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Federal Poverty Level (FPL)

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 total household 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 to the SEIB and furnish acceptable proof of total annual household income by providing your current (i.e. immediately preceding year) federal income tax return transcript ( View Sample Transcript ). 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.

Click on the links below for more details.