The below describes enrollment periods allowed under the State Health Benefit Plan.
Initial Enrollment Period (New Hires/Certain Former Employees)
- For SHBP purposes, a New Hire is a newly eligible employee enrolling in SHBP coverage for the first time, or a former member with a gap in SHBP coverage of 31 days or more.
- New Hires must elect SHBP coverage within 31 days of their hire date. To enroll, the New Hire has 31 days from the date of hire to go online and make an election for coverage.
- If no election is made, the system will default the Eligible Person to “No Coverage” and their next opportunity to enroll will be during the annual Open Enrollment period or upon a Qualifying Event.
- SHBP will not provide benefits for health services received before the effective date of coverage.
Open Enrollment (OE)
- Eligible Employees employed in a benefits eligible position that offers SHBP coverage, Active Members, including those on Approved Leave without Pay, Former Employees, and COBRA participants shall be given an opportunity to enroll or change Coverage during the annual Open Enrollment period.
- In order for Eligible Employees, Active Members, and Former Employees to continue their State Health Benefit Plan (SHBP) coverage as a Retiree, they and any dependents they want covered, must be enrolled in the Plan immediately prior to their retirement (e.g., if you had no coverage prior to Open Enrollment, and retire after Open Enrollment effective January 1, then you are not eligible for SHBP coverage as a retiree). If you are not enrolled in the SHBP and wish to carry coverage as a retiree, you will need to enroll during Open Enrollment the year prior to your retirement.
- If you make a change during Open Enrollment but retire before the change can become effective on January 1, your elections prior to Open Enrollment, including your Plan Option, Tier and covered dependents will remain the same.
Retiree Option Change Period (ROCP)
- Retirees do not have an open enrollment period and cannot enroll their spouses or dependents during Open Enrollment.
- During the Retiree Option Change Period, enrolled Retirees shall be given an opportunity to change their Plan Option to any Plan Option for which the Retiree is eligible. Since Retirees do not have an open enrollment period, they cannot change their Tier during the ROCP.
- When a Retiree’s SHBP coverage is terminated for any reason, it cannot be reinstated unless the Retiree returns to work in a benefits eligible position that offers SHBP coverage.
Special Enrollment Period / Qualifying Events
Eligible Employees employed in a benefits eligible position that offers SHBP coverage, Active Members, including those on Approved Leave without Pay, Retirees, Former Employees, and COBRA participants who have certain qualifying events during the year, may be able to make a coverage change that is consistent with the qualifying event.
Additional Eligibility and Enrollment Information
For more information regarding eligibility and enrollment (e.g., coverage effective dates, qualifying events, dependent verification), please visit the Plan Documents section of this website, specifically the Eligibility & Enrollment Provisions and State Rules & Regulations for SHBP.