Date: January 5, 2012
To: All Benefits Eligible Faculty and Staff
From: Vivian Fernández
Vice President Faculty and Staff Resources
Subject: Reminder of Changes in SHBP Insurance Premium Deductions and Federal Health Care Reform Plan Changes in 2012

This is a reminder that effective January 1, 2012 your State Health Benefits Program (SHBP) payroll deduction may change as a result of the new insurance premium structure and a change in the insurance premium deduction frequency.  These changes will be reflected in your paycheck dated January 6, 2012. In addition, we would like to alert you to enhancements in the State Health Benefits Program (SHBP) coverage implemented effective January 1, 2012 in response to Federal Health Care Reform legislation. For these reasons, it is important that you review these changes so you may plan accordingly.

Changes to the Insurance Premium Structure

The new State Health Benefits Program (SHBP) sliding fee scale premium structure for the SHBP medical and prescription plans became effective January 1, 2012. As stipulated by state law, under the new premium structure, if an employee’s current contribution rate is higher than what they would pay with the new premium structure, the employee will continue to contribute 1.5% of base salary until such time that the new premium exceeds the 1.5% contribution rate. The new SHBP premium structure will be phased in over a four-year period for current employees enrolled in a SHBP plan prior to June 28, 2011. Please note that under no circumstances will the SHBP contribution rates be reduced because of this change in premium contribution structure. Applicable changes in premium will be effective on January 1, 2012, and reflected in the paycheck dated January 6, 2011.

You may use the Employee Medical and Prescription Insurance Premium Estimator to help you determine the monthly premium costs for your medical and/or prescription coverage. When using the monthly premium calculator please keep in mind that premiums are deducted from your paycheck on a biweekly rather than monthly basis (see Changes to Insurance Premium Deduction Frequency below for more details).

Changes to Insurance Premium Deduction Frequency

Employees Paid Across the Calendar Year

Effective January 6, 2012, health insurance premiums will be deducted across 24 rather than 26 pay periods for the calendar year. As a result of this change, in the months with three pay periods, no premium deductions will be taken in the third pay period of the month.

Employees Paid Across the Academic Year

Effective January 6, 2012, health insurance and prescription premiums will be deducted across 20 pay periods. Double deductions will be taken commencing with the paycheck dated February 3, 2012 through March 16, 2012 in the same manner that dental insurance premiums are deducted in order to cover the summer months.These changes are due tothe new premium payment structure (i.e., a shift from premium contributions as a percent of base salary to a monthly premium payment).

Changes Due to the Federal Health Care Reform

Federal Health Reform legislation includes the passage of the Patient Protection and Affordable Care Act (PPACA) and the Health Care and Education Reconciliation (HCR) Act. This has resulted in the following enhancements to the State Health Benefits Program (SHBP) effective January 1, 2012:

  • Preventive Services, Immunizations and Certain Screenings
    Certain preventive care, such as immunizations (age and population restrictions may apply), certain screenings (blood pressure, cholesterol, depression, newborn, etc.), FDA-approved contraceptive methods, and well-baby care, will be covered by all of the SHBP medical plans without member cost sharing.  In addition, primary care well visits (annual exams) will no longer require a copayment or coinsurance by the member for certain wellness services provided by an in-network provider. However, if the preventive service is not the primary reason for the office visit, the member may still be responsible for a copayment or coinsurance. Contact your medical provider or plan for more information.
  • SHBP Coverage for Dependent Children up to Age 26
    A child up to age 26 is now eligible for coverage under the parent’s coverage even if the child is eligible for other employer-based coverage. Previously, the SHBP denied coverage if the child was eligible for other employer-based coverage. In addition, an “eligible dependent child” is defined as an enrollee’s child until age 26, regardless of the child’s marital, student, or financial dependency status – even if the young adult no longer lives with his or her parents.


If you have any questions, please contact a Benefits Specialist at 848-932-3990 or at