Frequently Asked Questions

State Employees Health Insurance Plan (SEHIP)

The FAQ documents below will help answer some of your questions about the SEHIP.

Who is required to participate in order to receive the wellness discount?

All active employees, covered spouses of active employees, non-Medicare retirees and non-Medicare covered spouses of retirees covered under the State Employees’ Health Insurance Plan Group 13000.

Where can I go for a wellness screening?

You must be screened at one of the following locations:
  Your worksite (through the SEIB’s worksite wellness screening program )
  A certified Participating Pharmacy location ,
  Your county Health Department , or
  A healthcare provider (through the submission of a Provider Screening Form).

What if I am an active employee and my spouse is Medicare eligible?

Both you and your spouse are eligible for a wellness premium discount because your spouse has SEHIP primary insurance coverage and Medicare is secondary.

Are new members eligible to receive the discount?

New employees and spouses are eligible to apply for the wellness premium discount. New employees will have 60 days from the date of hire and non-Medicare spouses will have 60 days from their effective date to apply for the discount.

What health risks are evaluated and how do I know if I am "At Risk"?

Risk factors and levels for at risk members include:

  • Blood pressure systolic reading of 160 or higher or your diastolic reading of 100 or higher;
  • Cholesterol reading is 250 or higher;
  • Glucose reading is 200 or higher;
  • Body mass index is 40 or higher.

What if I am found to be at risk? Can I still receive the discount?

Yes, you can still earn the wellness premium discount if you complete one of the following:

  • Submit health screening results indicating that you are not at risk for one or more of the above health risk indicators, or
  • Submit an office referral form indicating that you have been counseled by a healthcare provider for your identified risk(s), or
  • Submit proof of participation in a SEIB approved exercise or weight management program. You must provide SEIB with the name of the program, dates and location of participation, and a phone number for verification of your participation, or
  • Provide valid proof that you are self-managing and have made improvement in your identified risk(s). You must provide documentation of your improvement, or
  • Submit a completed provider screening form. It’s a good idea to have your provider complete and sign your form while you are in for an office visit. You can mail or fax your screening results to us and have the peace of mind knowing that your discount is in place.

How often should I participate in a wellness screening to continue receiving the discount?

In order to receive the wellness premium discount effective January 1 of any given plan year the criteria listed above should be satisfied no later than October 31st of the preceding year. Please note that it is your responsibility to make sure that SEIB has the required documentation in a timely manner.

How can I check the status of my wellness discount?

You can create an account at mySEIB and view your wellness status or you can call our wellness department at 1.866.838.3059

Please make sure your email address is correct in your mySEIB account. Important communications are periodically sent to members from SEIB.