STATE HEALTH BENEFITS PROGRAM (SHBP)
and
SCHOOL EMPLOYEES' HEALTH BENEFITS PROGRAM (SEHBP)
HEALTH BENEFITS FOR
ACTIVE EMPLOYEES
ACTIVE GROUP ELIGIBILITY | PLAN INFORMATION | ENROLLMENT | APPLICATIONS AND FORMS
PRESCRIPTION DRUG PLANS | DENTAL
PLANS | PLAN RATE CHARTS
HEALTH BENEFITS HOME | DEPENDENTS | RETIREES | COBRA | EMPLOYERS
ACTIVE GROUP ELIGIBILITY
Eligibility for Active Group SHBP/SEHBP coverage is determined by the State Health Benefits Program (SHBP) or School
Employees’ Health Benefits Program (SEHBP). All enrollments, changes to coverage,
terminations, etc. must be presented through your employer to the Division of Pensions and Benefits.
FULL-TIME EMPLOYEES
OTHER EMPLOYEES
If you
have any questions concerning eligibility in the SHBP/SEHBP, contact the Division of Pensions
and Benefits.
PLAN INFORMATION AND PROGRAM DESCRIPTIONS
HANDBOOKS AND PUBLICATIONS
PROVIDER INFORMATION — Find a participating doctor or hospital
PRIVACY PRACTICES
OTHER RESOURCES
ENROLLMENT
Employees and their dependents are not covered by the SHBP or SEHBP until enrolled. A Health Benefits
Program Application must be completed and submitted through the employer. Provide all the information requested on the application along with any required supporting
documentation.
APPLICATIONS AND FORMS
COVERAGE OF DEPENDENTS AND CHILDREN
If an employee or eligible dependents are not enrolled within 60 days of the time they first become eligible for coverage, the employee must wait until the next annual Open Enrollment period to do so.
PRESCRIPTION DRUG PLANS FOR EMPLOYEES
The State Health Benefits Commission and School Employees’ Health Benefits Commission
require that all covered employees have access to prescription drug coverage. The type of coverage provided and costs are determined by the prescription drug plan option provided by the employer and the medical plan the employee selects.
PRESCRIPTION DRUG BENEFITS ADMINISTRATOR
Express Scripts (formerly Medco Health Solutions) is the pharmacy
benefits administrator for the SHBP and SEHBP
Express Scripts (Medco) Order and Claim Forms
EMPLOYEE DENTAL
PLANS
The Employee Dental Plans are available
to State employees and to employees of local government and local education employers who elect to participate in the dental plans.
ACTIVE EMPLOYEE MEDICAL and DENTAL PLAN RATES
The Medical Plan Rates Listed Below Show Employer Costs —
Most State Employees and Local Government/Education Employees pay a percentage of the premium or 1.5% of salary, whichever is greater.
STATE BIWEEKLY AND STATE MONTHLY EMPLOYEES — Plan Year 2013
LOCAL GOVERNMENT EMPLOYER GROUP RATES — Plan Year 2013
LOCAL EDUCATION EMPLOYER GROUP RATES — Plan Year 2013
DENTAL PLAN RATES — Plan Year 2013
OVER AGE CHILDREN
RETIRED GROUP RATES
COBRA RATES
HEALTH BENEFITS HOME | DEPENDENTS | RETIREES | COBRA | EMPLOYERS |
Pensions and Benefits: Home | Employer
Manual | Health Benefits | Forms and Publications | Counseling Appointments