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State Employees' Group Insurance Program 

 

The benefits pages have changed PLEASE Click BENEFIES

Flu ShotThere 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, as well as the contact information for the Group Insurance Division, 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.

Benefit Statements

Benefit Statements

Members of the State of Illinois Group Insurance Program may now view their group insurance benefits information online. Online statements are updated the first Saturday of each month.  The benefit information reflected is as of the first of the month.


LATEST NEWS

  • On Thursday, November 15, the award resulting from the supplemental fully-insured HMO RFP was posted.  11/26/12
  • Effective today, November 16, 2012, CVS Pharmacy has joined the Express Scripts (Medco) Maintenance Network.  11/16/12
  • REMINDER: Medicare-eligible individuals enrolled in the State Employees Group Insurance Program have prescription drug coverage that is on average as good as, or better than, the standard Medicare prescription drug coverage (Medicare Part D) and should not enroll in a Medicare Part D plan during this Medicare Part D open enrollment season, unless you qualify for low-income/extra-help assistance.  10/17/12
  • On August 24, 2012, Governor Quinn signed into law SB 3240 that allows State of Illinois members and their covered dependents to assign their health and dental benefits to out-of-network providers.  09/28/12
  • The current emergency contracts with Health Alliance HMO, Health Alliance Illinois and Coventry HMO have been extended until the supplemental managed care procurement is completed, not to exceed June 30, 2013.  Check back for more information once the procurement is finalized.  09/05/12 
  • SB 1313 modifies the premium payments for retiree healthcare, allowing the Director of CMS to set the premiums that are paid.  This letter referenced during the debates in the House and the Senate is for your information.  At this time, CMS Benefits has no further information regarding the payment of premiums by retirees.  As information becomes available, it will be posted on this website and shared with your Group Insurance Representative.  05/14/12
  • Effective May 1, 2012, members of the State of Illinois Group Insurance Program can view their group insurance benefits statement online.  05/01/12
  • Effective April 2nd, Express Scripts acquired Medco Health Solutions. Members will continue to receive medications without changes to the plan or network.  04/04/12
  • The benefits handbook has been updated and is located on the Benefit Program Books page.  There is a handbook for employees and a separate handbook for retirees, annuitants and survivors.  11/16/11
  • Notice Regarding QCHP and QCDP Claim Payment Delay. Updated Daily.

Archived Notices

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.  Also included are amendments that update the handbook and a summary document indicating the benefit levels of the Quality Care Health Plan (QCHP).

COBRA

Information regarding continuation of coverage.

Contact Information

Whenever questions arise, plan participants have various resources they can use.  On the Contact Information page, members may view the phone number for the Group Insurance Division, a listing of agency/university group insurance representatives as well as links for all of the state insurance plan administrator websites.

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.

Leaves of Absence

Employees who either go on or return from a leave of absence have certain rights and responsibilities regarding their insurance coverage. Employees should read the documents regarding leaves of absence in order to be aware of those rights and responsibilities and to prevent unwanted termination of coverage.

Medicare

Information regarding Medicare and how it affects your group insurance coverage.

Notices

The State is required to provide certain federal notices regarding their privacy and 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 - Includes FSA, CSP and Deferred Comp

The State offers three programs which save employees valuable tax dollars.  The programs include Flexible Spending Accounts (FSA), Commuter Savings Program (CSP) and the Deferred Compensation Program.

Other Programs

In addition to the insurance coverage and pretax programs the State offers, employees are offered additional benefits when adopting a child, when needing support and information during difficult times and when participating in an approved smoking cessation program.

Plan Administrators

Members may view contact information, including phone numbers and addresses, for all plan administrators via these links.

Rates and Calculators

Members can view health, dental and life coverage rates, as well as Quality Care Health Plan deductibles and family caps. Members interested in adding a non-IRS domestic partner, civil union partner, child of a civil union partner or an adult veteran child can view the premiums and imputed income associated with those types of dependent coverage. 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.