The calendar is the hardest part to insure.
Private schools, preschools and childcare centers run on calendars that raise questions a typical office never faces.
- Academic-year staff and year-round staff in the same organization
- A summer break that raises who-pays and does-coverage-continue questions
- Ratios and classroom coverage that make group meetings hard to schedule
- Part-time aides, substitutes and after-school staff with variable hours
- Entry-level pay, where the employee's share of premium decides who enrolls
- Public-program assumptions borrowed from school districts
That last point causes avoidable confusion. SEBB is HCA's program for public school districts, charter schools and educational service districts, plus certain other employer groups HCA lists. A private school or childcare center should confirm what it can actually join instead of assuming a public-school program applies.
Illustrative: a 45-person private K-8 school with 30 teachers on academic-year contracts paid over 12 months, eight year-round office and facilities staff, and seven part-time aides. We would put the summer rule in writing for staff, set a measurement method for the aides, check the FTE count against the 50 line, and hold enrollment on the August in-service day with video follow-ups.
Four levers for schools and centers.
Write the summer rule before the school year starts.
An unwritten rule becomes a June emergency.
Put three answers in writing: whether coverage continues over the break, how employees pay their share for the summer months, and what anyone needs to do when school resumes. Don't drop and re-enroll people automatically; check the plan's terms, any leave obligations and the continuation rules first. The ACA also has specific rules for employment breaks at educational organizations, so have payroll or your ACA adviser confirm how summer is counted.
Set eligibility classes that match how people work.
Academic-year, year-round and part-time staff can need different rules.
Eligibility follows hours and plan terms, not titles. A plan waiting period can't exceed 90 days, so choose one that has August hires covered when classes begin. If you're an applicable large employer, full-time means 130 hours of service a month, and variable-hour aides and substitutes can be measured with a look-back period of 3 to 12 months. Check where you stand with the FTE calculator and our ACA compliance checklist.
Test the contribution against entry-level pay.
If staff can't afford their share, they won't enroll.
For an applicable large employer, the employee's share of the lowest-cost self-only plan that provides minimum value can't exceed 9.96% for 2026 plan years and 10.22% for 2027, measured by a safe harbor such as W-2 wages, rate of pay or the federal poverty line. Run it in our affordability calculator. Smaller employers aren't held to that test, but carriers can require up to 75% of eligible employees to enroll, and a share aides can't manage makes that hard to reach.
Explain the extras in plain terms.
Dental, vision and supplemental plans each have their own fine print.
Walk staff through annual maximums, waiting periods and any limits linked to employment status. Accident, hospital and critical illness plans are voluntary benefits, employee-paid through payroll deduction, and they sit beside medical insurance rather than replacing it.
Plan the benefits year on the academic calendar.
Spring: settle summer and next year's contracts.
Before staff leave for the summer, confirm how coverage and premiums work over the break and give every academic-year employee a written summary.
Early summer: review the renewal.
If your plan year starts with the school year, the quiet weeks after classes end are when we compare the renewal with other carriers. Send the census through our employee census page.
In-service days: enroll.
Use a professional development day for the group session, then one-on-one calls or live video for anyone who couldn't step away. Elections close in Employee Navigator.
Fall: onboard new and returning staff.
New hires follow a dated onboarding checklist, and returning staff get confirmation that coverage and deductions resumed as planned.
Winter: check hours and affordability.
Review variable-hour staff against your measurement method, and test next year's contribution before the budget is set.
Schools and childcare centers need different playbooks.
Academic-year schools.
The pressure point is summer. Write the break rule, time the renewal for the quiet weeks, and enroll on in-service days. Teachers on academic-year contracts should know in spring exactly what June through August looks like.
Year-round childcare centers.
The pressure point is coverage on the floor. Ratios make group meetings hard, so plan short sessions before opening or after close, then one-on-ones and live video. Where turnover runs high, the new-hire process and the COBRA handoff matter even more.
What heads of school and center directors ask us.
Are we eligible for SEBB?
Don't assume so. SEBB serves public school districts, charter schools, educational service districts and certain other employer groups HCA lists. A private school or childcare center should confirm with HCA, starting from the SEBB program page, before planning around it.
Can we end coverage in June and re-enroll staff in September?
Not as an automatic routine. Start with the plan terms, then any leave obligations and the continuation rules, and have your ACA adviser look at how breaks are treated for an educational organization. A written summer rule that keeps coverage running is often simpler to administer.
Do substitutes and part-time aides have to be offered coverage?
Federal law doesn't require an employer below the 50 full-time-plus-FTE line to offer coverage, and Washington adds no employer mandate. Your plan's eligibility terms still decide who can enroll. Above the line, the 130-hour monthly test applies, and a look-back measurement method can handle variable hours.
What waiting period makes sense for an August hire?
Whatever your plan sets, within the 90-day federal limit. Pick a rule that has coverage in place once classes begin, put it in the offer letter, and make sure payroll knows when deductions start.
Official references.
Washington Health Care Authority: SEBB program. IRS: applicable large employer status, identifying full-time employees and employer shared responsibility questions and answers. General information, not legal or tax advice.
Send your school calendar with your census.
We'll build the summer rule, the measurement method and the renewal timeline around it. You don't need a current plan to start.