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Benefits & Retirement

Next Open Enrollment Period is October 25, 2021 to November 22, 2021.  New elections effective January 1, 2022.

SEBB Benefits - as of January 2021

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Medical                                   Employee Monthly Premium                                        Annual Medical Deductible      
PLAN DEFAULT SEBB 
CODE
EMPLOYEE
ONLY

EMPLOYEE &
SPOUSE

SUBSCRIBER &
CHILDREN (2) 
FAMILY  
Kaiser Access PPO 1 Kaiser K01

K01ER
$66.00

K01SR
$132.00

K01CR
$116.00
K01FR
$198.00
 
Kaiser Access PPO 2 Kaiser K02 K02ER
$97.00
K02SR
$194.00
K02CR
$170.00
K02FR
$291.00
 
Kaiser Access PPO 3 Kaiser K03 K03ER
$146.00
K03SR
$292.00
K03CR
$256.00
K03FR
$438.00
 
               
Kaiser KPWA Core 1 Kaiser KW1 KW1ER
$16.00
KW1SR
$32.00
KW1CR
$28.00
KW1FR
$48.00
 
Kaiser KPWA Core 2 Kaiser KW2 KW2ER
$21.00
KW2SR
$42.00
KW2CR
$37.00
KW2FR
$63.00
 
Kaiser KPWA Core 3 Kaiser KW3 KW3ER
$91.00
KW3SR
$182.00
KW3CR
$159.00
KW3FR
$273.00
 
               
Premera Blue Cross High PPO Premera PH PHER
$76.00
PHSR
$152.00
PHCR
$133.00
PHFR
$228.00
 
Premera Standard PPO Premera PS PSER
$28.00
PSSR
$56.00
PSCR
$49.00
PSFR
$84.00
 
               
UMP Achieve 1 Regence V VUER
$33.00
VUSR
$66.00
VUCR
$58.00
VUFR
$99.00
 
UMP Achieve 2 Regence VA VAER
$98.00
VASR
$196.00
VACR
$172.00
VAFR
$294.00
 
UMP HDHP Plan Regence VHSA VHSAE
$25.00
VHSAS
$50.00
VHSAC
$44.00
VHSAF
$75.00
 
               
Tobacco Surcharge N/A   $ 25.00        
Spousal Surcharge N/A   $ 50.00        
SUPPLEMENTAL PLANS                                                                                                    VENDOR WESPAC CODE EMP ONLY EMPLOYEE & SPOUSE EMPLOYEE & CHILD FAMILY DISTRICT
Life Insurance and AD&D Metropolitan Life                                 Included         $3.95
Supplemental Life Metropolitan Life N/A (self bill)          
Long-Term Disability Standard Insurance Included         $2.10 
Supplemental LTD Standard Insurance LTDBU    

Vendor: Standard000

Medical Flexible Spending Navia HCFSA     Vendor: HCA-SEBBFlexSpend
Dependent Care Assistance Navia DCFSA     Vendor: HCA-SEBB000
Health Savings Plan Health Equity Included $31.25 $ 62.50 Vendor: HCA-SEBBFlexSpend

 

DENTAL PLANS DEFAULT SEBB CODE WesPac Code EMP ONLY

EMPLOYEE
& SPOUSE

EMPLOYEE
& CHILD
FAMILY DISTRICT
Delta Care Delta Dental 3S           $41.33
Uniform Dental Delta Dental 4S           $48.67
Willamette Willamette 9S           $49.90
VISION PLANS DEFAULT TZ            
Davis Vision Same T1           $4.36
Eye Med Same T2           $5.96
Met Life Same T3           $6.66
VENDOR (BILLING)                
 

Additional Benefits (Continuing)                  

VEBA Trust (PSE, Teamsters, Prof-Techs, Administrators, SEIU)     

  •  888-828-4953

VEBA Enrollment Form
Employee Assistance Program

 

  • Free, confidential help 24 hours a day at 360.715.6565 or 800.244.6142