State Employees Group
Insurance Program
Revised 11/20/09 Notice Regarding QCHP and QCDP Claim Payment Delay [PDF, 16KB]
Questions or concerns regarding the claim payment delay/hold? Send a message by clicking on claim response.
State Employees Group Insurance Program
There are several website links below that contain information for plan participants enrolled in the State Employees Group Insurance Program. For example, members can view information regarding the health, pharmacy, dental, vision and life insurance benefits by clicking on the Benefit Plans link. Members can view the Benefits Handbook, as well as the Benefit Choice Booklet for the current plan year by clicking on the appropriate link under Benefit Program Books. A list of current plan administrators for each benefit plan is located under the Contact Information link. All benefit forms are listed under the Forms link and are grouped by benefit type. All optional benefit programs are listed under either the Optional Pre-Tax Programs link or the Other Programs link. Rates for the current plan year are available under the Rates and Calculators link. Please scroll down to view a list of all available website links.
Adult Child Coverage
NEW Coverage for adult children age 19 up to age 26 (up to age 30 for veteran adult children) is available for dependents meeting the criteria effective July 1, 2009.
Public Act 95-0958 provides for the extension of health, dental, vision and prescription coverage for three new categories of dependents, referred to as 'Adult Children', who may or may not have previously had coverage under the State of Illinois Group Insurance Program. These categories are in addition to the dependent categories of Student, Handicapped and Other. Adult children added under these new categories are not eligible for life insurance coverage. The rates for non-IRS adult children (PDF, 15KB) are effective July 1, 2009, through June 30, 2010.
For more information about this benefit, please read the Adult Child Information Packet (PDF, 119KB).
Benefit Plans
The State offers several health plan options that include prescription benefits. Other benefits included in the benefit plans are vision, dental, life insurance coverage and behavioral health coverage. Outside the Benefit Choice enrollment period, members may change coverage elections only when a qualifying change in status occurs.
Benefit Program Books
All available benefit plans and programs are explained in detail in the Member Handbook and Benefit Choice Options Booklet.
COBRA
Information regarding continuation of coverage.
Contact Information
Whenever questions arise, plan participants have various resources they can use.
Changing Your Coverage
Coverage elected during the annual Benefit Choice Period remains in effect throughout the entire plan year, unless the Member experiences a Qualifying Change in Status or a special enrollment event which would allow them to change their coverage elections.
Dependent Coverage
Coverage is available for eligible dependents, including spouses, children
and unrelated same-sex domestic partners.
Enroll after Opting Out or Waiving Coverage
Members not currently enrolled in the health, dental, vision and prescription coverage offered by the State due to waiving or opting out may enroll in the Program during the annual Benefit Choice Period or upon experiencing a qualifying change in status.
Forms
Members can view all group insurance forms.
Health Insurance Portability and Accountability Act (HIPAA) – Privacy Notice
Plan participants have many rights with regard to privacy.
Leave of Absence
Medicare
Information regarding Medicare and how it affects your group insurance coverage.
Opt Out/Waiver of Coverage
The State allows for members who meet certain criteria to opt out or waive coverage.
Optional Pre-Tax Programs
Waiting for an Explanation of Benefits (EOB) to file for MCAP reimbursement? Find out what you should do by going to the Explanation of Benefits page. Other Programs
Rates and Calculators
Members can view health, dental and life coverage rates, as well as Quality Care Health Plan deductibles and family caps. Full-time employees can calculate the applicable contributions for coverage.
Retiree Information
State retirees have certain benefits available that are not available to all other members. Links are provided to the retirement systems’ websites.
Effective October 1, 2009, dental coverage for retirees and survivors will no longer be provided free of charge. Please see a copy of the Dental Retiree letter [PDF, 16KB] that was mailed on August 18, 2009, to all retirees and survivors regarding this change.
|
