SEBB benefits to a group of school employees under this section must notify the SEBB program each time the CBA is renegotiated.
[Statutory Authority: RCW
41.05.021 and
41.05.160. WSR 22-13-168 (Admin #2022-01), § 182-30-130, filed 6/21/22, effective 1/1/23; WSR 21-13-117 (Admin #2021-01.04), § 182-30-130, filed 6/21/21, effective 1/1/22. Statutory Authority: RCW
41.05.021,
41.05.160 and SEBB policy resolutions 2020-04. WSR 20-16-065 (Admin #2020-02), § 182-30-130, filed 7/28/20, effective 8/28/20. Statutory Authority: RCW
41.05.021,
41.05.160, 2017 3rd sp.s. c 13, 2018 c 260, and SEBB policy resolutions. WSR 19-14-093 (Admin #2019-01), § 182-30-130, filed 7/1/19, effective 8/1/19.]
