Your Health Plan
The State and School Employees’ Health Insurance Plan provides two options: the Select Plan and the Base Plan (also known as the High Deductible Health Plan or HDHP). In order to determine which type coverage is best for you, please review Base vs Select Coverage.
Your coverage will begin on your first day of employment or date of eligibility. If you don’t enroll or choose to waive coverage within 31 days of starting your job or date of eligibility, you can only apply during an open enrollment or special enrollment period.
Rates & Premiums
An employee who was initially employed before January 1, 2006, is a Legacy Employee. An employee employed on or after January 1, 2006, who was ever a full-time employee of a community/junior college, public library, public school district, State agency or university before January 1, 2006, is also considered a Legacy Employee. An employee initially employed on or after January 1, 2006, is a Horizon Employee.
View Health Plan Premiums/Rates for Horizon and Legacy Employees.
Wellness/Preventive Services
Adult Care
Wellness and preventive care benefits are provided at 100% of the allowable charge for certain diagnostic tests and up to two office visits each year. Wellness services are not subject to the calendar year deductible. Diagnostic tests are based on the participant’s age and gender. Wellness and preventive care benefits are only provided when a participating provider renders the service, and the wellness services are filed with a wellness diagnosis.
Well-Child Care
Benefits are provided for well-child care services for covered dependents up to age 18 at 100%. Services are not subject to the calendar year deductible. Benefits are only provided when a participating provider renders the service and the wellness services are filed with a wellness diagnosis.
Well-newborn nursery care is covered at 100 percent while a newborn is hospital-confined after birth. Well-newborn nursery care includes room, board and other normal care provided for which a network hospital or physician makes a charge. Also, well-child physician office visits, certain diagnostic tests and immunizations are covered at 100 percent.
If you have questions about this coverage, please contact Blue Cross & Blue Shield of Mississippi at 800-709-7881.
View Wellness/Preventive Coverage Information
Pharmacy Benefits
CVS Caremark is the pharmacy benefit manager (PBM) for the Plan’s prescription drug program and serves approximately 26 million members across the country. CVS Caremark processes prescription claims from participating pharmacies, mail order claims and paper claims filed by participants and is focused on keeping prescriptions affordable while providing a customer service experience that makes it easy to get necessary medicines.
Please note, you are not required to use CVS for your pharmacy needs. You are free to choose any pharmacy you prefer.
Online Provider Visits (Telemedicine)
Employees and their family members who are enrolled in the State and School Employees’ Health Insurance Plan have the opportunity to seek online services for minor medical care. Telemedicine services through UMMC2You provides an opportunity to consult with a board-certified medical care provider for common medical issues, such as headache, fever, rashes, sore throat, cold, flu and insect bites.
Generally, a diagnosis can be made and treatment prescribed but in some cases, the patient may receive a referral for in-office services. There are times when symptoms alone are not enough to provide diagnosis so lab work or diagnostics may be necessary.
View Telehealth Provider Visits Information
ActiveHealth Management
Motivating Mississippi – Keys to Living Healthy is the State and School Employees’ Health Insurance Plan’s wellness and preventative health program. Working with ActiveHealth Management, the Plan’s health management vendor, Plan participants are provided with the tools and resources to help them lead healthier lives. Services provided by ActiveHealth are included at no additional charge to Plan participants.