The SEHIP Planbook provides important information regarding the State Employees' Health Insurance Plan. Use the links below to view specific sections of the Planbook.
Medical Benefits (BCBS):
Health Planbook
Summary Benefits
Prescription Benefits (OptumRx):
Prescription Drug List
Preventive Care Medications
Additional Benefits: (SEIB)
Vision Care Network
Forms:
Summary of Benefits and Coverage
The Summary of Benefits and Coverage (SBC) is a short summary of coverage designed by the Department of Health and Human Services. The SBC provides a snapshot of coverage but does not contain all benefits, limits and exclusions provided to you. The SBC does not replace the more detailed summary of benefits found in the plan benefit matrix or a plan benefit booklet provided to you by the SEIB. For detailed plan benefits please view our planbook listed above.
SEHIP Summary of Benefits and Coverage
The State Employees’ Health Insurance Plan (SEHIP) is a self-insured employer group health benefit plan. This means that the State of Alabama assumes the risk of providing health care benefits for its employees instead of paying a risk premium to a third party to provide health insurance coverage.
The State Employees’ Insurance Board (SEIB) is a state agency established by the Alabama Legislature to administer the SEHIP pursuant to Alabama Code Sections 36-29-1 through 36-29-19.8.
The membership of the SEIB is composed of 11 members pursuant to Alabama Code Section 36-29-2. The members include the five members of the State Personnel Board, the Director of Finance, the Secretary-Treasurer of the Employees' Retirement System of Alabama, two elected active employees of the state and two elected retirees covered under the SEHIP.
The cost of providing health care benefits is simply a function of the amount of claims incurred by our members and paid by the SEHIP to the providers of service (plus administrative costs).
The cost to administer the SEHIP is less than 5% of total expenses. This means that more than 95 cents of every dollar expended on the SEHIP goes directly to paying member claims. Administrative costs are primarily composed of amounts paid to BCBS and OptumRx to process claims, SEIB personnel costs and consulting fees.
