The State Employees Health Care Commission Passes Changes for Plan Year 2025
Open Enrollment Begins October 1
All rates and plan design decisions are made annually by the State Employees Health Care Commission (HCC). At their June meeting, the Commission voted to implement the below changes for Plan Year 2025:
For care received after 1/1/2024:
- Added coverage for residential treatment centers as an eligible service provider.
- Enhanced coverage for ultrasound and MRIs for breast cancer screening.
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For members enrolled in Plan A, the plan will pay the allowed charge for ultrasounds and MRIs for breast cancer screenings in full when performed by a Network provider.
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For Plans C, J and N, ultrasounds and MRI screenings will be subject to the plan annual deductible. After the deductible is satisfied, the allowed charge for ultrasound and MRI breast cancer screenings will be paid in full when performed by a Network provider.
For care received after 1/1/2025:
- The Lifetime Orthodontic Benefit Maximum will increase from $1,000 to $1,500 per member.
- The Dental Annual Benefit Maximum will increase to $2,000 per member per year.
- For Plans C and N, the updated member plus dependent deductible will be $3,300 for the individual and the total family deductible remains $5,500. This change was necessary due to changes in the IRS minimum deductible requirement.
Rates for Plan Year 2025:
- Employer rates will increase 7.5% effective 7/1/2025
- Employee rates will remain unchanged.
HSA/HRA Contributions
- No changes to the Employer HRA/HSA contributions.
Health Care Commission Selects New Voluntary Prescription Eyewear Provider
Beginning January 1, 2025, Surency Vision will return as the prescription eyewear insurance provider for the State of Kansas employees.
Surency Vision will be offering both the Basic and the Enhance Plans. The Enhanced Plan will include a new benefit enhancement for progressive lenses.
Benefit and coverage details will be available during Open Enrollment.
Request a Printed Open Enrollment Guide
Once again, the SEHP will be producing a digital pdf of the 2025 Open Enrollment guide for all members. This file will be available on the SEHP website by mid-September.
Should members want a printed copy mailed to them, they will need to request a copy by completing this web form by July 31, 2024. All members will receive an email the second week of July with the request link.
Marathon Health Anywhere is a virtual care platform that provides access to a dedicated care team of primary care providers, behavior health specialists and health coaches.
Anywhere services are available to all active employees, spouses and dependents (age 2+) covered by State Employee Health Plan (Plans A, C, J and N). Preventive visits and health coaching are free for all members. Medical visits and Behavioral Health visits are free for Plan A members and $40 per visit for Plan C, J and N members. Through the Anywhere service, members can schedule a biometric screening in their area.
Whether you’re sick with a sinus infection, want to lose weight or need help managing your blood pressure or diabetes, the dedicated virtual care team offers the support you want as well as spending more time with you during your appointment.
In today’s ever-changing world, we understand that your mental health is just as important as your physical wellbeing. That’s why we offer behavioral health counselors to help with stress, grief, depression, and any other concerns on your mind.
To get started with the Marathon Health Anywhere program, you can schedule an appointment by calling (785) 783-4080 or by visiting the HealthQuest portal at www.HealthQuest.ks.gov.
Anywhere appointments can be scheduled Monday through Friday from 7 a.m. - 5 p.m. CST or with nurse on call from 5 p.m. to 7 a.m. CST
Open enrollment is October 1 through 31st, Information on open enrollment meetings will be available soon.
Important Dates & Deadlines
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July 18 - Wellness Webinar: The Value of an Annual Exam, Register in the HealthQuest Portal.
October 1-31 - Plan Year 2025 Open Enrollment
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