Your Health & Wellness Resources

Disease and Case Management services are available for members with chronic obstructive pulmonary disease (COPD), congestive heart failure, coronary artery disease, diabetes, asthma, cerebrovascular disease and peripheral artery disease. If you are eligible for this service, you will be notified.

Base PPO Plan (70/30) and Enhanced PPO Plan (80/20) Members:

Adult and child (age 6+) nutrition and weight management services are included under the Affordable Care Act’s preventive services, meaning that they are covered at 100% for members on the Base PPO Plan (70/30) and Enhanced PPO Plan (80/20). These services can be delivered in an in-network* office, urgent care, or outpatient facility settings and include:

• Nutritional Counseling, which may include counseling specific to achieving or maintaining a healthy weight
• Obesity Screening
• Behavioral Intervention

*For out-of-network costs associated with these services, please go to the Employee Benefits page and see your plan’s Benefit Booklet.
 
To find an in-network dietitian, use our Find a Doctor tool and search under "Specialist" for a licensed dietitian/nutritionist.

FDA-approved weight management medications and bariatric surgery are covered benefits. Go to the Employee Benefits page and refer to your plan’s Benefit Booklet and the Preferred Drug List for additional information and restrictions.

Members eligible for services are members whose primary health coverage is through the State Health Plan. Federal law prohibits the Plan from using your personal health information to discriminate against you in any way or from giving this information to your employing agency/school or other unauthorized third party, unless required by law.

Pregnancy Diagnosis and Maternity Visits
You can expect to pay an initial copay or coinsurance cost for your first pregnancy visit (diagnostic visit), or first visit, however, visits thereafter will be covered at no charge. Your remaining maternity visits are covered by one global fee subject to the inpatient copay, deductible, and coinsurance upon hospital admission/delivery.

Adding Newborns to Your Health Plan
You must take action to add your newborn to your health plan.  Your newborn must be added to your health plan within 30 days of their date of birth.

Remember, if you currently have employee-only or employee-spouse coverage, your coverage will change when you add your newborn to either employee-child or employee-family coverage. As a result, you will have to pay the additional premium for the month in which the child is born.

For more information, please see the Adding Dependents section of your plan’s Benefits Booklet, speak with your Health Benefits Representative or call the Eligbility and Enrollment Support Center at 855-859-0966.

Members eligible for services are members whose primary health coverage is through the State Health Plan. Federal law prohibits the Plan from using your personal health information to discriminate against you in any way or from giving this information to your employing agency/school or other unauthorized third party, unless required by law.

Tobacco Cessation Resources

As a State Health Plan member, you have access to a variety of tobacco cessation resources to help you quit smoking, chewing tobacco, using snuff, or even e-cigarettes (vaping).

• All plans cover in-person counseling with your provider or behavioral therapist
• $0 Prescription Medications [Base PPO Plan (70/30) & Enhanced PPO Plan (80/20)]
  • Nicotrol (nicotine inhalation system)
  • Nicotrol NS (nicotine nasal spray)
  • Generic bupropion sustained-release 150 mg
  • Generic varenicline tab 0.5 mg and 1 mg
  • Generic nicotine replacement products (patch, gum and lozenges)

Primary Care Provider Tobacco Cessation Counseling

During Open Enrollment or when enrolling within 30 days of being first eligible, State Health Plan members will need to attest that they do not use tobacco or will commit to visit a Primary Care Provider (PCP) who offers counseling for at least one tobacco cessation counseling session within 60 days after the last day of Open Enrollment or from their initial hire date, or risk losing their premium credit.

Only one session is required in order to maintain the premium credit. Members may present their State Health Plan ID card in order for the visit to be covered at 100% by the Plan.

In addition, all Plan members who are tobacco users and wish to enroll in PCP tobacco cessation counseling may do so.

Personal Health Portal

The Personal Health Portal, open to all active employees and non-Medicare retirees, provides a comprehensive library of tools and resources to help you assess health risks and engage in healthy activities.

The portal also includes a variety of resources:

• Health Challenges: Each quarter of the year you will have the opportunity to complete a 4-week challenge, covering nutrition, physical activity, weight management and stress.
• Online Health Assessment: This 15-minute online assessment helps you gauge your current health status and identify any concerns, so you can track your progress in the months ahead.
• Healthy Living Conversations: These are quick, interactive conversations covering a variety of health topics, such as stress, back pain and getting active.
• Online Monthly Seminars: Fun and interesting online seminars are available each month and focus on various health and wellness topics, such as nutrition, fitness and stress reduction.
• Extensive Health and Video Library: The portal provides a library of resources to assist you in assessing health risks and engaging in healthy activities, including more than 500 videos.

The Personal Health Portal is available via eBenefits, your one-stop shop for all member benefit information. To get started, click on eBenefits. Once logged into eBenefits, look for a link to Blue Connect in the left-hand menu. Once in Blue Connect, click Wellness at the top of the page.
 

Blue365, open to all active employees and non-Medicare retirees, offers premier health and wellness discounts and is free to join for State Health Plan members. A variety of exclusive discounts are available! Offers change weekly. Here’s just a sample of what’s available:

• Apparel & Footwear: Save on name brands
• Fitness: Gym and online experience discounts
• Hearing & Vision: Save on eye and hearing exams, vision products and hearing aids
• Home & Family: Find deals on vitamins, health supplies and wellness products
• Nutrition: Enjoy savings on nutrition services and products
• Personal Care: Save on mindfulness-based courses and personal care products
• Travel: Save on hotels, car rental and vacation activities

Remember, offers change weekly! Sign up for weekly emails to receive the deals using the steps below.

For State Health Plan members, Blue365 is available via eBenefits, your one-stop shop for all member benefit information. To get started, click on eBenefits. Once logged into eBenefits, look for a link to Blue Connect in the left-hand menu. Once in Blue Connect, click Wellness at the top of the page. Scroll down to Member Discounts Blue365 Program to click and save!