The following frequently asked questions about premium discounts are not meant to be exhaustive. Refer to your health benefits plan book or contact the SEIB for more information.
The non-tobacco user premium discount is a deduction from your monthly health insurance premium available to
subscribers and covered spouses who have not used tobacco products in the last 12 consecutive months.
Yes. A separate non-tobacco user premium discount is available to both the subscriber and the covered spouse.
If you and your covered spouse both use tobacco products, you and your covered spouse will each be subject to a separate tobacco user premium of $60.
Here’s how the premium structure will be applied:
To obtain the discount, you and/or your covered spouse must complete and submit a non-tobacco user premium discount
application to the SEIB verifying that the applicant has not used tobacco products in the last 12 consecutive months.
Applications are available from the SEIB or the website. No refunds are allowed for failure to submit an application.
Employees have 60 days from their enrollment date to apply for the non-tobacco user premium discount. Covered spouses
of active employees, non-Medicare retirees and non-Medicare covered spouses of retirees have 60 days
from their initial effective date of coverage to apply for the non-tobacco user discount.
For those who were not eligible for the premium discount at the date of hire, you or your spouse may apply for the discount
when the applicant has not used tobacco products in the last 12 consecutive months.
It is your responsibility to notify the SEIB immediately if you or your covered spouse starts using tobacco products while the
premium discount is in place. If you fail to notify the SEIB, you could be subject to disciplinary action, up to and including termination of coverage,
and will be required to repay all discounts.
The wellness premium discount is a deduction from your monthly health insurance premium available to those individuals who complete
the wellness requirements established under the SEIB’s Wellness Program.
The SEIB Wellness Program is voluntary and you are not required to participate in the wellness program or any components of the screenings.
If you choose to participate, you will be asked to complete a wellness screening, which includes measuring your height, weight, and waist size,
taking your blood pressure and a blood sample. The blood sample checks your cholesterol (total, HDL (good), LDL (bad), and triglycerides)
and glucose. You will be asked if you have or have had high cholesterol, high blood pressure, or diabetes and if you take medicine for those
conditions. The screening intends to let you know if you are at risk for certain medical conditions resulting from obesity, high blood pressure,
high cholesterol, or diabetes.
You may also have other preventive screenings based on age, sex, and/or diagnosis.
SEIB is offering, through BCBS, a preventive screening premium discount program that encourages healthy habits to
support and improve your overall health. You might ask, “What is a preventive screening?” National guidelines for
managing certain disease processes are recommended to better manage your health. If you are identified, it simply means that you are
missing one or more of the recommended guidelines, such as a lab test, or examination, necessary to manage your health. The program
focuses on the following healthcare standards:
This program applies to all active employees, covered spouses of active employees, non-Medicare retirees, and non-Medicare spouses of
retirees enrolled in the SEHIP (Group 13000)
If previous claims reveal that you have not met the required guidelines for any of the healthcare standards listed above,
you will receive a letter from BCBS outlining the necessary steps required. Members will have until October 31st to receive
the required preventive screenings. If you do not meet the requirements, your monthly premium will increase by $50 per month
beginning January 1st of the following year. However, you are not required to pay the $50 per month premium for the entire year
if you receive the preventive screening anytime during the year.
Yes. A separate wellness premium discount is available to both the eligible subscriber and the eligible covered spouse.
If you and your covered spouse both fail to meet the SEIB’s Wellness Program requirements, you and your covered spouse will
each be subject to a separate premium of $50.
Eligible individuals who are deemed by the SEIB to be at risk for any of the above health risk factors are eligible for an office visit referral with no office visit copay.
The effective date of the wellness premium discount depends on when the screening results and/or other documentation
is submitted to the SEIB. However, for the wellness premium discount to be effective on January 1 of a succeeding
year, you must qualify no later than October 31 of the preceding year.
New employees will have 90 days from their date of hire to apply for the wellness 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 apply for the wellness premium discount.
The Federal Poverty Level (FPL) Premium Discount is a percentage discount off your monthly health insurance premium based
on your adjusted gross income and household size.
Active and retired employees whose adjusted gross income is less than or equal to 300% of the FPL,
as defined by federal law, may be eligible for a percentage discount off the approved premium.
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 adjusted gross income by providing your current
(i.e. immediately preceding year) federal income tax return transcript. The discount will be effective on the first
day of the second month after SEIB’s receipt and approval of the application and transcript. The discount will
expire on June 30th. 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.
You must provide a copy of your current (i.e. immediately preceding year) federal income tax return transcript
when you send the application to the SEIB. If you are married and file taxes separately, you must also include
a copy of your spouses’ current (i.e. immediately preceding year) federal income tax return transcript. Include all pages of the transcript(s).
There is no charge to get your transcript from the Internal Revenue Service (IRS). To receive your free federal income tax
return transcript, visit IRS Get Transcript or call 800-908-9946.
You should receive your transcript within 7-10 business days.
The SEIB will use the number of dependents shown on your federal income tax return transcript to determine your
household size for purposes of calculating your potential premium discount.