State Employee Health Plan

2025 Retiree Enrollment Resources


Enrollment Portals

 

Membership Administration Portal page

Membership Administration Portal Technical Support page

 


What's New

Non Medicare Medical and Prescription

Action Required:

  • Annual Open Enrollment period is October 15 - November 16, 2024.

New Voluntary Prescription Eyewear Insurance

  • The new, voluntary prescription eyewear insurance provider is Surency Life and Health. For coverage, you MUST REENROLL.

Changes effective for Plan Year 2024

>> For care received after 1/1/2024:

  • Added coverage for residential treatment centers as an eligible service provider. 

  • Enhanced coverage for ultrasound and MRIs for breast cancer screening. 

    • For members enrolled in Plan A, the Plan will pay the allowed charge for ultrasounds and MRIs for breast cancer screenings in full when performed by a Network provider.

    • For Plans C, J and N, ultrasounds and MRI screenings will be subject to the plan annual Deductible. After the Deductible is satisfied, the allowed charge for ultrasound and MRI breast cancer screenings will be paid in full when performed by a Network provider.

Changes effective for Plan Year 2025

>> For care received after 1/1/2025:

  • The new orthodontic lifetime maximum will increase from $1,000 to $1,500.

  • The annual dental maximum benefit will increase to $2,000 per year. 

  • The new member plus dependent Deductible on Plans C and N will be $3,300 for the individual and the total family Deductible remains $5,500. This change was necessary due to changes in the IRS minimum Deductible requirement.

 

 


 

Medicare Eligible Medical and Prescription

Action Required:

  • Annual Open Enrollment period is October 15 - November 16, 2024.

Aetna Medicare Advantage Plans

  • Elimination of the Coverage Gap Phase for the prescription drug coverage included in Aetna Medicare Advantage Freedom and Elite Plans.

Delta Dental Changes for 2025

  • The annual dental maximum benefit will increase to $2,000 per year. 

  • The new orthodontic lifetime maximum will increase from $1,000 to $1,500.

New Senior Plan Option

  • Plan G High Deductible

New Voluntary Prescription Eyewear Insurance

  • The new, voluntary prescription eyewear insurance provider is Surency Life and Health. For coverage, you MUST REENROLL.

SilverScript Changes for 2025

  • Reduction to three phases - Deductible (if applicable), Initial Coverage and Catastrophic

  • Elimination of the Coverage Gap Phase

  • Introduction of a $2,000 annual out of pocket threshold

 

 


Enrollment Guide

Direct Bill Retiree Enrollment Guide


 


Medicare Eligible Benefit Resources


Non Medicare Benefit Resources

 

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