School Employees Benefits Board (SEBB) Program

Find a SEBB plan provider | Washington State Health Care Authority

 Find a SEBB plan provider | Washington State Health Care Authority

• Kaiser Permanente NW provider directories - Find Doctors and Locations in OR/SW WA | Kaiser Permanente
• Kaiser Permanente WA and Kaiser Permanente WA Options, Inc. provider directories
  • For Core 1, Core 2, or Core 3
  • For SoundChoice
  • For Summit PPO 1, Summit PPO 2, or Summit PPO 3
• Premera for High PPO and Standard PPO
• Premera HMO 
• Uniform Medical Plan (UMP)
  • UMP Achieve 1
  • UMP Achieve 2
  • UMP High Deductible
  • UMP Plus-Puget Sound High Value Network
  • UMP Plus-UW Medicine Accountable Care Network

Compare Medical Plans 

• Things to think about when choosing a medical plan
  • • Availability - Medical plan’s service area by county
    • Am I eligible to enroll in the plan? - High-deductible health plan (HDHP) with a health savings account (HAS)
• How do I compare plans? 
  • Medical Benefits Comparison Tool 
  • Medical Benefits At-a-Glance Comparison

Dental Providers

• DeltaCare – Delta Dental Find a dentist webpage (managed-care plan) (Group 9601)
• Uniform Dental Plan - Delta Dental Find a dentist webpage (managed-care plan) (Group 9600) – N/A
• Willamette Dental Group – Visit the Willamette Dental Group network provider directory

Compare Dental Plans 

• How do dental benefits compare?
• How do DeltaCare and Willamette Dental Group plans work?
• How does Uniform Dental Plan work?
• What providers can I see?
  • DeltaCare
  • Uniform Dental Plan
  • Willamette Dental Group
• What if I see an out-of-network provider?
• Preauthorization criteria
  • Delta Dental of Washington
  • Willamette Dental Group

Vision Plans and Benefits

• Davis Vision by MetLife - Davis Vision’s provider directory
• EyeMed – EyeMed’s provider directory
• MetLife Vision – MetLife’s provider directory

Compare vision plans

• Call the vision plan
• How do the vision plans compare?
• What does a vision plan cover?
• Does my medical plan cover vision?
• How do I find a provider?
  • Davis Vision by MetLife provider search
  • EyeMed provider search
  • MetLife Vision provider search
• Preauthorization criteria
  • Davis Vision
  • EyeMed
  • MetLife Vision

Tools to help you choose

• Compare vision plans using benefit comparisons

Plan Resources

• Find a provider for care
• Contact the plans with questions about benefits or providers
• Benefits while traveling. Learn how to access care when traveling

Contact

• The plans

Related forms and publications

• Vision Benefits At-a-Glance (SEBB) 2025
• Davis Vision by MetLife (SEBB) Certificate of Coverage (COC) 2025
• MetLife Vision (SEBB) Certificate of Coverage 2025
• EyeMed (SEBB) Certificate of Coverage (COC) 2025

Plan differences to consider

• Your provider / contact the medical plan
• Network adequacy –
  • Behavioral services by plan
  • Brennen’s Law (RCW 48.43.765)
• Preauthorization / contact the plan
• Coordination with your other benefits – WAC 182-31-070
• Premiums for school employees
• Premiums SEBB continuation coverage
• Deductibles
• Coinsurance or copays
• Out-of-pocket limit
• Referral procedures
• Paperwork

What to select?

• Managed-care plans
• Preferred provider organization (PPO) plans
• High-deductible health plans (HDHPs)

Contact

Related Links

• Medical plans and benefits
• Dental plans and benefits
• Vision plans and benefits

HCA Website

Before you travel

• Contact your plan
• Country Code’s How to dial internationally webpage

While you’re traveling

• Medicare’s Travel outside the US

Medical Services

• Kaiser Permanente NW
  • Kaiser’s Care while traveling webpage
• Kaiser Permanente WA and Kaiser Permanente WA Options
  • Kaiser’s Care while traveling webpage
• Premera
  • Benefits Book
  • Heritage Prime
  • Sherwood HMO
• Uniform Medical Plan (UMP)
  • Certificate of coverage
  • Online provider search tool
  • Network pharmacies across the US

Dental Services

• DeltaCare
• Uniform Dental Plan
• Willamette Dental Plan

Vision Services

• Davis Vision by MetLife
  • Davis Vision by Metlife network
  • Davis Vision by MetLife claim form
  • Certificate of Coverage
• EyeMed 
  • EyeMed’s Access Network
• MetLife Vision Plan
  • VSP Choice Network
  • MetLife Vision claim form
  • Certificate of coverage

Life, AD&D, LTD, FSA & DCAP benefits

Dependent Care Assistance Program (DCAP)

• Am I eligible? 
  • Washington Administrative Code (WAC) 182-31-040
• How can a DCAP help me?
  • Listen to the Fund Your Future DRS podcast episode
• How do I enroll?
  • Navia Benefit Solutions website
  • Midyear Enrollment Form
  • SEBB Change in Status Form
• How much can I contribute?
  • Tax Savings Calculator
• How do I submit claims?
  • Eligible expense
  • Navia Benefit Solutions
  • Mobile App: download for iPhone or Android
• What’s the deadline to spend down my DCAP account?
• What happens to my DCAP funds when coverage ends?
  • Online: https://sebb.naviabenefits.com/
  • Mobile App: download for iPhone or Android - https://pebb.naviabenefits.com/mynavia-mobile-app/

 Navia Benefit Solutions for school employees

Flexible Spending Arrangements (FSAs)

• What are FSAs?
  • Listen to the Fund Your Future DRS podcast episode
  • Need to manage your FSA? Visit Navia Benefit Solutions
  • What is an FSA?
    • Eligible expenses
  • What is a Limited Purpose FSA?
    • Eligible expenses
• Am I eligible?
  • • School employees eligible for SEBB benefits
      • Related laws and rules
        • Chapter 182-30
        • Chapter 182-31
        • WAC 182-31-040
        • WAC 182-30-130
        • WAC 182-31-070
        • WAC 182-30-080

Verify and Enroll Dependents

• What is dependent verification?
  • ESEBB Extended Dependent Certification
  • SEBB Extended Dependent Certification form
• When do I need to provide verification documents?
• What are valid dependent verification documents?
  • To enroll a spouse
  • To enroll a state-registered domestic partner
    • SEBB Declaration of Tax Status
    • Declaration of Tax Status (SEBB) 2025 form
    • SEBB Program Administrative Policy 33-1
      • Dependent eligibility and enrollment
        • 31-1 Verifying dependent eligibility before enrollment 1/1/2024
        • 31-2 Use of SEBB Spousal Plan Calculator 1/1/2025
        • 33-1 Verifying legal union’s residency status 1/1/2023
        • 36-1 Certifying eligibility for a dependent child with a disability who is age 26 or older 1/1/2025
        • 37-1 Certifying eligibility for an extended dependent child 1/1/2025
      • Special open enrollment 
      • Rescinded policies –
        • 11-3 Correcting School Employees Benefits Board Organizations and contacted vendor enrollment errors
          • 1/1/2023 
          • 1/1/2022
        • 12-1 Determining the first day of school for SEBB organizations 1/1/2022
        • 19-1 Termination due to loss of eligibility
          • 1/1/2024
          • 1/1/2023
          • 1/1/2022
        • 19-1A Addendum: Termination due to loss of eligibility of enrollment error – School employee
          • 1/1/2024
          • 1/1/2023
          • 1/1/2022
        • 19-1B Addendum: Termination due to loss of eligibility for nonpayment – Self-pay subscriber
          • 1/1/2024
          • 1/1/2023
          • 1/1/2022
        • 31-1 Verifying dependent eligibility before enrollment
          • 1/1/2023
          • 1/1/2022
        • 31-2 Use of premium surcharge help sheet and spousal plan calculator tools
          • 1/1/2024
          • 1/1/2023
          • 1/1/2022
        • 36-1 Certifying eligibility for a dependent child with a disability who is age 26 or older
          • 1/1/2024
          • 1/1/2023
        • 37-1 Certifying eligibility for an extended dependent child
          • 1/1/2024
          • 1/1/2023
          • 1/1/2022
        • 45-2 Special Open Enrollment (SOE)
          • 1/1/2024
          • 1/1/2023
          • 1/1/2022
        • 45-2A Special open enrollment matrix:  Summary of permitted election changes
          • 1/1/2024
          • 1/1/2023
          • 1/1/2022
        • 56-1 Continuation coverage reinstatement for subscribers with mental or physical impairment or incapacitation
          • 1/1/2024
          • 1/1/2023
          • 1/1/2022
        • 56-2 Election period tolling for applicants with mental or physical impairment or incapacitation
          • 1/1/2024
          • 1/1/2023
          • 1/1/2022
        • 91-1 Requesting a reasonable alternative for completing wellness incentive program requirements or avoiding the tobacco use premium surcharge
          • 1/1/2023
        • 91-2 Tobacco as it relates to religious or ceremonial use
          • 1/1/2023
          • 1/1/2022
        • 91-3 Washington Wellness worksite designation program incentive requirements
          • 1/1/2024
          • 1/1/2023
          • 1/1/2022
        • 93-2 SEBB Program payment plans for continuation coverage amounts 1/1/2023
        • 94-1 Accessing SEBB Program salary reduction plan document 1/1/2023
        • 94-2 Accessing SEBB Program wellness plan document 1/1/2023
        • 94-3 Subscriber mistake – Factor test
          • 1/1/2024
          • 1/1/2023
      • Salary reduction plan –
        • Charter schools
        • Educational Service Districts and school districts
      • Wellness Plan

SEBB Rulemaking

• SEBB Admin @2025-01.02
  • WSR 25-11-042
  • Preproposal (CR101) WSR 25-03-109
  • Proposal (CR102) WSR 25-11-042
  • Registration required
• SEBB Admin 2025-02
  • WSR 25-03-110
  • Preproposal (CR101) WSR 25-03-110
• SEBB Admin 2025-01.01
  • WSR 25-09-088
• SEBB Admin #2024-02.05 WAC 192-30-100, When may a subscriber enroll or revoke an election and make a new election under the premium payment plan, medical FSA, or DCAP?
  • WSR 24-15-112
  • Preproposal (CR101) WSR 24-04-064
  • Preproposal (CR102) WSR 24-11-1000
  • Permanent Adoption (CR103P) WSR 24-15-112
• SEBB Admin #2024-02-04 WAC 182-31-130, What options for continuation coverage are available to dependents who cease to meet the eligibility criteria as described in WAC 182-31-140 or 182-30-130?
  • WSR 24-15-111
  • Preproposal (CR101) WSR 24-04-064
  • Proposal (CR102) WSR 24-11-099
  • Permanent Adoption (CR103P) WSR 24-15-111
• SEBB Admin #2024-02-03 WAC 182-31-090, When is an enrollee eligible to continue SEBB health plan coverage under COBRA and where may school employee survivors go for additional coverage options?
  • WSR 24-15-110
  • Preproposal (CR101) WSR 24-04-064
  • Proposal (CR102) WSR 24-11-098
  • Permanent Adoption (CR103P) WSR 24-15-110
• SEBB Admin #2024-02-01 WAC 182-31-070, Is dual enrollment in school employees benefits board (SEBB) prohibited?
  • WSR 24-15-108
  • Preproposal (CR101) WSR 24-040064
  • Proposal WSR 24-11-095
  • Permanent Adoption (CR103P) WSR 24-15-108
• SEBB Admin #2024-02-02 WAC 182-31-080, When may a school employee waive enrollment in SEBB medical and when may they enroll in SEBB medical after having waived enrollment?
  • WSR 24-15-109
  • Preproposal (CR101) WSR 24-11-064 
  • Proposal WSR 24-11-097
  • Permanent Adoption (CR103P) WSR 24-15-209
• SEBB Admin #2024-01 General Updates
  • WSR 24-15-107
  • Emergency Adoption (CR103E) WSR 23-14-095  - 103E-23-14-095
  • Emergency Adoption (CR103E) - WSR 23-22-079 
  • Emergency Adoption (CR103E) - WSR 24-06-011 
  • Emergency Adoption (CR103E) - WSR 24-14-007 
  • Emergency Adoption (CR103E) - WSR 24-21-107 
  • Rescinded (CR103E) - WSR 25-02-108 
  • Preproposal (CR101) - WSR 24-04-062 
  • Proposal (CR102) - WSR 24-11-094 
  • Permanent Adoption (CR103P) -  WSR 24-15-107