View Admin Guide
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
Some of the topics covered in the SEHIP Handbook:
See Handbook for more topics.
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.
Requires that employees who retire after September 30, 2005 take other-employer
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
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
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
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.
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
$45 per month.