Available Benefit Premium Discounts and Waivers 2026

If you and/or your covered spouse have not used tobacco products in the last 12 consecutive months, you may be eligible for a non-tobacco premium discount. The non-tobacco premium discount will be applied as follows:

• If you or your covered spouse, do not use tobacco products, your non-tobacco premium discount will be $65 per month off of the base premium.
• If you and your covered spouse do not use tobacco products, your monthly non-tobacco premium discount will be $130 ($65 for you and $65 for your covered spouse) off of the base premium.

To obtain the discount, you must submit a completed non-tobacco premium discount application (IB05) to the SEIB. When the SEIB approves the application, you and/or your covered spouse will receive the non-tobacco premium discount and will continue to receive the discount if you and/or your covered spouse remain tobacco-free.

If you and/or your covered spouse have used tobacco products within the last 12 consecutive months, eligibility for the non-tobacco premium discount may be obtained by completing the SEIB tobacco cessation program (Quit Now). Upon completion of the Program, you must submit a completed annual tobacco user premium discount application (IB06) , along with required documentation, to the SEIB. It is your responsibility to ensure the SEIB receives your application. If you continue to use tobacco products, you must complete the tobacco cessation program each year and submit a tobacco user premium discount application (IB06) each year in order to receive the non-tobacco premium discount.

Employees have 90 days from their enrollment date to apply for the discount. Covered spouses of active employees, non-Medicare retirees, and non-Medicare covered spouses of retirees have 90 days from their effective date of coverage to apply for the discount.

All active employees, covered spouses of active employees, non-Medicare retirees and covered non-Medicare spouses of retirees enrolled in the SEHIP as their primary insurance plan are eligible for the Wellness Premium Discount by participating in the Achieve Wellness Program. To receive the $50 per month discount off the base premium, the following Achieve Wellness Program requirements must be completed by October 31st of each plan year:

• Annual Wellness Screening
  
  • Everyone – once every year
  • If a Risk Factor is identified during the screening, a referral will be issued to follow up with your healthcare provider.
  • New employees will have 90 days from their date of hire to apply for the Wellenss Premium Discount. Covered spouses of active employees, non-Medicare retirees, and non-Medicare covered spouses of retirees have 90 days from their effective date of coverage to complete the Annual Wellness Screening requirement.
  • Active employees, covered spouses of active employees, non-Medicare retirees and non-Medicare covered spouses of retirees can be screened at any one of the following locations.
    • ADPH Worksite Screenings
    • SEIB Wellness Center Screenings
    • Participating Wellness Screening Pharmacy Locations
• Colon cancer
  • Everyone Age 45 - 75
  • Colon Cancer Screenings
    One of the following is required:
    • Colonoscopy – once every 10 years
    • CT Colonography – once every 5 years
    • Sigmoidoscopy – once every 5 years
    • Cologuard Test – once every 3 years
    • Fecal Occult Blood Test – once every year
• Cervical cancer
  • Females Age 21 - 65
  • Pap smear once every three years
• Breast Cancer
  • Females Age 40 - 74
  • Mammogram once every 2 years.
• Diagnosed diabetics
  • Diabetes Eye Exam – once every year*

^{* Please email your test results to wellness@alseib.org or you may fax them to 334-859-6580. All documents faxed should include your name, date of birth, and insurance contract number.}

If you are unable to participate in the Achieve Wellness Program, you may be entitled to a reasonable accommodation or an alternative standard. You may request a reasonable accommodation or an alternative standard by contacting the SEIB Wellness Division at 1-866-838-3059 or 1-334-859-6641.

Employees and retirees whose spouses are enrolled in the SEHIP will be charged a $50 per month surcharge. The SEIB will waive $25 of the surcharge if the spouse is not eligible for other group health insurance coverage or the single monthly premium is $255 or more.

To have $25 of the spousal surcharge waived, you must complete the New and Active Employee Spousal Surcharge Waiver Application (IB25) or Retired Employee Spousal Surcharge Waiver Application (IB28) and submit the completed form, with appropriate documentation, to the SEIB.

If your spouse has retired or become unemployed since you filed your last tax return, you will also need to submit the Unemployed or Retired Spouse Verification (IB27).

Employees have 60 days from their enrollment date to apply for the spousal surcharge waiver. Covered spouses of active employees, non-Medicare retirees, and non-Medicare covered spouses of retirees have 60 days from their effective date of coverage to apply for the spousal surcharge waiver.

Full-time State employees and retirees enrolled in the State Employees’ Health Insurance Plan (SEHIP) may qualify for a premium discount based on family size and your and your spouse’s adjusted gross income. The assistance is provided in the form of a percentage discount off the approved premium.

The premium discount will be applied as follows:

• Over 300% of the FPL – employee pays 100% of the employee contribution
• 251% to 300% of the FPL – employee contribution reduced by 10%
• 201% to 250% of the FPL – employee contribution reduced by 20%
• 151% to 200% of the FPL – employee contribution reduced by 30%
• 101% to 150% of the FPL – employee contribution reduced by 40%
• 100% or less of the FPL – employee contribution reduced by 50%

In order to obtain the discount, you and your spouse must submit a completed FPL Premium Discount Application (IB12) to the SEIB and furnish acceptable proof of your adjusted gross income by providing your current (i.e. immediately preceding year) federal income tax return transcript ( View Sample Transcript ). The deadline to submit the application and transcript for recertification is May 30th. The discount will be effective the first day of the second month after SEIB’s receipt and approval of the application and transcript. The discount will expire June 30th of the following year. You must reapply every year. No refunds will be allowed for late or incomplete applications. No refunds will be allowed for failure to submit an application.

The discount does not apply to members on Leave of Absence, COBRA, or surviving dependent coverage.

For families/households with more than 8 persons, add $5,500 for each additional person.

Discounts are based on your income not exceeding the amount in the table for the applicable discount.