Open Enrollment

Below are some upcoming changes to all SEBB plans:

• Vision hardware benefit: Will increase up to $200 per year (from $150) for prescription eyeglasses or contact lenses and will reset on odd years (2025, 2027, etc.).
• Deductible for UMP High Deductible:The IRS raised the minimum deductible for high-deductible health plans to $1,650 for single subscribers and $3,300 for families.
• Diagnostic and supplemental breast exam coverage:Diagnostic and supplemental breast exams will be covered without cost to members. UMP High Deductible members need to meet their deductible before the plan will pay.
• Health savings account (HSA) maximum: The annual maximum contribution to the Health Savings Account (HSA) will increase to $4,300 for a single subscriber and $8,550 for a subscriber with at least one enrolled dependent.
• Deductible for High-Deductible Health Plan: The IRS raised the minimum deductible for high-deductible health plans to $1,650 for a single subscriber and $3,300 for a subscriber with at least one enrolled dependent.
• Flexible spending arrangement (FSA): The annual maximum contribution for the FSA and Limited Purpose FSA will increase to $3,200.
• Behavioral Health Resources: The 2025 Medical Benefits At-a-Glanceincludes a section to compare behavioral health benefits by plan. You can also visit the Behavioral health services by plan webpage.
• Reduction in cost for inhalers and epinephrine injectors: Out-of-pocket costs will be capped at $35 for a 30-day supply of inhaled corticosteroids combination products and epinephrine autoinjectors.
• Increasing access to Human Immunodeficiency Virus (HIV) Post-Exposure Prophylaxis (PEP): Plans will be prohibited from cost-sharing or prior authorization requirements for at least one full PEP regimen.

Updates to individual health plans can be found at https://www.hca.wa.gov/about-hca/news/announcements/changes-sebb-benefits-2025.

You can explore plans and find providers at www.hca.wa.gov/employee-retiree-benefits/school-employees/find-sebb-plan-provider. Or use the links below to compare various plans.

• Compare Medical Plans: www.hca.wa.gov/employee-retiree-benefits/school-employees/compare-medical-plans
• Compare Dental Plans: www.hca.wa.gov/employee-retiree-benefits/school-employees/compare-dental-plans
• Compare Vision Plans: www.hca.wa.gov/employee-retiree-benefits/school-employees/compare-vision-plans

A virtual benefits fair is a way to learn about your benefit options through an online experience — and it’s available anytime, day or night.

Visit and explore to learn more about all the benefits available. You will find links to videos, webinars, downloadable content, provider searches, and other information to help you choose the right benefits for you and your dependents. Use your computer, tablet, or smartphone to explore at your own pace. Go to hca.wa.gov/vbf-sebb to start exploring.

Kaiser Permanente, Premera and Uniform Medical Plan are also offering open enrollment webinars. Visit www.hca.wa.gov/employee-retiree-benefits/open-enrollment-webinars-sebb to view the schedule.

Flexible Spending Arrangement (FSA) allow you to set aside pretax money from your paycheck to pay for out-of- pocket health care costs. Dependent Care Assistance Program (DCAP) allows you to also set aside pretax money from your paycheck to pay for qualifying childcare or elder care expenses. If you are participating in the FSA (formerly known as Medical FSA), Limited Purpose FSA, or DCAP for 2025, you must enroll during annual open enrollment even if you are not changing your contribution amount.

Don’t wait until the last minute! The SEBB OE deadline is closer than you think. Navia Benefit Solutions must receive your enrollment no later than November 25, 2024.

The minimum contribution amount for the FSA and Limited Purpose FSA in 2025 is $120 and the maximum is $3,200. The maximum annual amount for DCAP in 2024 is $5,000 per household ($2,500 each if you and your spouse file separate tax returns).

How to enroll

You may enroll one of two ways:

• Log in and enroll on the Navia Benefit Solutions website
• Complete Navia’s 2025 Annual Open Enrollment form, available on Navia’s Forms & Documents webpage, and submit it as instructed on the form.

Navia Benefits Solutions must receive your enrollment no later than November 25, 2024.

FSAs and high-deductible health plans don’t mix

If you enroll in both an FSA and UMP High Deductible, you will be automatically disenrolled from the FSA. You or your spouse or state-registered domestic partner cannot have both an FSA and a high-deductible plan with a health savings account (HSA) in the same year.

If you have UMP High Deductible with an HSA, you can enroll in a Limited Purpose FSA for eligible dental and vision expenses

FSA funds may carry over

If you are enrolled in an FSA for 2024, unused funds up to $640 may carry over and be used for 2025. IRS rules require that any amount over $640 will be forfeited to the plan administrator, the Health Care Authority. The minimum carryover is $120. Any amount under $120 will be forfeited unless you enroll in an FSA for 2025.

Deadlines for claims

All 2024 FSA expenses must be incurred by December 31, 2024. You must submit all 2024 claims to Navia Benefit Solutions for reimbursement by March 31, 2025.

DCAP enrollees have until December 31, 2024 to incur expenses. You must submit all 2024 claims to Navia Benefit Solutions for reimbursement by March 31, 2025.

More information

Find out more on the SEBB Program’s Flexible Spending Arrangement and Dependent Care Assistance Program webpages or contact Navia at 1-800-669-3539 from 5:00am to 5:00pm PST, Monday through Friday.

The SEBB program offers two dental plans administered by Delta Dental that are often confused. Sometimes people intend to enroll in the Uniform Dental Plan (UDP) but accidentally enroll in DeltaCare, or vice versa. During annual open enrollment, be careful to choose the dental plan you want.

• DeltaCare (Group 9601) is a managed-care plan with a narrow network. You must choose a primary care dentist within the network, or you will be assigned a primary care dentist. Your primary care dentist must give you a referral to see a specialist. The plan will not pay claims if you see a provider outside of the network.
• Uniform Dental Plan (Group 9600) is a preferred provider plan. You may choose and change to any dental provider at any time, but you will typically have a lower out-of-pocket cost if you see in-network providers.

Compare your dental plan options on the SEBB Program’s Dental plans and benefits webpage. Before you enroll in a dental plan, check with the plan (DeltaCare or UDP, not the provider) to see if your provider is in the plan’s network and confirm the group number. You can call the dental plan’s customer service or use the plan’s online directory.

If you cover your spouse on your medical insurance, you should login and do the attestation (needs to be done yearly) to avoid the $50 monthly spousal fee. 

More information about attestation can be found at https://www.hca.wa.gov/sebb-benefits-admins/enrollment/premium-surcharges. Attestation can only be done during open enrollment.

Long-term substitutes are notified of their benefits eligibility when they hit 630 hours worked.

You must enroll in the FSA, Limited Purpose FSA, or DCAP each year you want to participate. You can enroll between October 28 and November 25 on Navia’s website at sebb.naviabenefits.com.