2.2. When combined with the beneFIT Well-Being Program, State employees have all of the resources and options necessary to make informed health care decisions and healthier life choices. Telemedicine provides quick access to a doctor over the phone, email or video call and can often eliminate visits to your primary care physician (PCP), urgent care center, or ER and the high costs associated with those visits. State employees can make allowed changes to health insurance through December 31, 2020. No action is required if you wish to keep your current health plan. An employee hired for at least 4.5 months (one semester) at 100% time. In general, managed care plans, such as, There are several managed care plans located throughout the state available to State members. Capitol Square Healthcare. Welcome to the State of Florida MyBenefits Website! Health Savings Account (HSA), CDHP/HSA members will receive a $500 State contribution for an individual member or $1,000 for family. If you and your spouse (or civil union partner) are both employees of the University of Illinois or any other State of Illinois agency, and both are eligible for SEGIP coverage, then you must each be insured individually. To be eligible for SEGIP health insurance benefits, you must meet the following criteria: 1. Enhanced benefits are available for QCHP members who receive services from a New this year to active State employees is the Reduced Tier 1: The Reduced Tier 1 pharmacy benefit is available through an HMO carrier. You are encouraged to use in-network providers for the lowest out-of-pocket costs in the QCHP. The Division of State Group Insurance is pleased to present a wide selection of pretax ⦠Out-of-network providers are paid based on the Maximum Reimbursable Charge (MRC), which is the maximum that the insurance company will pay for billed services, after your deductible is met. In this case, you will be responsible for a portion of the State’s contribution to your group insurance premium cost in addition to your employee contribution. Consumer Driven Health Plan (CDHP). Prior to receiving health care out-of-network, always contact the plan to complete the pre-determination process to ensure the services meet medical necessity criteria. There are no employee premiums for dental coverage, basic life, basic accidental death and dismemberment, and basic long-term disability insurance. State Health Plan Coverage. For a map of the health plans available in your area, see the Health Plan Map. Active Employees. Office of Employee Health & Benefits Phone: (207) 624-7380 or 1-800-422-4503 TTY: dial Maine Relay 711. The level of coverage for specific services varies among plans. Contact plan for additional details. Out-of-pocket costs in an HMO are usually lower than other plans. Be covered under a high deductible health plan. The deductibles do not cross accumulate across Tier II and Tier III, meaning that the deductible paid for services in one tier are not applied toward the deductible in the other tier. An OAP combines the benefits of an HMO and traditional health coverage. Full-time employees who are eligible for and/or enrolled in SEGIP may, with proof of other non-State comprehensive health coverage, elect not to participate in SEGIP health insurance. You are allowed to mix and match providers among all tiers. To be eligible for SEGIP health insurance benefits, you must meet the following criteria: You may also cover eligible dependents on a SEGIP health plan. The University of Illinois System is the flagship higher education system in the state of Illinois. Take a look at your 2020 benefits now! Out-of-pocket costs are based on coinsurance, which is a percentage of the lesser of total billed cost or MRC for eligible services. Out-of-pocket costs vary between plans – see your plan’s Summary of Benefits and Coverage. You may opt out of health/vision and dental coverage and provide supporting documentation on CMS MyBenefits. Employees are eligible for health benefits if they have an appointment of more than six months (at least six months plus one day) and a time base of half-time or more. To find providers, see Provider Directories. It looks like your browser does not have JavaScript enabled. Health Maintenance Organizations (HMOs) and the For more information regarding ⦠This includes Part A, Can’t be claimed as a dependent on someone else’s tax return. Open Access Plan (OAP), deliver healthcare through a system of network providers and have a lower monthly premium than the Quality Care Health Plan (QCHP). Welcome to the Statewide Benefits Office (SBO) website. All SEGIP health plans include coverage for physical health, behavioral/mental health, emergency care, and prescription drugs. QCHP network provider. Both are designed to make it easier for you to compare your options and understand exactly what you are buying. See Part-Time Employees. View up to date information on how Illinois is handling the Coronavirus Disease 2019 (COVID-19) from the See your plan’s Summary of Benefits and Coverage for more details. Out-of-pocket costs are based on a percentage of in-network charges and out-of-network allowable charges, after the plan year deductible is met. NOTE: Although your employment status may be classified as full-time, your eligibility for the State Employee Group Insurance Program could be classified as part-time based on an annual review of hours worked conducted by Central Management Services (CMS). The QCHP includes a nationwide network of providers to choose from. For a more comprehensive comparison of all the plans being offered for FY21, click on the following links to: You will now have telemedicine available to you under your HMO and OAP health plans for a reduced copayment. You may enroll in or change your SEGIP health plan only at the following times: See HMOs for more details. In addition to managed care, the State plan offers the A temporary employee with an appointment of 50% or more for at least 9 months. This program provides insurance benefits (health, dental and life) for current and certain former elected state officials and the employees under their jurisdiction, employees of state agencies, boards, ⦠Whether you are a new employee, current employee, or recently separated employee, this is the place to learn about your benefits. Quality Care Health Plan (QCHP), administered by Benefits Service Center www.cityofchicagobenefits.org 1-877-299-5111 8 am - 5 pm ⦠This information is intended as a general overview of SEGIP health plans. To find providers, see Provider Directories. There is a separate annual plan year deductible for prescription drugs. For additional details, refer to the following sections of the State Employee Benefits Handbook: Eligibility Requirements beginning on page six, Contribution Payment beginning on page 17, and Time Away from Work beginning on page 20. In order to provide you with targeted information about your benefits⦠RSL BasicCare - A separate limited plan offered to employees ⦠This tier allows members to obtain specific medications in either a 30- or 90-day supply for a reduction of the normal tier 1 applicable copayment. You may opt out during your 30 calendar day initial enrollment period, during the annual Benefit Choice period, or within 60 calendar days of an eligible qualifying event. Your PCP will manage your health care and treatment plans, and will issue referrals for specialized services. The health insurance plans available to State members differ in the benefit levels they provide, the doctors and hospitals you can access and the out-of-pocket cost ⦠provider. And, no waiting for an appointment in a room full of other sick people. You can visit a CVS Caremark Flu Shot network pharmacy or your doctorâs office. For eligibility and benefits administration questions, please contact SHBP Member Services via email at SHBPservicecenter@adp.com or by phone at 800-610-1863. In addition to managed care, the State plan offers t, Members will find a listing of providers who participate in the health plan's network when they go to the, State of Illinois Deferred Compensation Plan (“Plan”), State of Illinois Coronavirus Response Site, Understand How You Pay for Healthcare in Each Plan, glossary of health coverage and medical terms, Register, Become a Vendor & State Government. The following is New IRS Guidance for State Employees which can affect your Flexible Spending (Pre-Tax) Contributions for FY20 & FY21, click here: Maintenance Choice: The Maintenance Choice tier is available to those members covered under an OAP, QCHP or CDHP. You can ask for an estimate of the amount that the plan will pay if you provide detailed provider and procedure code information from your doctor. HSAs are portable. The New Jersey State Health Benefits Program (SHBP) and School Employees' Health Benefits Program (SEHBP) offer employees and their covered dependents the opportunity to join a ⦠State Employee Health Benefits Program 109 SW 9th St #600 Topeka, KS 66612 785-368-6361 SHBP Member Services Extended Hours ⦠Consumer Driven Health Plan (CDHP) members may This tier allows members to obtain specific medications in a 90-day supply from a CVS Caremark® pharmacy or through the CVS Caremark® Mail Service Pharmacy for half of the copayment. See your plan’s Summary of Benefits and Coverage for more details. A temporary employee with an appointment of 50% or more for at least 9 months. Have no other health coverage (except what is permitted under Other health coverage: Not be enrolled in Medicare. Certain HMO and OAP plans are only available in certain regions. The health insurance plans available to State members differ in the benefit levels they provide, the doctors and hospitals you can access and the out-of-pocket cost to you. glossary of health coverage and medical terms. An out-of-network provider is considered Tier III. For plan details, refer to the Summary of Benefits and Coverage and the Benefit Choice booklet. You can ask your OAP for an estimate of the amount that the plan will pay if you provide detailed provider and procedure code information from your doctor. CDHP has a nationwide network View the PayFlex Quick Reference Guide for more details. Search by agency, individual name, position, salary, or even ⦠Either or both spouse(s) may elect health coverage for dependents; however, the same dependent cannot be enrolled under both spouses for the same type of health, dental, or life insurance coverage. Mailing Address 61 State House Station Augusta, ME 04333-0061. Please turn on JavaScript and try again. Chicago Benefits Office 333 South State Street - Room 400 Chicago, IL 60604-3978 8:30 am - 4:30 pm Monday - Friday. Your plan can provide you with additional information regarding this benefit. Health Benefits Overview. The Affordable Care Act rules require health plans to provide a Aetna, which allows plan participants to access any provider nationwide. • Benefits information for State of Maine active employees and retirees The programs administered by the State of Maine's Office of Employee Health & Benefits are listed to the left. responsibility to know and follow the specific requirements of the CDHP. You will usually not need to submit any claim forms, unless emergency care takes place outside of your coverage area. The Tier II network offers an expanded range of providers to choose from, but you will pay copays, coinsurance, and have an annual plan year deductible. Except for emergency services, generally HMOs WILL NOT COVER services rendered by out-of-network doctors or other non-participating providers. Eligible employees have 60 calendar days from the date of appointment or a permitting event to enroll in a health ⦠Benefits The goal of the South Dakota State Employee Benefits Program is to offer quality, affordable health care and flexible benefits options. You may contribute an additional amount to your HSA through pre-tax payroll deductions or a post-tax direct payment. State Employees Group Insurance Program (SEGIP) health insurance is available to employees who meet the eligibility criteria and to eligible dependents. The Plan offers health benefits to teachers, state employees, retirees and their dependents. You may also cover eligible dependentson a SEGIP health plan. If you are a retiree, please visit NYSHIP Online for Retirees. The State Employee Group Insurance Program (SEGIP) provides comprehensive medical and pharmacy coverage. Welcome to NYSHIP Online, where you will find information on the New York State Health Insurance Program for State and Local Government for active employees. Employee Salary Database The Employee Database tracks salary information on state employees from the current year as well as previous years. See QCHP for more details. • Biweekly paid employees will see half the total cost deducted from each of 24 pay checks (no premium is deducted from the third pay when there are three pay checks in the same month). The PCP you choose must be within the health plan’s network, which is typically limited to a specific region. The new requirements will also make it easier for employers to compare health insurance options to provide for their employees. When appropriate, the consulting doctor can prescribe a medication and send the prescription to the member's preferred pharmacy. Two dental plans are available through SEGIP. Unprotected dock time (e.g., unapproved absences, unpaid personal leave, suspension) greater than 30 days during the audit period (June 1 – May 31 each year) will result in this change to part-time status for State group insurance purposes (effective 9/1). You must be eligible to participate in SURS. And, when paired with the You will incur high out-of-pocket costs when using Tier III/out-of-network providers. You cannot be enrolled in both an HSA and the MCAP Flexible Spending Account. Benefits are outlined in the plan's Summary Plan Document (SPD). Your employee contributions for SEGIP health plan premiums are based on your annual salary and the health plan selected and are deducted from payroll. It is the member's In general, managed care plans, such as summary of benefits and coverage (SBC) and a choose any physician or hospital for medical services; however, members receive enhanced benefits, resulting in Hours: Mon-Fri ⦠Eligible part-time employees also pay a portion of the State contribution in addition to the employee cost. The CDHP has an annual plan year deductible that applies to medical services and prescription drugs. If you have any questions about your benefits, please contact your agency's Benefits Coordinator or the Employee Benefits Division: ebd.mail@maryland.gov 410-767-4775 General Information 1-800-30-STATE ⦠Please contact your HMO to determine if your medication is available under this benefit. The HSA is a tax-saving, interest bearing account that active employees can use to pay for qualified medical expenses now, or in the future. Please contact CVS Caremark® to determine if your. The QCHP has an annual plan year deductible that applies to most services. During the annual Benefit Choice period in May. Members will find a listing of providers who participate in the health plan's network when they go to the provider directory page on the plan's website. Your cost will typically be lowest while using Tier I providers – services are usually covered with only a copay, similar to an HMO. In the employee contributions table, the Managed Care column lists rates for HMO and OAP plans; the Quality Care column lists rates only for the QCHP. The flu shot is free under your PEBTF/REHP benefits. See OAPs for more details. Youmust enroll or reenrollin a Flexible SpendingAccount each plan year. There are several managed care plans located throughout the state available to State members. Eligible part-time employees may elect to waive SEGIP coverage. Each individual program's ⦠Tier III (out-of-network) providers are paid at a percentage of the Maximum Allowable Charge (MAC) based on Medicare rates in a geographical location, after the deductible is met. Four types of health plans are available: Health Maintenance Organizations (HMOs), Open Access Plans (OAPs), Quality Care Health Plan (QCHP), and the Consumer Driven Health Plan (CDHP) with a companion Health Savings Account (HSA). lower out-of-pocket costs, when receiving services from a CDHP in network A regular employee with an appointment of 50% or more. Group Insurance Commission GIC State Employee Benefits GIC State Employee benefits include health, life, dental and vision, long term disability, flexible spending accounts, and employee assistance programs⦠The MCAP benefit is notavailable if enrolling in an HSA. However, you or your provider will need to seek pre-authorization for certain services/care. Dependent premiums are separate and in addition to your employee premium. To find providers, see Provider Directories. Page Content. The specific plan administrator is determined by the plan in which you enroll. Contact Us. If you enroll in the CDHP, you may choose any provider or hospital for medical services, however, you will experience lower out-of-pocket costs when receiving services from a CDHP in-network provider. Capitol Square Healthcare provides on-site, affordable, preventive, primary and acute care services for state employees, covered spouses and covered children ages 2 and older, ⦠See Part-Time Employees. When you see a health care provider, you will also typically pay some out-of-pocket expenses such as copays, coinsurance, and/or deductibles. An employee hired for at least 4.5 months (one semester) at 100% time. medical, prescription, dental, vision, life) for State of Montana Employees⦠NYSHIP Opt-out Employees ⦠The benefit levels listed in the SBCs go into effect July 1st of each year. The dental benefit for retired state employees differs from the plan for active state employees, although the plan administrator is the same. The provider networks in an OAP are divided into two separate benefit levels called Tier I and Tier II. Urbana-Champaign: Employee Development and Learning, Chicago: UIC HR Professional Development/Training, System Offices Professional Development Guidelines, System Offices Educational Funding Program, Distinguished Employee Leadership and Team Award (DELTA), Staying Engaged and Energized While Remote Working, Policy & Benefits Administration Contacts, System Office Performance Appraisal Information, https://www.irs.gov/publications/p969#en_US_2019_publink1000204039, Glossary of Health Coverage and Medical Terms. Health insurance carriers have announced changes for 2021. Benefit Programs. State/University employees may not enroll as a dependent of their spouse in either SEGIP, Local Government Health Plan, Teachers' Retirement Insurance Program, or the College Insurance Program. Prior to receiving health care under Tier III, always contact the OAP to obtain preauthorization of benefits to ensure services meet medical necessity criteria. 2.3. of providers through Aetna PPO. Beginning July 1, 2020, a $2,500 benefit for hearing instruments and related services every 24 months is available through all plans when a hearing care professional prescribes a hearing instrument. Department of Human Resources - Statewide Benefits Office website. Members can view the summary of benefits and coverage for each plan. The CDHP is a high-deductible health plan as defined by the IRS. Your out-of-pocket costs in an OAP will vary depending on the tiers you use: You are encouraged to use OAP Tier I and Tier II providers. Telemedicine coverage includes both General Practitioners and Behavioral Health providers. Distributions are tax-free when used for qualified medical expenses. You must be one of the following: 2.1. This is a high deductible health plan as defined by the IRS. SEGIP coverage is provided through the State of Illinois Department of Central Management Services (CMS). Employees must reenroll in MCAP for the new plan year in order to qualify for the rollover. Your HSA is funded by a State contribution of one-third of the CDHP deductible. With state and local governments employing over 7.4 million full-time workers throughout the U.S., public employee benefits like health insurance coverage are of great importance ⦠If you enroll in the QCHP, you are free to choose any provider, but you will have significantly lower out-of-pocket costs when using an in-network provider. There is an annual plan year deductible for prescription drugs. University employees may be eligible for one of two benefit programs: State Employees Group Insurance Program (SEGIP) - Health insurance and other benefit plans offered by the State of Illinois Department of Central Management Services (CMS) to employees meeting certain eligibility criteria. You do not need to designate a Primary Care Physician (PCP) and may see specialists without a referral. The health insurance plans available to State members differ in the benefit levels they provide, the doctors and hospitals you can access and the out-of-pocket cost to you. QCHP and CDHP enrollees will receive the benefit at the same coinsurance level; however, due to the reduction in the cost of the visit, you as the member, will experience significant savings. If you choose an HMO, all of your medical care will be coordinated through your selected Primary Care Physician (PCP). State of Illinois Coronavirus Response Site, Illinois Department ofCentral Management Services. See Monthly Contributions for the current premiums. You or your provider must submit a claim form and itemized bills to the QCHP administrator. MCAP-DCAP UpdatesNONBC.pdf. You may enroll in, drop, or change dental plans during the Open Enrollment period held every other year or if you experience a qualifying life event. MyBenefits provides information about health, retirement, employee assistance program and other benefit options to prospective and current employees⦠A regular employee with an appointment of 50% or more. medication is available under this benefit. See CDHP for more details. The Health Care & Benefits Division (HCBD) is a division within the Department of Administration. Benefit recipients may view a map of the various plans' coverage areas below: Members will find a listing of providers who participate in the health plan's network when they go to the provider directory page on the plan's website. If you opt out, you and your dependents will no longer be enrolled in SEGIP health, vision, or dental coverage and COBRA is not available. See HSA for more details. 70/30 Plan The 70/30 Plan is a Preferred Provider Organization (PPO) plan ⦠Within 30 calendar days of becoming eligible for SEGIP benefits. Office of Employee Benefits Department of Administration One Capitol Hill, 3rd Floor Providence, RI 02908 Phone: (401) 574-8530 Fax: (401) 574-9281 Doa.oeb@doa.ri.gov Companion to CDHP enrollment only. The MCAP maximum contribution amount will be $2,750 for the FY21 plan year with a $500 maximum rollover. Although it does not protect against COVID-19, getting the flu shot is still important for our health, and also for the overall health ⦠2. HCBD manages the State of Montana Benefit Plan (State Plan) which provides benefits (ie. After the opt-out application process, you will be notified by CMS if your request has been approved or denied. 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