Form SI7533 (756494-A) Long-Term Disability Insurance Enrollment / Change Form - School Employees Benefits Board (Sebb) Program - Washington

What Is Form SI7533 (756494-A)?

This is a legal form that was released by the Washington State Health Care Authority - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form SI7533 (756494-A)?
A: Form SI7533 (756494-A) is the Long-Term Disability Insurance Enrollment/Change Form for the School Employees Benefits Board (SEBB) Program in Washington.

Q: Who is eligible to use Form SI7533 (756494-A)?
A: This form is for school employees who are part of the SEBB Program in Washington.

Q: What is the purpose of Form SI7533 (756494-A)?
A: The purpose of this form is to enroll in or make changes to the long-term disability insurance coverage offered through the SEBB Program.

Q: What information do I need to provide on Form SI7533 (756494-A)?
A: You will need to provide personal information, employment details, and make selections regarding your long-term disability insurance coverage.

Q: Are there any deadlines for submitting Form SI7533 (756494-A)?
A: Yes, you must submit this form within 31 days of becoming eligible for the SEBB Program or within 31 days of a qualifying life event.

Q: Who can I contact for assistance with Form SI7533 (756494-A)?
A: You can contact the SEBB Program directly or reach out to your school district's benefits office for assistance with this form.