Enroll in the State Health Plan

Who is eligible to enroll in a benefit plan with the State Health Plan?

State employees with a permanent appointment working at least 30 hours per week. For these employees, the state pays 100% of the cost of the coverage.
Permanent state employees working 20 or more hours but less than 30 per week. These employees may enroll, but they must pay the full cost of coverage.
Dependents' coverage, paid by the employee alone, is available at group rates.

New employees who enroll themselves and dependents within 30 days of employment are not subject to a waiting period for pre-existing conditions.

To enroll in a plan, follow these simple steps:

Enroll
- Enrollment form(PDF, 82KB)
- Enrollment form(PDF, 172KB)
  For National Guard, Fire Department, Rescue Squad and Emergency Medical Services Members.
Complete any necessary forms for your dependents
- Certification of Dependent Eligibility (PDF, 117KB)
  If you have a child whose last name is different from yours, you will need to complete this form.
- Coverage Request for Incapacitated Dependent (PDF, 62.65KB)
  If you have a child over age 19 who is eligible as a mentally or physically incapacitated dependent, complete this form.
Indicate if you were covered under a previous plan
- Prior Health Coverage Information (PDF, 183KB)
  If you had coverage under a previous plan, you can apply to receive credit against the waiting period for pre-existing conditions.

Please print out the appropriate forms above and give the completed forms to your Health Benefits Representative in your human resources department for processing.