(Effective January 1, 2025)
May employer groups applying for participation in school employees benefits board (SEBB) insurance coverage include their retirees?
An employer group that applies for participation in school employees benefits board (SEBB) insurance coverage under WAC
182-30-200 will have a one-time opportunity to request inclusion of retired school employees who are covered under its retiree health plan at the time of application. The retirees included will be enrolled in public employees benefits board (PEBB) retiree insurance coverage.
(1) The authority will use the following criteria to approve or deny a request to include retirees:
(a) The employer group retiree health plan must have existed at least three years before the date of the employer group application;
(b) Eligibility for coverage under the employer groups' retiree health plan must have required immediate enrollment in retiree health plan coverage upon termination of school employee coverage; and
(c) The retirees must have maintained continuous enrollment in the employer group retiree health plan.
(2) If the employer group's application is for a subset of their school employees (e.g., bargaining unit) only retirees previously within the bargaining unit may be included in the transfer.
(3) Retirees and dependents included in the transfer unit are subject to the enrollment and eligibility rules outlined in chapters
182-08, 182-12, and
182-16 WAC.
(4) School employees eligible for retirement subsequent to the employer group transferring to SEBB health plan coverage must meet retiree eligibility as outlined in chapter
182-12 WAC.
(5) To protect the integrity of the risk pool, if total employer group retiree enrollment exceeds 10 percent of the total PEBB retiree population, the PEBB program may:
(a) Stop approving inclusion of retirees with employer group transfers; or
(b) Adopt a new rating methodology reflective of the cost of covering employer group retirees.
[Statutory Authority: RCW
41.05.021,
41.05.160,
41.05.740, 2023 c 13 § 2, and 2023 c 51 § 3. WSR 24-15-107 (Admin #2024-01), § 182-30-205, filed 7/22/24, effective 1/1/25.]