Special Open Enrollment

What is a special open enrollment?

Certain events let you make account changes (like changing plans or enrolling a dependent) outside of annual open enrollment. We call these special open enrollment events.

 The change in enrollment must be allowable under the Internal Revenue Code and Treasury Regulations, and correspond to and be consistent with the event that creates the special open enrollment for the employee, the employee’s dependents, or both. A special open enrollment event must be an event other than an employee gaining initial eligibility for SEBB benefits.

 In addition, subscribers can make changes to their supplemental life and AD&D insurance, Medical FSA, DCAP or the premium payment plan during a special open enrollment.


How long am I eligible to make changes for a special open enrollment?

60 days from the date of the event!

Please be in contact with Cheryl Matava, the Benefit Administrator for Tahoma if you have a special open enrollment event. 425-413-3422, cmatava@tahomasd.us

 

What events qualify for a special open enrollment?

  • Marriage
  • Registering a state registered domestic partnership
  • Birth or adoption
  • Newly eligible extended dependent
  • Dependent loses eligibility
  • Loss of other coverage
  • Change in employment status(dependent)
  • Change in school district
  • Change under other employer-based group health plan’s open enrollment
  • Dependent moves from outside USA to USA, or from USA to outside USA
  • Change in residence
  • Court Order
  • Gain or lose eligibility for Medicaid or CHIP
  • Become eligible for state premium assistance subsidy for SEBB health plan coverage from Medicaid or CHIP
  • Gain or lose eligibility for Medicare
  • Health plan becomes unavailable
  • Continuity of care
  • Gain or lose eligibility for Tricare

 

How do I make changes during a special open enrollment?

You must provide evidence of the event that created the special open enrollment (for example, a marriage or birth certificate) via SEBB My Account or to the benefit administrator, no later than 60 days after the event.

In many instances, the date your change is received affects the effective date of the change in enrollment.

Please use the Special Open Enrollment User Guide for School Employees to walk you through how to request your Special Open Enrollment event and make plan changes in your SEBB My Account.

https://www.hca.wa.gov/assets/pebb/sebb-my-account-soe-user-guide-school-employees.pdf


What documents are needed and what changes can I make?

This can be found on the 45-2A Special Open Enrollment Matrix found at the link below.

https://www.hca.wa.gov/assets/pebb/sebb-policy-addendum-45-2A-special-open-enrollment-matrix-2020.pdf
Website by SchoolMessenger Presence. © 2021 Intrado Corporation. All rights reserved.