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Medical Insurance Providers

The State Employee Health Plan (SEHP) offers two types of plans, and the same plans are available through either Aetna, or Blue Cross and Blue Shield of KansasCaremark serves as our prescription drug provider.  Visit each provider’s website to determine which providers are considered in-network.

Current employees can go to https://sso.cobraguard.net/seer_login.php to review their current insurance enrollments, edit information, and upload or download related documents. Full details of the SEHP can be found at http://www.kdheks.gov/hcf/sehp/default.htm. Additionally, the SEHP newsletter can be found at www.kdheks.gov/hcf/sehp/SEHP-MemberNews.htm.

 

Plan Options

Plans A and Q are traditional PPO plans, and Plans C and N are qualified high deductible plans.  Plan J was designed to meet the requirements for employees on a J-Visa (but anyone can elect plan J).  All options cover 100% of the network provider costs of preventative care services including: a well-person exam, immunizations, routine hearing exam, routine vision exam, and other age-appropriate preventative services.  The chart below offers a quick comparison between the plans while using Network Providers, and a more in-depth comparison is available on page 16 of the SEHP Open Enrollment Book.

 

Plan A

Plan C

Plan Q

Plan N

Plan J

Annual Deductible

$1000 Employee

$2000 Employee & 1

$3000 Employee & 2+

$2,750 Employee

$5,500 Employee & 1+

$500 Employee

$1,000 Employee & 1+

$2,750 Employee

$5,500 Employee & 1+

$500 Employee

$1,000 Employee & 1+

Payment

Deductible, 20% Co-insurance, and/or            Co-payment

Deductible and 20%     Co-insurance

Deductible and 50%   Co-insurance

Deductible and 35%    Co-insurance

Deductible and 25%   Co-insurance

Out of Pocket Maximum 
(includes deductible, co-insurance, and co-payment)

$6,250 Single

$12,500 Family

$5,500 Single

$11,00 Family

$6,650 Single

$13,300 Family

$6,650 Single

$13,300 Family

$7,350 Single

$14,700 Family

Spending/Savings Account

FSA- optional

HSA or HRA- mandatory

HRA* or FSA- optional

HSA or HRA- mandatory

HRA* or FSA- optional

*An HSA (Health Savings Account) or HRA (Health Reimbursement Account) is required to receive the HealthQuest employer contributions. A limited-FSA for dental and vision is also available for individuals with an HSA or HRA.

 

Cost of Premiums

The 2018 semi-monthly premium of each plan is described in the chart below.  For the Employee + Children, and the Employee + Family options, the premiums do not change regardless of how many children are covered.

 

Plan A

Plan C

Plan Q

Plan N Plan J

Full Time

Employee Only*

$38.61

$34.06

$25.50

$22.50

$50.86

Employee + Spouse**

$225.15

$117.37

$89.74

$80.00

$145.54

Employee + Children*

$122.48

$62.92

$47.33

$42.50

$88.33

Employee + Family**

$394.19

$197.70

$169.72

$142.50

$249.37

Part Time

Employee Only*

$111.95

$50.92

$38.12

$33.64

$63.48

Employee + Spouse**

$335.88

$150.12

$114.79

$102.33

$170.58

Employee + Children*

$193.76

$85.47

$64.29

$57.73

$105.29

Employee + Family**

$532.99

$238.41

$204.66

$171.84

$284.31

*Subtract $20 from the semi-monthly cost for employees who have qualified for the HealthQuest Rewards Program Premium Incentive Discount.

**Subtract $10 for employees and $10 for spouses who have qualified for the HealthQuest Rewards Program Premium Incentive Discount.

HealthQuest Rewards

From January 1, 2018 to December 31, 2018, employees and spouses may choose to participate in the HealthQuest Rewards Program in order to receive a credit toward the cost of premiums in 2019; new employees can also earn the credit for the remainder of 2018 as well.  Employees and spouses enrolled in plans C or N can also earn additional employer contributions to their HSA/HRA accounts by earning HealthQuest points (plans J and Q can also earn contributions to an HRA account by earning points).  See the table below for specific details of the incentives.

 

Plan Type 2019 Premium Discount 2018 HSA/HRA Contribution

Employee, Employee & Children

Employee earns 40 points to receive a $480 premium discount for 2018. $10 Employer contribution for each point earned up to $500 (50 points).

Employee & Spouse, Employee & Family

Employee and spouse earn 40 points each to receive a total of $480 off the premiums for 2019. If only the employee (or spouse) earns 40 points, the total discount is $240 for 2019.

$10 Employer contribution for each point earned up to $1,000 ($500 [50 points] earned by employee, and $500 [50 points] earned by spouse).

 

In order to receive the discount, participants must log-in to the HealthQuest Portal, and complete the Health Assessment Questionnaire.  Additionally, participants must earn credits by completing and recording any of a variety of health related behaviors including: well-person exam, dental exams, vision exam, tobacco cessation program, condition management sessions, and other online or telephone activities.  In most cases, the activities are covered 100% by the health plan, or are otherwise free. For more information on the incentives, click the appropriate link: Plan A or Plan C, Q, N, and J.

The deadline to earn points for the premium discount is December 31st.  For the HSA/HRA contribution, points must be posted by November 19th. Be aware that claims data is now used to report the Annual Wellness Exam, Annual Eye Exam, and the two Annual Dental Exams. Claims processing can take up to 21 days (according to BCBS Customer Service). This does not include the time it takes the doctor’s office to file the claim, nor for the data to be sent to and uploaded into HealthQuest. Therefore, the State Employee Health Plan will not specify the date by which exams must be completed in order to count for the HSA/HRA employer contribution, only that claims data needs to be posted to the system by November 19th. Based upon this information, it is a good idea to schedule appointments at least a month prior this deadline.

 

Healthy Kids

The Healthy Kids program helps eligible employees cover the cost of the premiums for their children enrolled in the State Employee Health Plan.

For families with children enrolled in the Healthy Kids program, the 2018 semi-monthly premium of each plan is described in the chart below.  The premiums do not change regardless of how many children are covered.

 

Plan A

Plan C

Plan Q

Plan N

Plan J

Employee + Children*

$80.15

$47.78

$35.94

$32.28

$76.95

Employee + Family**

$294.70

$180.82

$155.22

$130.33

$234.88

*Subtract $20 from the semi-monthly cost for employees who have qualified for the HealthQuest Rewards Program Premium Incentive Discount.

**Subtract $10 for employees and $10 for spouses who have qualified for the HealthQuest Rewards Program Premium Incentive Discount.

 

New Amwell/Telehealth and Teledoc

In 2018, BCBS is offering Amwell/Telehealth, and Aetna is offering Teledoc.  Both of these services allow plan members to electronically (phone, tablet, computer) meet with a doctor for common conditions such as cold, flu, fever, rash, pink eye, ear infection, and migraines.

For the BCBS Amwell program

For the Aetna Teladoc program