Eligible employees have the option to enroll in one of several available State health plans.
- HMO’s (Health Maintenance Organization)
- Members are required to stay within the health plan provider network
- Members will need to select a primary care physician (PCP) from a network of participating providers
- The PCP will direct all healthcare services and make referrals to specialists and hospitalization.
- OAP (Open Access Plan)
- Members will have three tiers of providers from which to choose to obtain services.
- Members can mix and match providers and tiers.
- QCHP (Quality Care Health Plan)
- Members can choose any physician or hospital for medical services and any pharmacy for prescription drugs.
- Nationwide network of physicians, hospitals, ancillary providers, pharmacies, and behavioral health services
- CDHP (Consumer Driven Health Plan)
- High deductible health plan as defined by the IRS
- Members may choose any physician or hospital for medical services
- Nationwide network of providers through Aetna PPO
- When paired with a Health Savings Account (HSA), receive a State contribution of one-third of the CDHP deductible for the plan year.
Summary of Health Benefits and Coverage
Health Plan Provider Directory
State Employees Group Insurance Program Benefit Choice Booklet
- The health plans map (Page 2) specifies which plans are available in your area.
- Monthly contribution rates of individual and dependent health plans can be found on Page 3.
- Each health plan includes prescription benefits.
Employees also have the option to opt out of the state-provided coverage.
