State Employees Group Insurance Program


LATEST NEWS - Archived

  •  Affordable Care Act tax Forms 1095-B and 1095-C - Per IRS guidance, Forms 1095-B and 1095-C are for record keeping purposes only and are not required to be filed with a participant’s 2017 tax return. You do not need this form to file your taxes. The forms are proof of the 2017 offer and enrollment in health insurance coverage. The information on these forms indicates that the participant and any spouse or dependent were offered coverage and the respective enrollments, if any, for each month during 2017. 01/19/2018
  • The Affordable Care Act requires issuers of insurance and some employers to send Forms 1095-B and 1095-C to members.  A list of Frequently Asked Questions has been compiled for those who are anticipating these forms. 01/19/2018
  • Employees who are experiencing issues with their payroll deductions need to contact their agency Group Insurance Representative (GIR) for questions and concerns.  Your GIR name and contact info is listed (alpha by agency) on the CMS Benefits website: https://www.illinois.gov/cms/benefits/StateEmployee/Documents/GIRList.pdf   11/15/2017
  • The 2016 Commuter Savings Program (CSP) pretax maximum amount for bus, train and vanpooling expenses incurred for work-related commuting costs has increased from $130 to $255 per month effective immediately for the February 2016 benefit month. 01/07/16
  • FAQs regarding the impact of the budget impasse on State employee and retiree group insurance coverage. 09/25/15
  • NOTICE REGARDING BUDGET IMPACT on Group Insurance.  09/18/15
  • Effective July 1, 2015, CVS/caremark is the new prescription benefit manager (PBM) for the self-insured health plans of the Quality Care Health Plan (administered by Cigna), Coventry OAP and HealthLink OAP. 06/29/15
  • Notice Regarding QCHP and QCDP Claim Payment Delay. Updated Daily
  • HMS Employer Solutions (HMS), an independent firm, will be conducting a Dependent Eligibility Verification Audit (DEVA).  The intent of this audit is to ensure that only eligible dependents are covered under the State Employees Group Insurance Program (SEGIP).  This audit will be required of university employees and members who retired on or after September 1, 2013.  09/18/15
  • IMPORTANT NOTICE REGARDING DEPENDENT AUDIT: September 9, 2015, is the last day State Employees (non-university employees) will be able to load documentation verifying your dependent’s eligibility to the HMS Employer Solutions website, www.AuditOS.com. After this date, you will need to take the documentation to your agency Group Insurance Representative (GIR). 09/09/15
  • FY 2016 Dental Schedule of Benefits has been updated with new benefit amounts effective July 1, 2015.  07/01/15
  • Effective June 1, 2015, Commuter Check Direct (CCD) will be the state’s new Commuter Savings Program (CSP) plan administrator. 05/19/15
  • Due to the Mental Health Parity provision of the Affordable Care Act, residential treatment is now eligible for coverage as a behavioral health services benefit under the Quality Care Health Plan (QCHP) effective July 1, 2014. 07/01/15
  • IMPORTANT NOTICE REGARDING DEPENDENT AUDIT: HMS Employer Solutions (HMS) has experienced multiple phone issues which in some cases has caused long hold times.  The Group Insurance Division at CMS is working with HMS to ensure that the problems are rectified as quickly as possible and calls are answered in a timely manner.  Employees have until August 20th to submit documentation, so we are urging patience in these early stages of the audit.  07/21/15
  • HMS Employer Solutions (HMS), an independent firm, will be conducting a Dependent Eligibility Verification Audit (DEVA).  The intent of this audit is to ensure that only eligible dependents are covered under the State Employees Group Insurance Program (SEGIP).  07/17/15
  • A website has been created which contains information regarding the Kanerva Health Insurance Refund class action, including case filings, notices, important dates and more. Additionally, the website includes information on who to contact with any questions or to obtain additional information relating to the Kanerva case. 02/03/15
  • Effective July 1, 2014, the Flexible Spending Accounts (FSA) program will be administered by ConnectYourCare (CYC).   06/30/14
  • In anticipation for the FY2015 Benefit Choice Period, several Benefit Fairs have been scheduled at various locations throughout the state.  These fairs are open to all active and retired members.  Representatives from the State-sponsored vendors will be present at each fair to address any questions or concerns you may have.  Please note: Although the fairs are open to retirees, because the TRAIL open enrollment period is in the fall, these fairs will not be attended by the TRAIL vendors.  04/24/14
  • The new TRAIL website has been launched and contains important information for retired members who are enrolled in Medicare Parts A and B. Medicare primary members should use the new website at www.cms.illinois.gov/thetrail to review information about these plans and the enrollment period as new information will be posted to that site as it comes available.  11/04/13
  • Effective with the November 2013 benefit, administration of the State of Illinois sponsored Commuter Savings Program (CSP) will move to a new system supported by WageWorks, Inc (WageWorks).  09/03/13
  • NEW!! The Medicare Advantage plan administrators phone numbers are available. The Retiree Medicare Advantage Seminar Schedule will be posted as soon as it is finalized. Initial letters have been mailed to all impacted members. NOTE: All impacted members should receive their Medicare Enrollment Packet the week of November 11th. 10/28/13
  • NEW!! The initial letter that gives more information, including rates, about the new Medicare Advantage plans that are being offered to members enrolled in Medicare Parts A and B will be mailed the week of October 21, 2013.  The map of the Illinois counties that the HMO plans are available will be included in the enrollment kit, which member will receive prior to the fall Open Enrollment Period start date of November 12, 2013.  10/21/13
  • The enrollment period for the Medicare Advantage plans has been set for November 12 through December 13, 2013. The effective date of the new plan will be February 1, 2014. 10/16/13
  • The Department of Central Management Services (CMS) announced today that the Medicare Advantage procurement has concluded and contracts are being awarded to the winning vendors. 10/02/13
  • The State of Illinois requested bids for a State-sponsored Medicare plan on June 21, 2013. 08/15/13
  • Effective July 1, 2013, Public Act 98-0019 extends the financial incentive to non-Medicare annuitants of all five state retirement systems (SERS, SURS, TRS, JRS and GARS) and increases the amount of the opt-out financial incentive for annuitants with over 20 years of service to $500. Survivors are not eligible for the opt-out incentive. A letter is being sent to all eligible members. 08/09/13
  • Walgreens pharmacies have now joined the State of Illinois Express Scripts Maintenance (90-day) Network.  The Maintenance Network allows plan participants of HealthLink OAP, Coventry Health Care OAP and the Quality Care Health Plan to receive a 90-day supply of maintenance medication through any Walgreens retail pharmacy for only 2 1/2 copayments.  The Maintenance Network listing has been updated to indicate that all Walgreens pharmacy locations nationwide are now in the 90-day network. 07/19/13
  • A letter dated May 1, 2013, was mailed to all retirees, annuitants and survivors regarding Public Act 97-0695 signed by the Governor on June 21, 2012, which authorized the Director of Central Management Services to establish the amount that retirees, annuitants and survivors will pay for their health insurance. 05/03/13
  • It has come to our attention that HealthLink OAP inadvertently sent new health insurance ID cards to all individuals who were ever a dependent in the past on the HealthLink OAP member�s coverage. 07/09/13
  • Effective July 1, 2013, Public Act 98-0019 extends the financial incentive to non-Medicare annuitants of all five state retirement systems (SERS, SURS, TRS, JRS and GARS) and increases the amount of the opt-out financial incentive for annuitants with over 20 years of service to $500. Survivors are not eligible for the opt-out incentive. 07/01/13
  • 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
  • AFSCME members are currently in the process of re-voting over the terms of the new contract. The signing of the new contract is dependent upon the outcome of that vote. Due to time constraints concerning the targeted implementation of the changes in benefits, the State has begun the process of informing employees about the changes contained in the new contract. At this stage, however, this is purely an educational process.  05/01/13
  • FY 2014 Benefit Fairs have been scheduled at various locations throughout the State.  All members of the Group Insurance Program, including active state and university employees, retirees and survivors can attend.  The State-sponsored vendors for Health, Dental, Vision and Life plans will be available to answer questions.  04/02/13 
  • A Special Enrollment Period is being held from now until January 31, 2013, for all members currently covered under Health Alliance Illinois.  Those members will need to change their carrier by January 31, 2013.  12/15/12
  • On Thursday, November 15, the award resulting from the supplemental fully-insured HMO RFP was posted.  11/26/12
  • 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
  • The FY2013 Benefit Choice Period will be May 1 through June 15, 2012, for all members.  05/21/12

  • Four of the State's managed care plans that will be in place for FY2013 may now be elected during the Benefit Choice Period.  05/08/12

  • The FY2013 Benefit Choice Period begins May 1, 2012, for all members. 05/01/12

  • The Group Insurance Division will be moving from its current location at 201 E. Madison St. to 801 S. 7th St. in Springfield beginning Wednesday, February 1st.  Phones will be unavailable on February 2nd and 3rd.  Members needing assistance should contact their Group Insurance Representative during this time.  01/23/12

  • Coventry Health Care HMO members (previously PersonalCare HMO) who utilize a primary care physician (PCP) at Christie Clinic recently received a letter from Coventry Health Care indicating that Christie Clinic will not be a part of the Coventry HMO network after December 31, 2011.  If you received this letter, you have been identified as someone who will no longer be able to utilize their PCP after January 1, 2012, and therefore, have a qualifying event which allows you to change to a new health plan. 12/09/11
  • Commuter Savings Program maximum pre-tax limits changing for January, 2012. 11/15/11
  • Effective June 1, 2011, in accordance with Public Act 96-1513, members will be permitted to add a civil union partner and/or their children to their coverage. 05/20/11
  • Special Enrollment Period will be held from October 10, 2011 through October 28, 2011.
  • Important Message - Special Enrollment Period Finalized. The Chief Procurement Officer held a hearing today and approved the extension of contracts for all current 90-day emergency managed care vendors through the remainder of the fiscal year, June 30, 2012, for the health plans administered by the Department of Healthcare and Family Services (DHFS) and the Department of Central Management Services (CMS). 08/31/11
  • The timeframes for the Special Enrollment Period(s) have been set. 08/30/11
  • The Commission on Government Forecasting and Accountability (COGFA) held a hearing on August 16, 2011, to consider a request by the State to continue to offer self-insured managed care plans. At the end of that hearing, COGFA voted to authorize the State to continue to offer the self-insured managed care plans through June 30, 2012. 08/17/11
  • The following vendors have signed a 90-day contract, which will be effective July 1st: Health Alliance HMO, Health Alliance Illinois, HealthLink OAP, PersonalCare HMO, and PersonalCare OAP. These options are in addition to HMO Illinois, BlueAdvantage HMO and the Quality Care Health Plan (administered by CIGNA), which are also available. 6/27/11
  • Special Enrollment Period Update. In order to address any member concerns, CMS has committed to a Special Enrollment Period prior to the end of the calendar year. 06/07/11
  • On Friday, June 10, 2011, a trial judge for the Sangamon County Circuit Court entered an order prohibiting any further State action in the awarding or signing of self-insurance contracts by the State of Illinois. - 06/12/11
  • HealthLink OAP Network Update. St. Margaret's PHO in Spring Valley has signed a Tier I agreement with HealthLink OAP. 06/09/11
  • HealthLink OAP Network Update. Springfield Clinic in Springfield has signed a Tier I agreement with HealthLink OAP. 06/02/11
  • The Executive Ethics Commission ruling has been released. The managed care plans that will be in effect for the FY 2012 Benefit Choice Period will be HMO Illinois, HealthLink OAP, PersonalCare OAP and Blue Advantage. 05/25/11
  • At this time, a final decision regarding the managed care contracts for FY 2012 has not been made. As a result, vendor names, coverage areas and rates are not available. 04/29/11
  • The State of Illinois has selected four managed care plans to provide benefits to state employees, dependents and retirees starting July 1. These plans will continue to offer you the same benefits and level of care. 04/06/11
  • Long-Term Care Coverage Notification. MetLife has informed CMS that they have decided to discontinue the sale of Long-Term Care (LTC) insurance products (includes Employer Group and Individual - including Multi-Life). 04/06/11
  • Important changes to the Quality Care Health Plan effective March 1, 2011.
  • Cummins v. State of Illinois (02-cv-4201) class action lawsuit notification.
  • Early Retirement Reinsurance Mailing. Effective November 29, 2010, members and dependents were mailed a letter mandated by the federal government regarding reimbursement to plan sponsors for healthcare benefits paid to early retirees.
  • Important FSA Announcement. Effective January 1, 2011, under the Patient Protection and Affordable Care Act, over-the-counter items that are classified as a "medicine" or a "drug" will no longer be eligible for reimbursement through the Medicare Care Assistance Program (MCAP) without a prescription.
  • Significant Changes to the Retail Maintenance Pharmacy Network effective September 20, 2010. The Retail Maintenance Pharmacy Network for the Quality Care Health Plan, Health Alliance Illinois, Humana-Winnebago and HealthLink OAP will be changing effective 09/20/10.



Updated 04/24/2018