Your SEHP Benefits
Your State Employee Health Plan (SEHP) Benefits
Plan year 2019 information for new hires with coverage beginning in October, November or December of 2019.
Visit the 2020 Enrollment Book for detailed information about Plan Year 2020 (beginning 1/1/20) plan options, changes and premium rates.
To help you understand and select benefits in a personalized way, please visit a new interactive tool called Ask Alex.
Medical Plans, Caremark Prescription Drug, Preferred Lab Benefits, and Rx Savings Solutions
The SEHP offers five medical plan options. When reviewing medical plans, consider several factors:
Premium and Member Cost Sharing
For a side-by-side comparison of the plans:
- See the Benefits Summaries provided by Blue Cross and Blue Shield of Kansas or Aetna
- Summary of Benefits and Coverage - summarizes important information in a standard format to help you compare your options.
- Watch Blue Cross Blue Shield of Kansas Comparison video (you may need to click the speaker in the upper right corner).
Plan A Overview Video (4:51)
Health Care Provider Network:
Both Aetna and Blue Cross Blue Shield of Kansas offer the following:
- Access to a broad network of providers nationwide which allows you flexibility in obtaining care with coverage from both Network and Non Network Providers.
- 100 percent coverage for certain preventive care services, such as an annual preventive exam, colonoscopy, mammograms and age-appropriate immunizations (including flu shots).
- Policies have no lifetime maximum.
- Prescription drug coverage through Caremark.
- Preferred Lab Benefit programs through either Quest Diagnostics or Stormont-Vail HealthCare.
- TeleHealth benefits for virtual doctor’s office visits through Amwell (Blue Cross and Blue Shield of Kansas) or Teladoc (Aetna)
For additional information, visit State Employee Health Plan page.
Caremark Prescription Drug
Prescription drug coverage is provided through Caremark for all medical plans, and its cost is included in the medical plan rates. While the Preferred Drug List (PDL) is the same for all plans, the amount you pay will vary depending on the plan you select.
- Plan A. Under this plan, generally you pay a Coinsurance for your prescription drug costs throughout the year, up to a combined medical and pharmacy Out Of Pocket maximum of $6,250 for single and $12,500 for member with dependent coverage per year.
- Plans C, J, N and Q. Until you reach your deductible, you will pay 100% of the discounted cost for your prescription drugs when you present your Caremark ID card. Once you have reached your annual medical plan Deductible, you pay a Coinsurance for your prescription drug costs throughout the year, up to a combined pharmacy and medical Out Of Pocket maximum.
- For additional information about prescription drug plan, see page 16 and 17 in the 2020 Enrollment Book, visit SEHP Caremark page or call Caremark at 800-294-6324.
Preferred Lab Benefit
This is an benefit you can utilize voluntarily and is provided at no additional cost. Present your SEHP medical plan card identifying your membership. The lab benefit logos are on your Aetna or Blue Cross Blue Shield medical ID cards.
Rx Savings Solutions
Rx Savings Overview Video (2:15)
Employees and dependents of the State Employee Health Plan (SEHP) can potentially save money on their prescriptions. Rx Savings is available to all those enrolled in a SEHP medical plan, employees and dependents.
For more information about this benefit, visit page 15 in the 2020 Enrollment Book or visit RX Savings webpage or their FAQ.
Need Assistance? Member service representatives are available at 1-800-268-4476 (M-F 7 am to 8 pm CST).
Delta Dental and Surency Vision
2020 Delta Dental Benefits Summary- A guide to understanding and maximizing your Delta Dental benefits.
With Delta Dental you have access to two nationwide networks. Over 95% of dentists in Kansas, and 82% of dentists nationwide participate with Delta Dental.
Need Delta Dental customer service assistance? Call 1-800-234-3375.
Plan features include:
- Comprehensive eye exam
- Overall material savings of up to 40% off
- An allowance, copay and frequency for exams, lenses and frames
- Convenient access to vision care 7 days a week
- Savings on eye care and eye wear all year long
Need Surency Vision customer service assistance? Call 1-866-818-8805.
Flexible Spending Accounts, HSA and HRA
Flexible Spending Accounts (FSA)
With FSAs, you set aside pre-tax dollars to cover eligible health care and dependent care expenses. NueSynergy is the third party administrator.
Need NueSynergy customer service assistance? Call 1-855-750-9440.
Forms and Guides:
IRS Annual Limits
The SEHP has announced Plan Year 2020 contribution limits for the Flexible Spending Accounts.
- The annual maximum contribution amount for the Healthcare FSA and the Limited Purpose FSA is $2,700.
- The annual maximum for the Dependent Care FSA is $5,000.
Please ensure that you enroll in the correct FSA. Money cannot be transferred between accounts. A FSA Calculator allows you to estimate your federal income tax savings based on your FSA contributions.
Health Savings Account (HSA)
2020 HSA Overview Video (5:59)
With HSAs, employees enrolled in Plan C or Plan N can set aside pre-tax dollars to pay for eligible medical expenses. Examples of the types of medical expenses you can spend your HSA funds for include:
- Deductibles and Conisurance
- Dental, Prescription and Vision expenses
- Over-the-counter medications if you have a prescription from your doctor
IRS Annual Limits:
- Maximum HSA Contribution levels (including employer contribution) for Plans C and N are $3,500 (increased $50) for Single coverage and $7,000 (increased $100) for Family Coverage.
- Members ages 55+ in 2019 can make additional "catch up" contributions each year until they enroll in Medicare. The 2019 catch up contribution remains at $1,000.
Health Reimbursement Account (HRA)
Employees who enroll in Plans J and Q will have an HRA for dollars earned through HealthQuest activities during the plan year and need to elect the HRA during the enrollment process. Employees and their covered spouses are eligible to each earn up to $500 in contributions into the employee's HRA. See pages 22 in the 2020 Enrollment Book for more information.
HealthQuest Rewards Program (HQ)
Employees and covered spouses who participate in the HQ program can earn credits toward the $480 premium incentive discount for PY 2021. And, those with an HSA or HRA can earn additional employer contributions to the employee’s HSA/HRA (up to $500 each per employee and covered spouse). There have been no changes to the HealthQuest plan for 2020, all is the same as 2019.
MetLife Voluntary Supplemental Insurance Benefits
Accident, Critical Illness and Hospital Indemnity Insurance are voluntary benefits offered by MetLife for PY 2020.2020 Enrollment Book, visit MetLife State of Kansas page or call 1800-GET-MET8 (1-800-438-6388) Monday through Friday, 8 am - 8pm EST to speak to a MetLife Benefits Consultant.
Annual enrollment is required.The HealthyKIDS program helps eligible employees with the premiums to cover their children enrolled in the SEHP. Eligibility for the HealthyKIDS program is based in part on family income. The HealthyKIDS application website is found in MAP towards the bottom of MAP’s Enrollment & Events tab.
Employee Assistance Program (EAP)
EAP Benefits Overview Video (14:58)
All active, benefits-eligible employees, their dependents and other family members living in the same household are eligible to use the EAP. With a single call to 1-888-275-1205 (option 1), you and your family members can receive confidential assistance 24 hours a day, seven days a week at no cost to you. For more information, see page 23 in the 2020 Enrollment Book, or visit SEHP Employee Assistance Program page.