OPEN ENROLLMENT for Medical, Dental and Vision Insurance is

October 1-October 31, 2011

Please check out the information at the link below to become informed about the choices you have for insurance coverage.  This will help you decide what coverage will be best for you this year.

http://www.kdheks.gov/hcf/sehp/NSEGroup.htm

HealthQuest - State of Kansas Health & Wellness Program

http://www.kdheks.gov/hcf/healthquest/default.htm

HealthQuest Member Portal - where you can sign into HealthQuest.

https://www.kansashealthquest.com/portal/server.pt

NEWLY ELIGIBLE DEPENDENTS

Adding dependents may be made during Open Enrollment or within 31 days of a qualifying event.

You must complete and sign all Enrollment or Change Forms adding newly eligible dependents within 31 days

of the event that makes the dependent(s) newly eligible.

The following appropriate documentation is required to be submitted to the SEHP with the Enrollment or

Change Form:

1. Marriage License in English (for proof of spouse and stepchild eligibility)

2. Birth certificate or hospital birth announcement in English for newborns (Note: Birth registration cards

are not acceptable proof for child eligibility)

3. Petition for adoption or placement agreement in English for dependent child

4. Legal custody or guardianship document in English issued by the court

5. Court order in English for dependents who are not natural or adopted children of yours

6. Certificate of birth in English and Dependent Grandchild Affidavit for children born to a covered

dependent (grandchild)

7. An Application for Coverage of Permanent and Totally Disabled Dependent Child affidavit for covered

dependent children aged 26 or older

8. Copies of the most current year’s filed Federal tax return (for proof of spouse eligibility only.) The

pages needed from the current filed Federal tax returns depend on which Tax form was filed:

· Form 1040—pages 1 & 2 showing filer’s name, spouse’s name and both the filer’s and spouse’s

signatures

· Form 1040A-- pages 1 & 2 showing filer’s name, spouse’s name and both the filer’s and

spouse’s signatures

Please note: Income information may be blacked out on the Federal tax return prior to submission to SEHP Membership Services.

9. Divorce decree in English (first and last page only of court document)

Please contact your Human Resources office for additional information.

NOTE: Regarding a newborn child of your dependent child (grandchild); your grandchild will only be covered for the first 5 days from the date of birth. Coverage for your grandchild will end on the 6th day if you do not complete a Change Form requesting to add your dependent grandchild to coverage (along with appropriate supporting dependent documentation) within 31 days from the date of birth.