SEBB Insurance Resources

Breaking news (1/9/2020)

This was just released by Health Care Authority.  It explains the SEBB appeals process and gives a phone number to call to check on the status of an appeal or to request an expedited appeal if there is an urgent medical issue:   https://www.hca.wa.gov/sebb-program-addressing-appeals

There is more detail on the website, but here is the specific part regarding the phone line:

How to check if your appeal has been received or request an expedited appeal for an urgent medical need

Effective immediately, you can call 1-800-200-1004 (and select menu option “7”) 8 a.m. to 4:30 p.m. Monday through Friday to:

  • Learn whether your appeal has been received.
  • Request to expedite review of your appeal if you or a dependent have an urgent medical need.

Please keep in mind that call wait times may be longer than usual due to the high volume of appeals. Until all appeals are logged in, our records may not show your appeal as being received yet. Our goal is to process all approved appeals that do not need additional action by a school employee by mid-January.  Please do not resubmit your appeal until all appeals have been processed.

There have been many frustrated members who have been looking for any kind of update on their appeal.  Hopefully, this phone line and the initial mailing of appeal resolution letters will help to bring some peace of mind to those who are frustrated with this transition.

The Legislature has approved and funded a new health care system for K-12 school employees that begins in January 2020. The new School Employees Benefits Board (SEBB) program will replace the existing health insurance negotiated locally in each school district. That means all K-12 public school employees will have a new insurance plan beginning January 1.

Summary of Benefits and Coverage – Coverage, limitations, preauthorizations:    https://www.hca.wa.gov/employee-retiree-benefits/school-employees/benefits-and-coverage-plan#what-is-sbc

Provider Directories: https://www.hca.wa.gov/employee-retiree-benefits/school-employees/find-provider

NEED HELP?!!  WEA Health Care Hotline 1-855-668-5039 (Monday-Friday 7:30 am – 5:00 pm)

Appeals must be filed within 30 days of the denial notification.  https://www.hca.wa.gov/about-hca/file-appeal-sebb#who-can-appeal    1-800-351-6827