Frequently Asked Questions
Note: These FAQ responses apply to Active State of Kansas employees. If you are enrolled as a Direct Bill or COBRA member, the information may differ. Please contact the SEHP at (785) 368-6361 for assistance.
Employee Health Benefit FAQs
Eligibility & Enrollment
Newly hired or newly eligible employees have 31 days from their first day of work to enroll in benefits. For newly hired or newly eligible employees, coverage will be effective on the first day of work.
Yes - In addition to covering yourself, you may elect coverage for your eligible dependents. They include your lawful spouse and/or your child(ren) or stepchild(ren) under the age of 26.
A Qualifying Event is a recognized family status change such as marriage, divorce, birth or adoption of a dependent, death of a spouse or dependent, gain or loss of group benefits for a spouse or dependent.
A Qualifying Event enables you to make a coverage change during the middle of a Plan Year, provided the change is consistent with the family status change, and the request for the change is made within 31 days of the event and includes the required supporting documentation.
Review the complete list.
Premiums & Payroll
Deductions should start with the first available paycheck after the SEHP processes the benefit elections. Non state employees should check with their HR department for information.
Contact Membership Services to determine why your premium amount changed. Call (785) 368-6361 or email.
Medical Plan Coverage & Networks
There are different types of doctor visits and covered services under the Plan, specific benefit details can be found each vendors Summary of Benefits and Coverage statements: Aetna or Blue Cross and Blue Shield of Kansas
Aetna and Blue Cross and Blue Shield of Kansas have different networks.
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Aetna Network Provider Directory
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Blue Cross and Blue Shield of Kansas Provider Directory - Select the drop down arrow under Network and select “State of Kansas Employee Health Plan Network”
Health plan benefits do not require a referral; however, check with your primary care doctor to see if they need to provide one before you schedule an appointment with a specialist.
Yes – SEHP health plans cover a set of preventive services — like well exams, preventive lab work, and immunizations — at no cost to you when using a Network provider. The HealthQuest Health Center provides these services as well.
HRAs, HSAs & FSAs
These tax-advantaged accounts have different functionalities and criteria. Watch this video to understand the main differences.
Prescription & Dental
Prescription drug coverage through Caremark is included with Plans A, C, J, and N. While the Preferred Drug List is the same for all plans, the amount you pay will vary depending on the plan you select.
Yes - Home delivery is available through Caremark and reorders are processed in as little as five to seven days. To place an initial order or reorder by phone, call 1-800-294-6324 or email. You may access the mail order service online form.
The SEHP offers dental benefits through Delta Dental Plan of Kansas. There is a single plan with multiple levels of coverage. The benefit description of dental care coverage outlines the services covered under the plan.
Voluntary Prescription Eyewear
There are two different voluntary prescription eyewear plans from which to choose, Basic and Enhanced. Premiums differ based on level of coverage. To search for a Network provider near you, or to find additional information on these plans, including other value added benefits can be found at Surency's website.
When you visit a Network provider, the provider will submit the claim to Surency for processing. If you visit a Non Network provider, you have Non Network benefits as part of your Voluntary Prescription Eyewear Plan, but you will need to pay at the time of service and submit a claim form and receipts for reimbursement. Submit a claim with a PDF form when using a Non Network provider. If you do not know your Member ID#, you can access this information by registering your Member Account on the Surency website.
Wellness & HealthQuest
State Employee Health Plan members who complete activities that promote physical, mental, and emotional wellness earn credits towards premium discounts and/or HRA/HSA reward dollars. Watch this helpful video to learn about HealthQuest.
Yes - waived members can participate. Although credits may appear in a waived members portal, those credits will not go towards the next year’s premium incentive discount and waived members will not earn reward dollars.
Track progress in the HealthQuest portal.
Yes – spouses can participate. Although credits may appear in the spouses' portal, those credits will not go towards the next year’s premium incentive discount and spouses will not earn reward dollars.
Retiree and/or Direct Bill
The SEHP has a web page to help you prepare you for retirement.
For eligible members that have retired before age 65, the SEHP offers a variety of benefits through the Direct Bill Program. Email or call 866-541-7100.
Contact
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