Health Enhancement Program
SEBAC provides for a Health Enhancement Program in which you have the opportunity to enroll. This program provides for increased monitoring of health care measures, while also offering new wellness programs such as weight management, smoking cessation, etc. Although this is strictly a voluntary program, employees who do not enroll will pay $100 per month higher in premiums, and will have an annual $350 per individual in-network medical deductible.
Health Enhancement Program Requirements
You and your enrolled family members must get age-appropriate wellness exams, early diagnosis screenings (such as colorectal cancer screenings, Pap tests, mammograms, and vision exams).
For calendar year 2013 you must complete at least one dental cleaning. All of the plans cover up to two cleanings per year (HEP enrollees are covered 100% for these cleanings). Periodontal maintenance is not subject to an annual maximum for HEP participants; however, cost shares and frequency limits may still apply. See page 22 for additional information.
Additional Requirements for Those With Certain Conditions
If you or any of your enrolled family members have
1) Diabetes (Type 1 or 2),
2) asthma or COPD,
3)heart disease/heart failure,
4)hyperlipidemia (high cholesterol), or
5) hypertension (high blood pressure),
You or that family member will be required to participate in a disease education and counseling program for that particular condition.
You will receive free office visits and reduced pharmacy co-pays for treatments related to your condition (see Your Prescription Drug Coverage at a Glance on page 18 for cost details).These particular conditions are targeted because they account for a large part of our total health care costs and have been shown to respond particularly well to disease education and counseling programs. By participating in these programs, affected employees and family members will be given additional resources to improve their health.
New HEP Administrator and Website
Care Management Solutions, an affiliate of ConnectiCare, is the new administrator for the Health Enhancement Program (HEP). The HEP participant portal has new features to help you manage your health and your HEP requirements. You can visit www.cthep.com to:
- View HEP requirements and download HEP forms
- Check your HEP compliance status
- Access a library of health information and articles
- Set and track personal health goals Exchange messages with HEP Nurse Case Managers and professionals
- You can also call Care Management Solutions to speak with a representative.
Care Mangement Solutions
Monday – Friday, 8:00 a.m. – 5:00 p.m.
An online tutorial has been created to provide information about the new site and help you with registering. Visit www.cthep.com and click on the hyperlink to your right.
REVISED CHILD ELIGIBILITY RULES EFFECTIVE JULY 1, 2011
In accordance with the "Affordable Care Act" medical/prescription drug eligibility rules are revised to allow enrollment of the Subscriber's natural, adopted child, or stepchild who are:
1) Up to age 26;
2) Any age if permanently and totally disabled, and who are enrolled as a dependent in the State plan or an equivalent plan at the time the disability occurred;
3) And, whether or not they are:
(a) Married (a dependent's spouse or the employee's grandchildren are still not eligible for coverage);
(b) Living in Connecticut;
(c) Living with the Employee;
(d) In School;
(e) Financially dependent on the employee; or
(f) Eligible to enroll in their employer's health coverage.
Eligibility rules for the state dental plans are not affected by the federal "Affordable Care Act".
Please do not hesitate to contact the HR office with questions or concerns. Please
direct all initial health insurance and benefit questions to Fran Poole at x25059