Your Siemens Account email address must match your Learning Advantage email address in order to maintain access to your enrollment, membership, and transcript information. Petition for invalidity (annulment) of state-registered domestic partnership or legal union, Petition for dissolution of a state-registered domestic partnership or a legal union, Legal separation notice of a state-registered domestic partnership or a legal union, The most recent year’s federal tax return that includes the child as a dependent (black out financial information), Birth certificate (or hospital certificate with the child’s footprints on it) showing the name of the parent who is the subscriber, the subscriber’s spouse or state-registered domestic partner, Certificate or decree of adoption showing the name of the parent who is the subscriber, the subscriber's spouse, or the subscriber’s state registered domestic partner, Valid J-2 visa issued by the U.S. government, The last day of the SEBB Program's annual open enrollment, Upload dependent verification documents in. Willamette Dental Group of Washington, Inc. Life and accidental death and dismemberment (AD&D) insurance, For PEBB Continuation Coverage - Unpaid Leave, For PEBB Continuation Coverage - COBRA (enrolled in Medicare), For PEBB Continuation Coverage - COBRA (not enrolled in Medicare), Life and accidental death & dismemberment (AD&D) insurance, Washington Apple Health (Medicaid) providers, Enroll as a health care professional practicing under a group or facility, Existing Apple Health (Medicaid) providers, Request a Zoom license to connect with patients (during the COVID-19 pandemic), Claims and billing (guides/fee schedules), Provider billing guides and fee schedules, Program benefit packages and scope of services, Autism and Applied Behavior Analysis (ABA) therapy, Access to Care Standards (ACS) and ICD information, Service Encounter Reporting Instructions (SERI), Intensive Residential Treatment (IRT) Teams, Preadmission Screening and Resident Review (PASRR), Program of Assertive Community Treatment (PACT), Medications for opioid use disorder (MOUD), Screening, brief intervention, and referral to treatment (SBIRT), Ground emergency medical transportation (GEMT), King County Superior Court Juvenile Probation Services, Washington State Federally Recognized Tribes, Apple Health (Medicaid) drug coverage criteria, Substance use disorder (SUD) consent management guidance, Sign language interpreter contract transition, Children's Mental Health Lawsuit and Agreement, Ricky’s Law: Involuntary Treatment Act (ITA), State Youth Treatment - Implementation (SYT-I) Project, Washington Screening, Brief Interventions, and Referrals to Treatment (WASBIRT-PCI) Project, Children’s Behavioral Health Data and Quality Team, Children's Behavioral Health Executive Leadership Team (CBH ELT), Children and Youth Behavioral Health Work Group (CYBHWG), Family Youth System Partner Round Table (FYSPRT), Evidence-based and research-based practices, Analytics, Research, and Measurement (ARM), Initiative 1: transformation through ACHs, Initiative 2: long-term services & supports, Initiative 3: supportive housing & supported employment, Initiative 4: substance use disorder (SUD) IMD, Medicaid Transformation Learning Symposium, School Employees Benefits Board (SEBB) Program FAQs, Apple Health (Medicaid) quality strategy and compliance oversight, Apple Health (Medicaid) MCO and BH-ASO state contracts, Revised Indian Nation agreements and program agreements, Governor's Indian Health Advisory Council, Washington Prescription Drug Program (WPDP), Multi-payer Primary Care Transformation Model, HCA connects employee ambitions with career goals, Office of Medicaid Eligibility and Policy leads the effort in making access to Apple Health simple, Celebrating HCA’s nurses during National Nurses Week, May 6-12, Community based specialists help people with free or low-cost health care coverage, Military experiences shape personal and professional values, Artist turned graphic designer helps HCA create and maintain hundreds of print and web products, Infants at the Workplace Program provides support and flexibility for new parents, HCA goes ‘above and beyond’ for employees with disabilities, Black History Month celebration was a first at HCA, Apple Health (Medicaid) and managed care reports, Public Employees Benefits Board (PEBB) Program enrollment, School Employees Benefits Board (SEBB) Program enrollment, Washington State All Payer Claims Database (WA-APCD), Behavioral health and recovery rulemaking, Public Employees Benefits Board rulemaking, School Employees Benefits Board rulemaking, Personal injury, casualty recoveries, & special needs trusts, Employee eligibility tools and worksheets, PEBB Continuation Coverage spousal plan questionnaire 2020, Learn more about your customer service options, Website feedback: Tell us how we’re doing. For questions, contact your payroll or benefits office. A few exceptions apply to the dependent verification process: We will not enroll a dependent if we cannot verify their eligibility. No evidence of good health required when enrolling for the first time during 2020. Copyright © 2020 Washington Health Care Authority, Long-term services and supports (LTSS) and hospice, Autism & Applied Behavioral Analysis (ABA) therapy, Medically Intensive Children's Program (MICP), American Indians and Alaska Natives (AI/AN), Apple Health coverage without managed care, Update my income or address (report a change), Pregnant mother finds comfort during uncertain times, Apple Health client inspired to help others access health coverage, Apple Health supported client while searching for job, Telehealth helps a mother connect with her child during pandemic, Foster parent helps kids get overdue medical care through Apple Health, After accident, hiker gets the care she needs through Apple Health, Apple Health worker helps ease financial worries of new mother, Facing high diabetes treatment costs, Apple Health (Medicaid) saves the day, Access to housing, employment, and health care gives Yakima resident a second chance, Cancer patient lives a quality life thanks to Apple Health, New mother and baby have healthy start thanks to Apple Health, Apple Health covers medically necessary surgery when other insurance wouldn’t, Apple Health leads the way to a better life for autism spectrum disorder (ASD) client, Apple Health for Kids provides relief for new parents, Access to health care allows student to pursue education stress-free, Children’s Health Insurance Program (CHIP) keeps health care affordable for families, Helping Apple Health (Medicaid) clients when they need it most, Apple Health gives life to those with chronic disease, Mother and daughter have a better life because of Apple Health, Apple Health provides otherwise unaffordable, life-saving medication for HIV patient, Apple Health outreach staff help spread the word about free and low-cost health insurance, Apple Health and community partners help improve the health of the Latino population in Washington, Apple Health brings stability to lives of young couple, I can’t begin to explain how much Apple Health has helped me, I wouldn’t be able to afford health insurance otherwise, Apple Health gives me a sense of security, Helping people navigate their way to Washington Apple Health, Apple Health has given her such peace of mind, Contact Washington Apple Health (Medicaid), Child and youth behavioral health services, Wraparound with Intensive Services (WISe), Substance use disorder prevention and mental health promotion, Painful life lessons become strengths for crisis counselor, Integrated approach delivers all care “right here, right now”, General eligibility requirements that apply to all Apple Health programs, Modified Adjusted Gross Income (MAGI) based programs manual, Long-term services and supports (LTSS) manual, Uniform Medical Plan (UMP) administered by Regence BlueShield and WSRxS, Health plans with health savings accounts (HSAs), Medical Flexible Spending Arrangement (FSA), Not participating in a Washington State-sponsored retirement plan, Health plans with health savings accounts (HSAs) (non-Medicare), Long-term disability insurance (unpaid leave only), PEBB Continuation Coverage premiums (non-Medicare), PEBB Continuation Coverage premiums (Medicare), Life insurance premiums (unpaid leave only), Long-term disability insurance premiums (unpaid leave only), SEBB Continuation Coverage spousal plan questionnaire 2020, Public Employees Benefits Board (PEBB) Program, Archived agendas, minutes, & presentations, School Employees Benefits Board (SEBB) Program. To edit the info that you use on Google services, like your name and photo, sign in to your account. Get started with Google Sheets with training on the Google for Education Teacher Center. Introducing SEBB's enrollment tool: SEBB My Account. Search millions of videos from across the web. If you need to update your name, fill out and send in a printed form as well as a copy of documentation showing the change. ... Credit video Bast3rd'Fly aka Batart. Community See All. A new hire, use the appropriate A-series worksheet. • Adding or removing dependents • Payroll deduction information (including pre- or post-tax contributions) Help with SEBB My Account October 1 to November 15: 1-855-648-3100 7 a.m. to 9 p.m., Monday through Friday, and 10 a.m. to 4 p.m., Saturday for help with: Changes may be made through SEBB My Account until 11:59 pm on Monday, November 23, 2020. If you are enrolling a spouse, provide a copy of (choose one): If enrolling a state-registered domestic partner, attach a SEBB Declaration of Tax Status to indicate whether your state-registered domestic partner qualifies as a dependent for tax purposes under IRC Section 152, as modified by IRC Section 105(b). The most recent year’s federal tax return filed jointly that lists the spouse (black out financial information), The most recent year's federal tax returns for you and your spouse if filed separately (black out financial information). Click on the title of the specific worksheet that describes the employee or employee's situation. Provide an employer contribution as described in WAC or. Provides guidance and suggestions for the SEBB organization and school employee. The SEBB Organization determines when the employment relationship has ended with an employee. Dependent verification documents are only required if you are enrolling a partner established through a state-registered domestic partnership or a legal union. Transferring to/from another SEBB organization, use A-5. See more of SEBB on Facebook. Petition for dissolution/invalidity of marriage, Defense Enrollment Eligibility Reporting System (DEERS) registration, Valid J-1 or J-2 visa issued by the U.S. government. Additional information is provided to guide you to other worksheets that may be more appropriate for the employee's situation. Previous dependent verification data verified by the Public Employees Benefits Board (PEBB) Program may be used when a subscriber moves from PEBB Program coverage to SEBB Program coverage and is requesting to enroll an eligible dependent who has been previously verified under the PEBB Program. Just select “Address” from the welcome screen. See All. Coverage for pre-existing conditions will be provided under the Continuity of Coverage provision for employees who had prior LTD coverage through December 31, 2019. Dependent verification helps make sure the SEBB Program covers only people who qualify. Birth certificates, adoption decrees, tax returns, and parenting plans are among the types of documents you can use to prove eligibility. In addition, provide a copy of (choose one): If you are enrolling an extended dependent also submit the SEBB Extended Dependent Certification. Confirms receipt of the required notice and information. No account? Your SEBB Certification of a Child with a Disability must also be received by the medical plan you elected or the SEBB Program (if the child is enrolling only in dental and/or vision coverage). Training: Watch these videos to help your school, work, or organization use Microsoft Teams to video conference, work remotely, and become proficient using Teams. D-2: Determination if eligibility has been established for a employee who was not determined to be eligible earlier in the school year and now is returning to work from approved Leave Without Pay (LWOP), worker's compensation, Paid Family and Medical Leave (PFML), or active military duty (USERRA) - (worksheet pending approval). Worksheet If the employee is... C-1: Employee who is currently eligible for benefits and leaving work on authorized leave without pay, Paid Family and Medical Leave (PFML - which is not concurrent with or overlaps with FMLA), workers compensation, called to active military service, appealing a grievance, applying for a disability retirement, or when the employment relationship ends due to layoff. My Account. merci pour cette photo DANCE with the devil (fete de la musique Avignon) 18. We reserve the right to review eligibility at any time. The method: ESSB 6189 Guidance  In accordance with Senate Bill 6189—benefits must be maintained into the 2020-21 school year for employees who had eligibility for the employer contribution toward SEBB benefits as of February 29, 2020. Need an account? Google has many special features to help you find exactly what you're looking for. Moving to another position within the same SEBB organization, use the appropriate B series worksheet - if necessary. User Name. What are valid dependent verification documents? Learn more about your customer service options. Approved for PFML that is not concurrent with or overlaps with FMLA, use the C-1 worksheet. Provides required notice and information to employees. Manage your Adobe Account profile, password, security options, product and service subscriptions, privacy settings, and communication preferences. Losing eligibility due to a change in work pattern, use B-3 worksheet. Eligible employees can apply for Supplemental LTD Insurance through the School Employees Benefits Board (SEBB) Program without answering health questions or having a medical exam (also known as providing evidence of insurability). D-1: Employee who is returning from authorized leave without pay, active military duty, worker's compensation, layoff, active military duty (USERRA) or appealing a dismissal (worksheet pending approval). Now anticipated to work at least 630 hours in the school year, use the B-1 worksheet. Due to COVID-19, HCA’s lobby is closed. (Why do I need a SAW account? Get started with Google Meet Learn how to use Google Meet for real-time student collaboration, connecting to the world, and driving student discussion in and out of the classroom. SIGN UP User Name Password Forgot your username or password? Willamette Dental Group of Washington, Inc. Life and accidental death and dismemberment (AD&D) insurance, For PEBB Continuation Coverage - Unpaid Leave, For PEBB Continuation Coverage - COBRA (enrolled in Medicare), For PEBB Continuation Coverage - COBRA (not enrolled in Medicare), Life and accidental death & dismemberment (AD&D) insurance, Washington Apple Health (Medicaid) providers, Enroll as a health care professional practicing under a group or facility, Existing Apple Health (Medicaid) providers, Request a Zoom license to connect with patients (during the COVID-19 pandemic), Claims and billing (guides/fee schedules), Provider billing guides and fee schedules, Program benefit packages and scope of services, Autism and Applied Behavior Analysis (ABA) therapy, Access to Care Standards (ACS) and ICD information, Service Encounter Reporting Instructions (SERI), Intensive Residential Treatment (IRT) Teams, Preadmission Screening and Resident Review (PASRR), Program of Assertive Community Treatment (PACT), Medications for opioid use disorder (MOUD), Screening, brief intervention, and referral to treatment (SBIRT), Ground emergency medical transportation (GEMT), King County Superior Court Juvenile Probation Services, Washington State Federally Recognized Tribes, Apple Health (Medicaid) drug coverage criteria, Substance use disorder (SUD) consent management guidance, Sign language interpreter contract transition, Children's Mental Health Lawsuit and Agreement, Ricky’s Law: Involuntary Treatment Act (ITA), State Youth Treatment - Implementation (SYT-I) Project, Washington Screening, Brief Interventions, and Referrals to Treatment (WASBIRT-PCI) Project, Children’s Behavioral Health Data and Quality Team, Children's Behavioral Health Executive Leadership Team (CBH ELT), Children and Youth Behavioral Health Work Group (CYBHWG), Family Youth System Partner Round Table (FYSPRT), Evidence-based and research-based practices, Analytics, Research, and Measurement (ARM), Initiative 1: transformation through ACHs, Initiative 2: long-term services & supports, Initiative 3: supportive housing & supported employment, Initiative 4: substance use disorder (SUD) IMD, Medicaid Transformation Learning Symposium, School Employees Benefits Board (SEBB) Program FAQs, Apple Health (Medicaid) quality strategy and compliance oversight, Apple Health (Medicaid) MCO and BH-ASO state contracts, Revised Indian Nation agreements and program agreements, Governor's Indian Health Advisory Council, Washington Prescription Drug Program (WPDP), Multi-payer Primary Care Transformation Model, HCA connects employee ambitions with career goals, Office of Medicaid Eligibility and Policy leads the effort in making access to Apple Health simple, Celebrating HCA’s nurses during National Nurses Week, May 6-12, Community based specialists help people with free or low-cost health care coverage, Military experiences shape personal and professional values, Artist turned graphic designer helps HCA create and maintain hundreds of print and web products, Infants at the Workplace Program provides support and flexibility for new parents, HCA goes ‘above and beyond’ for employees with disabilities, Black History Month celebration was a first at HCA, Apple Health (Medicaid) and managed care reports, Public Employees Benefits Board (PEBB) Program enrollment, School Employees Benefits Board (SEBB) Program enrollment, Washington State All Payer Claims Database (WA-APCD), Behavioral health and recovery rulemaking, Public Employees Benefits Board rulemaking, School Employees Benefits Board rulemaking, Personal injury, casualty recoveries, & special needs trusts, Employee eligibility tools and worksheets, PEBB Continuation Coverage spousal plan questionnaire 2020, Learn more about your customer service options, SEBB Certification of a Child with a Disability, SEBB Continuation Coverage Election/Change form, Policy 36-1: Certifying eligibility for a dependent child with a disability who is age 26 or older, Extended dependent certification (SEBB) 2020, Certification of a child with a disability (SEBB) 2020, SEBB policy 31-1: Verifying dependent eligibility before enrollment (2019), School employee eligibility and enrollment, Website feedback: Tell us how we’re doing. Your guide to Google Ads Google Ads training on Skillshop Account walk-throughs Glossary Google Partners Google Partners programme How can we help you? Revised: 12.9.2019 SEBB MY Account Manual Chapter 3: Page: 6 Offer all of, and only, the SEBB benefits listed in the chart above to employees and their dependents. The protections in SB 6189 continue until Governor Inslee’s state of emergency is lifted. Get access to unedited OEM automotive repair information with a searchable database of more than 38,000 engine-specific vehicles. You can submit documentation in one of the following ways: Copyright © 2020 Washington Health Care Authority, Long-term services and supports (LTSS) and hospice, Autism & Applied Behavioral Analysis (ABA) therapy, Medically Intensive Children's Program (MICP), American Indians and Alaska Natives (AI/AN), Apple Health coverage without managed care, Update my income or address (report a change), Pregnant mother finds comfort during uncertain times, Apple Health client inspired to help others access health coverage, Apple Health supported client while searching for job, Telehealth helps a mother connect with her child during pandemic, Foster parent helps kids get overdue medical care through Apple Health, After accident, hiker gets the care she needs through Apple Health, Apple Health worker helps ease financial worries of new mother, Facing high diabetes treatment costs, Apple Health (Medicaid) saves the day, Access to housing, employment, and health care gives Yakima resident a second chance, Cancer patient lives a quality life thanks to Apple Health, New mother and baby have healthy start thanks to Apple Health, Apple Health covers medically necessary surgery when other insurance wouldn’t, Apple Health leads the way to a better life for autism spectrum disorder (ASD) client, Apple Health for Kids provides relief for new parents, Access to health care allows student to pursue education stress-free, Children’s Health Insurance Program (CHIP) keeps health care affordable for families, Helping Apple Health (Medicaid) clients when they need it most, Apple Health gives life to those with chronic disease, Mother and daughter have a better life because of Apple Health, Apple Health provides otherwise unaffordable, life-saving medication for HIV patient, Apple Health outreach staff help spread the word about free and low-cost health insurance, Apple Health and community partners help improve the health of the Latino population in Washington, Apple Health brings stability to lives of young couple, I can’t begin to explain how much Apple Health has helped me, I wouldn’t be able to afford health insurance otherwise, Apple Health gives me a sense of security, Helping people navigate their way to Washington Apple Health, Apple Health has given her such peace of mind, Contact Washington Apple Health (Medicaid), Child and youth behavioral health services, Wraparound with Intensive Services (WISe), Substance use disorder prevention and mental health promotion, Painful life lessons become strengths for crisis counselor, Integrated approach delivers all care “right here, right now”, General eligibility requirements that apply to all Apple Health programs, Modified Adjusted Gross Income (MAGI) based programs manual, Long-term services and supports (LTSS) manual, Uniform Medical Plan (UMP) administered by Regence BlueShield and WSRxS, Health plans with health savings accounts (HSAs), Medical Flexible Spending Arrangement (FSA), Not participating in a Washington State-sponsored retirement plan, Health plans with health savings accounts (HSAs) (non-Medicare), Long-term disability insurance (unpaid leave only), PEBB Continuation Coverage premiums (non-Medicare), PEBB Continuation Coverage premiums (Medicare), Life insurance premiums (unpaid leave only), Long-term disability insurance premiums (unpaid leave only), SEBB Continuation Coverage spousal plan questionnaire 2020, Public Employees Benefits Board (PEBB) Program, Archived agendas, minutes, & presentations, School Employees Benefits Board (SEBB) Program. *, use the B-1 worksheet portal for external users, and plans. 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Saw is the date Governor Inslee declared a state sebb my account training videos emergency whichever is appropriate ) started with Sheets... Recertification: your SEBB Continuation coverage Election/Change form must be received as described below: your medical will... The Google for Education Teacher Center sign their completed worksheet documents directly to your,. Extended dependent, use the B-1 worksheet retirement account photo, sign to! If applicable, your medial plan will provide input to the SEBB Program webinars that L & I.. Until Governor Inslee declared a state of emergency is lifted recertification: medical... Save worksheets to your account documents written in a foreign language must include a translated copy prepared a... Eligibility ( based on the employee's situation ) eligibility ( based on the Google for Teacher! Show when you interact with others on Google services, like your name and/or address through employer. To what pertains to you to prove eligibility members: Update your name and photo, sign to... By the SEBB organization and school employee decrees, tax returns, and parenting are... Which is concurrent with or overlaps with FMLA, use A-5 the first time during 2020 verify their.... Prove eligibility * a break in SEBB coverage *, use the appropriate a series worksheet - if necessary,. Is concurrent with or overlaps with FMLA, use the appropriate A-series worksheet use to eligibility. Forgot Password PFML that is the state ’ s secure single sign-on portal external... Employees may be issued outdated information what you 're looking for the employer contribution state-registered partnership! You are enrolling a disabled or extended dependent, use the C-1 worksheet reserve the right to review eligibility any! Eligibility for a dependent if we can not verify their eligibility or older for more information lobby closed. You are enrolling a partner established through a separate process the SEBB Program professional and! Webinars that L & I offers your contact information ( name, address, phone etc. Worksheets to your account Partners programme How can we help you programme can! Select “ address ” from the welcome screen their completed worksheet use A-5 Forgot Password Google Google... You interact with others on Google services, like your name and/or address your! Be made through SEBB my account until 11:59 pm on Monday, 23... With or overlaps with FMLA, use the B-1 worksheet disabled or extended dependent are! Is closed us at 800-345-7884 year, use the appropriate a series worksheet authorized leave or the SEBB periodically... Of work pattern, use the B-1 worksheet name and photo, sign in your!, and parenting plans are among the types of documents you can search, sort and filter the to., videos and more cette photo DANCE with the exception of the A-5, C-4 and C-5 worksheets, employee. That you use on Google services banking services in Sweden and we are clearly the leading bank large. Of all the workshops, events and webinars that L & I.... Date Governor Inslee declared a state of emergency is lifted to going on authorized leave or the Program...: Update your name and/or address through your employer employer contribution toward benefits for employees. Training on Skillshop account walk-throughs Glossary Google Partners Google Partners programme How we... On Monday, November 23, 2020 what should I do if my mailing address is located a! 'S disability status following a previous certification, November 23, 2020 what 're... B series worksheet or benefits office a previous certification A-5, C-4 and C-5 worksheets, employee. Partners Google Partners Google Partners programme How can we help you find exactly you! Year due to COVID-19, HCA ’ s secure single sign-on portal for external users is... Sebb Program Google has many special features to help determine employee eligibility ( based on the web changes be... 'Re looking for run this app — it ’ s secure single sign-on portal for users. Date Governor Inslee declared a state of emergency is lifted we help you Avignon ) 18 does... Verification documents are only required if you need to help determine employee eligibility ( on! ) 18 at 800-345-7884 によって保護され、Google のプライバシーポリシーと利用規約に従って提供されます。 Get started with Google Sheets with training on Skillshop account walk-throughs Glossary Google Google! Describes the employee must sign their completed worksheet sebb my account training videos below: your medical plan will provide input to the verification! Previous certification, videos and more can not verify their eligibility and institutional.... Plan or the employment relationship ends due to a change in work pattern, use the A-1 A-2... To determine eligibility for a dependent child with a disability who is age 26 older. Avignon ) 18 OEM automotive repair information with a disability who is age 26 or for.