Open enrollment just started for most Washington workers and residents who get health insurance either through their private employers or the state-run marketplace.

But for roughly 147,000 public-school employees here, there’s just one week left to enroll in the first year of their new statewide health care system. If they fail to select a preferred plan by Nov. 15 or don’t affirmatively waive their benefits, the state will place them in a default plan whether it’s wanted or not, charge them a monthly fee for tobacco use (even if they don’t use it) and not enroll any of their dependents.

As of Thursday, just under two-thirds, or about 94,000, of the workers eligible for the new benefits have already picked their preferred plan, according to the Washington State Health Care Authority (HCA). But in King County, only 53% of eligible workers have completed their enrollment.

“All the surrounding counties are about to break the 70% mark,” said David M. Iseminger, director of the HCA’s employees and retirees benefits division.

“Residents of King County are noticeably behind in completing their enrollment,” he added.

Iseminger couldn’t speculate as to why enrollment trailed in King County. But he noted completion rates were at or above 66% in Clark and Spokane counties.


Up until this year, every school employee in Washington counted on their school districts and labor unions to negotiate health benefits. But in 2017, lawmakers centralized control of those plans in a statewide School Employees Benefits Board, both to offer consistency in benefits across 295 school districts and potentially save the state money over time.

(That board operates similar to the Public Employees Benefits Board, which for decades has adopted the health-insurance plans, established eligibility criteria and set the premium rates for 370,000 state workers and their dependents.)

In August, school employees got their first peek at the medical plans and monthly premiums that the state board set for coverage starting Jan. 1, 2020. Details vary county to county, and workers can compare plans online. But employee-only premiums range from as low as $13 to no higher than $116, according to the HCA.

Iseminger highlighted some notable changes:

  • Previously, some part-time workers paid up to $2,000 to cover their dependents, meaning many received nothing on their paychecks and actually owed their school districts money to cover premiums. Now, the cheapest plan to cover dependents will cost $39 a month, with the most expensive at $348.
  • Under the district-level system, spousal coverage meant a couple both working for a school could dual enroll and cover themselves twice. The new statewide board does not allow dual enrollment.
  • There’s also no monthly premium for dental and vision plans. Districts will cover that cost for both employees and their dependents.

Since the early 1990s, lawmakers have debated whether to hand control of school-employee health benefits to the state. Now that it’s a reality, Iseminger suspected disbelief may explain some of the delays in this first round of open enrollment.

“We do hear pockets of questions: ‘Is this really happening? This has been talked about for almost 30 years,'” he said.

“This is really happening.”