In accordance with Public Act 92-0600, full-time employees, retirees, annuitants and survivors may elect to Opt Out of the State Employees Health Insurance Program if proof of other major medical insurance can be provided by an entity other than the Department of Central Management Services. Opting out will terminate all health, dental, vision and prescription coverage for the member and any dependents; however, the member's life insurance coverage will remain in force (Basic Life and any elected Optional Life). Non-Medicare annuitants and survivors who elect to opt out, will be opting out of health, vision, behavioral health and prescription coverage. Dental and optional life insurance coverage will remain in effect unless the annuitant specifically terminates the coverage during the Benefit Choice Period.
Members who wish to Opt Out must complete the Opt Out Certificate, attach proof of other insurance coverage (such as a copy of an insurance card from another health plan that names you as being insured) and return to the Group Insurance Representative within 60 days of the qualifying event date. Annuitants interested in opting out and receiving a financial incentive must complete the Opt Out with Financial Incentive packet on the Annuitants Opt Out page.
Members opting out of the Program are not eligible for the:
- Free influenza immunizations offered annually by the Department of Healthcare and Family Services
- COBRA continuation of coverage
- Smoking Cessation Benefit
- Weight-Loss Benefit
Employees opting out of the Program are eligible for the:
- Flexible Spending Account (FSA) Program
- Commuter Savings Program (CSP)
- Paid maternity/paternity benefit
- Either of the two separate Employee Assistance Programs
- Long-Term Care Program
- Adoption Benefit Program
Individuals who opt out under either public act may re-enroll in the Program only during the annual Benefit Choice period (May 1 - 31 each year), or within 60 days of experiencing an eligible qualifying change in status.