Options for Members Without Other Group Health Insurance (OGHI)

State Employees’ Health Insurance Plan

The State Employees' Health Insurance Plan (SEHIP) is basic hospital medical coverage administered by BlueCross BlueShield of Alabama (BCBS) with prescription benefits administered by OptumRx. This plan is offered to state employees who do not have OGHI coverage available through a spouse, other employer or previous employer. It is intended to help you and your covered dependents pay for healthcare costs. This option requires:

• Monthly premiums
• Copays, coinsurances and/or deductibles for health and pharmacy services
• Monthly 1) wellness premiums, 2) premiums for tobacco use, 3) gap in care surcharges (if identified) and 4) spousal surcharges for those members adding a spouse as a dependent. Discounts, incentives, and waivers are available.

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Options for Members With Other Group Health Insurance (OGHI)

The following plans are available to state employees when they have OGHI available through a spouse, other employer or previous employer:

Premium Cash Option

The Premium Cash Option (PCO) is a premium-only Health Reimbursement Arrangement (HRA) administered by ConnectYourCare and funded solely by the State of Alabama to reimburse full-time, active State employees for eligible OGHI premiums.

• There is no fee to enroll
• Reimburses up to $175 per month to offset your OGHI premium. For monthly premium reimbursements less than $175, the balance remains in your HRA for later use.
• The monthly reimbursement can be mailed directly to you or direct deposited into your checking or savings account.
• Eligible to participate in the SEIB Wellness Program.

You may not enroll in the PCO if your OGHI is with the SEHIP, Medicaid, Medicare, or the Marketplace. Members enrolled in the PCO can disenroll and return to the SEHIP on the first day of any month.

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Optional Plan

The State Employees’ Insurance Board Optional Insurance Plan (Optional Plan) provides dental, vision, cancer, and hospital indemnity coverage, all-in-one. This Plan is administered by Southland Benefit Solutions (Southland) and is offered at no cost to you. Participants may elect individual or family coverage. This option provides the following great benefits:

• Enrollment in the Optional Plan is free.
• The dental benefits included in the Optional Plan include an extensive provider network with enhanced benefits.
• Cancer and Hospital Indemnity benefits are paid directly to you.
• Eligible to participate in the SEIB Wellness Program.

You may not enroll in the Optional Plan if your OGHI is with the SEHIP or Medicaid. If you are an active employee and your primary coverage is TRICARE, you are not eligible for the Optional Plan. After 12 months in the Optional Plan, members can disenroll and return to the SEHIP during Open Enrollment.

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Supplemental Plan

The State Employees’ Supplemental Coverage Plan (Supplemental Plan) is administered by Blue Cross Blue Shield of Alabama. If you enroll in coverage through an eligible employer group health plan, you can opt out of the SEHIP and elect supplemental coverage through the SEIB, at no charge. The SEIB Supplemental Plan will cover most of your out-of-pocket expenses that your primary OGHI does not cover 100%.

• The Supplemental Plan is free for you and your eligible dependents.
• The Supplemental Plan pays for copays, coinsurances, and/or deductibles
• Members enrolled in the Supplemental Plan can enroll in or continue Stand-alone dental, vision, and/or cancer policy coverage with the SEIB.
• Eligible to participate in the SEIB Wellness Program.

You may not enroll in the Supplemental Plan if your OGHI is with the SEHIP, Public Education Employees Health Insurance Program (PEEHIP), Local Government Health Insurance Program (LGHIP), the Marketplace, TRICARE, Medicaid or Medicare. OGHI plans with an in-network deductible higher than $1,350 for individual or $2,700 for family coverage are not eligible. Members enrolled in the Supplemental Plan can disenroll and return to the State Employees’ Health Insurance Plan (SEHIP) on the first day of any month.

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Decline Health Coverage

State employees have the option to decline all health coverage options offered through the SEIB. If you are enrolled in one of the Stand-alone policies and select this option, your coverage will continue for the Stand-alone policy unless you submit a separate Enrollment/Cancellation Form (IB21).