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State Employees' Health Insurance Plan

The State Employees' Health Insurance Plan (SEHIP) is a basic medical coverage available to State employees and their eligible dependents.

SEHIP Handbook provides all the information regarding the State Employees' Health Insurance Plan.

Some of the topics covered in the SEHIP Handbook:

  • Eligibility and Enrollment
  • Retiree Eligibility and Enrollment
  • Termination of Coverage
  • Continuation of Group Health Coverage (COBRA)
  • Inpatient Hospital Benefits
  • Precertification/Utilization Management
  • Maternity Management

See Handbook for more topics.

Health Insurance Rates

Retiree Re-employment

Congress recently passed the Medicare, Medicaid and SCHIP Expansion Act that established mandatory reporting requirements for group health insurance plans and included significant fines for employers that do not comply. See Details link below for more information.

Retiree Other-Employer Coverage

Requires that employees who retire after September 30, 2005 take other-employer health insurance.

If you retire after September 30 and go to work for another employer, you may be required to enroll in the other employer’s health insurance plan. If you are eligible for coverage in your new employer’s health insurance plan and your new employer contributes 50% or more of the individual premium, you will be required to drop the SEHIP as your primary coverage and enroll in the new health plan. The SEIB will offer you supplemental coverage and supplemental policies to cover most of your out-of-pocket expenses.

Retiree Sliding Scale

Service

Employees retiring after September 30, 2005 will be subject to a sliding scale premium, based on years of service.

If you retire after September 30, 2005, but prior to January 1, 2012 then you will be subject to a sliding scale premium structure based on your years of service. For employees retiring with 25 years of service, the State would pay 100% of the State share premium. Each year less than 25, the State share would be reduced by 2% and the retiree share will be increased accordingly. Each year over 25, the State share would be increased by 2% and the retiree share reduced accordingly. NOTE: this 2% applies to the State share only.

For employees that retire after December 31, 2011, each year less than 25, the State share would be reduced by 4% and the retiree share will be increased accordingly. Each year over 25, the State share would be increased by 2% and the retiree share reduced accordingly.

Age

Employee’s age at retirement. The difference in employee’s age at retirement and the Medicare entitlement age is used in the age component of the retiree sliding scale premium calculation. Most people are entitled to Medicare at age 65 or earlier if disabled.

Subsidy

Section 19.7(e) of Act 2011-698 allows a five (5) year phase-in of the new sliding scale premium increases. No later than October 1, 2016, the net employer contribution to the health insurance for non-Medicare retirees who retire after December 31, 2011 shall not exceed the amount of the employer contribution to cover the cost of an active employee.

Tobacco Policy

SEIB can adjust premiums for avoidable risk factors such as smoking.

If you and your covered spouse are non-tobacco users, your premium can be discounted $50 per month.

Privacy Notices

State Employees' Health Insurance

Resources

Quick Links

Contact SEHIP

Telephone Number 1-866-836-9737
Telephone Number 1-334-263-8341
Fax Number 1-334-263-8541

Other Helpful Links

  • Important Notice About Your Prescription Drug Coverage and Medicare - Learn More