If you plan on enrolling in Medicare at age 65, you should consider switching to a plan that is not a HDHP plan during the annual open enrollment prior to the year you turn age 65. If you’re on Medicare and SEBB employer-sponsored benefits, SEBB medical plans provide primary coverage, and Medicare coverage is ordinarily secondary. Premera Blue Cross has been providing health plans to school employees across the state for nearly 60 years. We have a variety of plan options that make dental … For eligibility information and general FAQs, visit hca.wa.gov/sebb-employee. What is Medicare Supplement Insurance (Medigap)? vision, basic life, basic accidental death and dismemberment, basic long-term disability insurance. Medical plans Dental plans Uniform Dental Plan : COPAY: On the DeltaCare plan, you pay a fixed dollar amount for each treatment you receive. TRICAR plan. Please contact Medicare for coverage questions as Medicare Part B is primary. PPO PLAN. Note: Medicaid and TRICARE never pay first for services covered by Medicare. Please note that SEBB employees who do not either enroll in or waive SEBB Program coverage during open enrollment will automatically be enrolled into the Uniform Dental Plan. Medical Plans: Kaiser Foundation Health Plan of the Washington Kaiser Permanente NW 1,2,3 MY.KO.ORG/SEBB 1-800-813-2000 Kaiser Foundation Health Plan of Washington Dental Plans. Since your employer’s medical plan would be the primary coverage over any Medicare plans, they should consider whether enrolling in a Medicare plan holds any value for them. However, you will remain enrolled in SEBB dental, vision, basic life and accidental death and dismemberment (AD&D) insurance, and long-term disability (LTD) coverage. 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(3) A dependent enrolled in SEBB medical, dental, or vision who becomes eligible for SEBB benefits as a school employee must elect to enroll in SEBB benefits as described in WAC 182-30-080(1). Please see the Certificate of Coverage for a There are circumstances where Medicare would be the primary payer even when you are enrolled in employer-sponsored benefits. Actual rates vary based on plan choice, your age, your location, number of people insured, their age, and relationship to you. If you enroll or cancel (terminate) enrollment in Medicare Part D, you may need a “notice of creditable coverage” to prove to Medicare or the prescription drug plan that you have had continuous prescription drug coverage to reenroll at a later date without penalties. To avoid paying a higher premium, you should enroll in a Medicare Part D plan within 63 days after your SEBB medical coverage ends. For specific details of each plan’s coverage, please refer your patients to the Washington … If you wait until the last four months of the initial enrollment period to sign up your coverage will be delayed. For example: If they join a Medicare supplement plan, that plan will not pay claims unless Medicare is the primary payer. Program Members . May help lower your prescription drug costs and help protect against higher costs. Check that your dentist is in-network or find a Presented are just some of the most common procedures covered in your plan. Explore our dental plans. If you change medical plans mid-year, your annual deductible and out-of-pocket maximum will start over with your new plan. You and any enrolled dependents must be enrolled in the same dental plan. Entitlement to Medicare also qualifies as a special open enrollment event, allowing you to change your health plans. DENTAL ENROLLMENT GUIDE Willamette Dental Group Plan, Effective January 1, 2020 Underwritten by Willamette Dental of Washington, Inc. School Employees Benefits Board (SEBB) Group Plan Number: WA733 007-WA733(8/19) SCHOOL EMPLOYEES BENEFITS BOARD If you select this plan, you may have to enroll in Medicare Part D to get your prescriptions, unless you have other creditable prescription drug coverage (e.g., VA). A school employee who waives enrollment in SEBB medical must enroll in dental, vision, basic life insurance, basic accidental death and dismemberment (AD&D) insurance, and basic long-term disability insurance. ALEX, the SEBB program’s online interactive benefits adviser, will help you understand your benefits and guide you through choosing your medical, dental, and vision plans, or suggest plans for you to consider. Welcome School Employees Benefit Board (SEBB) Members. The PEBB Program offers Premera Blue Cross Medicare Supplement Plan G at a lower cost for PEBB eligible retirees than the same plan offered to the general public. For employees and their enrolled spouses ages 65 and older, SEBB medical plans provide primary coverage, and Medicare typically provides secondary coverage. However, if you are in a high deductible health plan (HDHP) with a health savings account (HSA), you should not sign up for Medicare unless you are changing plans. UMP is available in all counties. You can call the SEBB Program at 1-800-200-1004 (select menu option 6) to request a notice of creditable coverage. A special open enrollment event must be an event other than a school employee gaining initial eligibility for SEBB benefits. However, you will remain enrolled in SEBB dental, vision, basic life and AD&D insurance, and basic LTD insurance (if eligible), and your dependents will not remain enrolled in medical coverage. SEBB coverage, as the primary, pays up to the limits of its coverage, and then Medicare, as the secondary payer, only pays if there are costs not covered by the primary payer that are within the Medicare-approved amounts. When you or your covered dependents become entitled to Medicare, the person entitled to Medicare should contact the nearest Social Security office to ask about the advantages of immediate or deferred enrollment in Medicare Part B. Medicare will not penalize you for delaying enrollment in Medicare Part B when covered by employer-sponsored health care. The Medicare Initial Enrollment Period (IEP) trumps any Special Enrollment Period (SEP). Action is required whether the employee wishes to enroll-in or waive benefits. If you don’t enroll within the 63-day deadline, your Medicare Part D plan’s monthly premium may increase by 1 percent or more for every month you didn’t have creditable coverage. Compare dental plans. The School Employees Benefits Board (SEB Board) studies, designs, and approves comprehensive and cost-effective insurance benefit plans for school employees, and establishes eligibility criteria for participation in these plans. Benefit coverage begins January 1, 2020. Our self-insured plan is called the Uniform Medical Plan (UMP), administered by Regence BlueShield. Make sure you understand the Medicare enrollment timelines to avoid late enrollment penalties. ... Home > Welcome School Employees Benefit Board (SEBB) Members > Welcome to School Employees Benefit Board (SEBB) Members. No. Retiree health plan coverage for SEBB members is offered through the PEBB Program. Or, if you have a special open enrollment event that allows the change, you can enroll in medical coverage. They only pay after employer group health plans and Medicare. Each supplement plan is identified by a letter A through N. All plans offer the same basic benefits and some offer additional benefits. UNIFORM DENTAL PLAN ... 2020 Delta Dental of Washington. Dental Insurance Plans Take the first step to protecting your smile and learn more about our individual and family dental benefit plans. Note: You cannot remove your spouse from medical coverage when they … Review the Medicare and Other Health Benefits: Your Guide to Who Pays First for an explanation of those circumstances. Delta Dental of Washington offers private dental insurance plans to meet the needs of individuals, families, and employers. The School Employees Benefits Board (SEBB) Program administers health insurance and other benefits to all employees in school districts and charter schools, and union-represented employees of educational service districts in Washington. This includes making an election to enroll in or waive enrollment in SEBB medical as described in … CTRL click to choose multiple options. If anything in these charts conflicts with the plan’s Certificate of Coverage (COC), the COC takes precedence and prevails. The initial enrollment period is seven months. SEBB Behavioral health services by plan These webpages include online resources for PEBB and SEBB members to reach 24-hour customer service and get timely access to care. A “self-insured” plan is offered by the employer organization — in this case, Washington State. The SEB Board is separate and independent from the Public Employees Benefits Board (PEBB). When you plan to terminate your employment and want to enroll in PEBB retiree health plan coverage, you will need to contact the PEBB Program about 90 days prior to terminating employment at 1-800-200-2004 (select menu 5 ) to ask general PEBB retiree insurance questions. or Medicare. You and any enrolled dependents must enroll in the same SEBB dental plan. For questions about Medicare Part D, call the Centers for Medicare & Medicaid Services at 1-800-633-4227. When you or your covered dependents become entitled to Medicare Part A and Part B, the person entitled to Medicare should contact the nearest Social Security office to ask about the advantages of immediate or deferred enrollment in Medicare Part B. If your Medicare entitlement is due to a disability, contact a Social Security office regarding deferred enrollment. Benefit coverage begins January 1, 2020. If you are not working more than 3 months after turning age 65, use caution and make sure you aware of the initial enrollment timelines to enroll in Part B. Eligible employees must enroll in SEBB dental. The SEBB Program is working on a solution. Dental plan confirmation message: Subscribers receive a confirmation message once they make their benefit elections. Starting in 2020, employees of Washington’s school districts and charter schools, and represented employees of Washington’s educational service districts, will receive benefits through the School Employees Benefits Board (SEBB) Program. Additionally, SEBB offers Uniform Dental Plan, a Preferred Provider Organization (PPO) plan administered by Delta Dental of WA. The plan will consists of a $50 deductible with 100% coverage for preventative services, 80% coverage for basic services and 50% coverage for major services (100/80/50). It waive Plan (UDP) Group #09600. Underwritten by Willamette Dental of Washington, Inc. 6950 NE Campus Way, Hillsboro, OR 97124 Dental services must be provided by a Willamette Dental Group, P.C. Learn more about your customer service options. Employees thet elect to SEBB medical coverËge must enrolled in other employer-based group mediffl. You must remove them during the annual open enrollment period that occurs before or after their Medicare entitlement. The Uniform Dental Plan, through Delta Dental, has cost shares for some services, e.g. There is no prescription drug coverage with this plan. This insurance program is managed by the School Employees Benefits Board (SEBB) of the Washington State Health Care Authority. Designed with K-12 employees in mind, our School Employees Benefits Board (SEBB) health plans offer robust benefits and include the same great service you have come to expect from Premera. Willamette Dental Group of Washington, Inc. 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