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, 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 Pretax 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.LATEST NEWS
- 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
- 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.
- 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.
- 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
- The Supreme Court of Illinois has issued a ruling in the Kanerva vs Weems court case regarding retiree health insurance premiums. We are aware that many people have questions about the impact this will have on current retirees. CMS is currently reviewing the ruling and will have more information at a later time. 07/03/14
- Notice Regarding QCHP and QCDP Claim Payment Delay. Updated Daily.
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).
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.
Information regarding continuation of coverage.
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.
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.
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.
Members on a leave of absence may pay for their group insurance premiums electronically by using E-Pay. E-Pay is a system developed by CMS Group Insurance and the Illinois Treasurer's Office to provide a quick and convenient way for members of the State Employees Group Insurance Program to pay group insurance premiums online.
The State is required to provide certain federal notices regarding their privacy and insurance coverage.
Opt Out/Waiver of Coverage
Optional Pretax Programs
The State offers three programs which save employees valuable tax dollars.
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. when participating in an approved smoking cessation or weight loss program.
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.
The State offers many valuable wellness programs to help keep our members healthy and help our members get healthier. The goal is for all State members to lead better, more satisfying lives. This Wellness Chart lists many of the wellness benefits currently available to members through their health plans, most free of charge.Source: www.illinois.gov