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State Employees' Health Insurance Plan (SEHIP)
The State Employees' Health Insurance Plan (SEHIP) is a basic medical coverage available to State employees and their eligible dependents.
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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)
- Retiree Eligibility and Enrollment
- Inpatient Hospital Benefits
- Precertification/Utilization Management
- Maternity Management
Health Insurance Rates
Highlights
State Employees' Children's Health Insurance
Children of State employees may be eligible for coverage under the new State Employees’ Children’s Health Insurance Plan (SECHIP). This is no premium low copay coverage for children ages newborn through 18 years of age. You will be notified by direct mail of the application process.
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
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, 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 will pay 100% of the State share of the premium. Each year less than 25, the State share will be reduced by 2% and the retiree share will be increased accordingly. Each year over 25, the State share will be increased by 2% and the retiree share reduced, accordingly.
Effective August 1, 2008, the SEIB can deduct years of non-State service in calculating the sliding scale retiree health insurance premiums. Exceptions are allowed for service in the US Armed Forces, public education employees and employees in the Teacher's Retirement System, and employees in a post secondary institution who are eligible for PEEHIP.
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 $30 per month. We will notify all active and retired employees of the non-tobacco user certification process by direct mail.
