upon the employer group ending participation in insurance plans and contracts with the health care authority (HCA). Routine Routine services are those provided as preventive, not because of an injury or illness. In the case of covered immunizations, routine refers to covered immunizations included on the CDC schedules (see page 66). Same-day surgery center See the “Ambulatory surgery center (ASC)” definition. School Employees Benefits Board (SEBB) The School Employees Benefits Board (SEBB) is a group of representatives, appointed by the governor, who designs and approves insurance benefit plans for school employees and their dependents, and establishes eligibility criteria for participation in insurance benefit plans. School Employees Benefits Board (SEBB) Program The School Employees Benefits Board (SEBB) Program is the program within HCA that administers insurance and other benefits for eligible school employees and eligible dependents. Scientific evidence Scientific evidence means scientific studies published in or accepted for publication by medical journals that meet nationally recognized requirements for scientific manuscripts and that submit most of their published articles for review by experts who are not part of the editorial staff. Scientific evidence also refers to findings, studies, or research conducted by or under the auspices of federal government agencies and nationally recognized federal research institutes. However, scientific evidence does not include published peer-reviewed literature sponsored to a significant extent by a pharmaceutical manufacturing company or medical device manufacturer or a single study without other supportable studies. Scope of practice Scope of practice refers to the services a provider may perform and bill for, based on the provider’s professional license as issued by local authorities. For example, some provider types may prescribe prescription drugs, and some may not. Screening Screening refers to services performed to prevent or detect illness in the absence of disease or symptoms. Secondary coverage When you are covered by more than one group health plan, you have secondary coverage that may pay a part or the rest of a provider’s bill after your primary payer has paid. See the “If you have other medical coverage” section for more information on how this plan coordinates benefits. Skilled nursing care Skilled nursing care is services from licensed nurses in your own home or in a nursing home. Skilled care services are from technicians and therapists in your own home or in a nursing home. 202 2024 UMP Classic (PEBB) Certificate of Coverage