Opt Out of Coverage
- In accordance with Public Act 92-0600, full-time employees, retirees, annuitants and survivors may elect to Opt Out of the State Employees Health Insurance Program if proof of other major medical insurance can be provided by an entity other than the Department of Central Management Services. Opting out will terminate all health, dental, vision and prescription coverage for the member and any dependents; however, the member's life insurance coverage will remain in force (Basic Life and any elected Optional Life).
Members who wish to Opt Out must complete the Opt Out Certificate (PDF 27 KB), attach proof of other insurance coverage (such as a copy of an insurance card from another health plan that names you as being insured) and return to the Group Insurance Representative within 60 days of the qualifying event date.
Members opting out of the Program are not eligible for the:
Þ Free influenza immunizations offered annually by the Department of Healthcare and Family Services
Þ COBRA continuation of coverage
Þ Smoking Cessation Program
Employees opting out of the Program are eligible for the:
Þ Flexible Spending Account (FSA) Program
Þ Commuter Savings Program (CSP)
Þ Paid maternity/paternity benefit
Þ Either of the two separate Employee Assistance Programs
Þ Long-Term Care Program
Þ Adoption Benefit Program
- In accordance with Public Act 94-0109, non-Medicare State Employees’ Retirement System (SERS) annuitants who are enrolled in the State Employees Health Insurance Program and have other comprehensive medical coverage may elect to opt out of the plan and receive a financial incentive of $150 per month. The SERS Opt Out with Financial Incentive form (PDF 20 KB) is available through the SERS Group Insurance Representative.
- Individuals who opt out under either public act may re-enroll in the Program only during the annual Benefit Choice period (May 1 - 31 each year), or within 60 days of experiencing an eligible qualifying change in status. Members who re-enroll, and their dependents, are subject to possible health benefit limitations for pre-existing conditions. A Certificate of Creditable Coverage from the previous insurance carrier must be provided to reduce the pre-existing conditions waiting period.