Skip to main content

State Members

Enrollment

Eligible Members

 Employees

Employees

MCHCP plans are available for individuals who are:

  • Active state employees covered by the Missouri State Employees' Retirement System (MOSERS) or another retirement system whose members are grandfathered for coverage under the plan by law; or
  • Eligible variable-hour (part-time) employees of a MOSERS participating department or agency; or
  • Active Department of Conservation, Department of Transportation, or Highway Patrol employees (Dental and Vision only).

View information for New Employees
View information for Medicare

 Retirees, Long-Term Disability, Terminated Vested Subscribers and Survivors

Retirees, Long-Term Disability, Terminated Vested Subscribers and Survivors

MCHCP plans are available to individuals who are eligible for benefits from MOSERS or another retirement system whose members are grandfathered for coverage under the plan by law.

View information for Retirement
View information for Long-Term Disability
View information for Terminated Vested
View information for Survivors
View information for Medicare

 Dependents

Dependents

MCHCP plans are available to dependents of enrolled subscribers. Proof of Eligibility is required for enrollment to be complete. Dependents include:

  • Spouse
    Marriage must be recognized by Missouri law.
    • Exceptions
      • Spouses who are also active state employees must enroll separately.
      • Spouses employed by the Missouri Department of Transportation, Department of Conservation or the Highway Patrol must be covered separately.
      • Active employees, terminated vested subscribers and retirees with coverage through MCHCP may transfer to/from one another’s plans, as long as coverage is continuous.
      • Spouses employed by a covered public entity may not have duplicate MCHCP coverage.
  • Children
    Dependent children are eligible for coverage through the end of the month in which they turn 26. Eligible children include:
    • Natural children
    • Adopted children from the date legal obligation begins for total or partial support of the child
    • Stepchildren
    • Foster children
    • Children for whom the subscriber or spouse is the court-appointed legal guardian
    • Newborn of a covered dependent, as long as the dependent continues to be covered by the subscriber
    • Children for whom the subscriber or spouse is required to provide coverage under a Qualified Medical Child Support Order (QMCSO)
    • Exceptions
      • Children age 26 or older may continue coverage if they became permanently disabled prior to age 26. New employees may add eligible disabled dependents as long as the disability occurred prior to age 26.
      • Children under 26 who are state employees may continue coverage under a parent's plan.
      • Children may have dual coverage if the parents are divorced or have never married, and both have coverage through MCHCP. MCHCP will only pay for a service once. If a child has coverage under both parents, the child will have a separate deductible and coinsurance under each policy.

Family Roll Up
Two married state employees who cover children may combine medical deductibles by participating in Family Roll Up.

Enrollment Periods

 New Employees

New Employees

New employees must enroll or waive coverage through the Statewide Employee Benefit Enrollment System (SEBES) within 31 days of hire date. Eligibility for coverage begins the first of the month after the hire date. Coverage begins on the first day of the month on or after enrollment is completed.

New hires will receive a SEBES enrollment password by email if email address is provided to their human resource/payroll representative. Otherwise, the SEBES password will be mailed to the new hire’s home address. Contact MCHCP for help accessing SEBES.

View information for New Employees

 Open Enrollment (October 1-31)

Open Enrollment (October 1-31)

During the annual Open Enrollment period, active employees may elect coverage and/or change coverage levels for themselves and eligible dependents, effective the following Jan. 1.

Terminated vested, long-term disability, retiree or survivor subscribers may change plans during Open Enrollment, but cannot add dependents nor enroll in new coverage.

View information for Retirement
View information for Long-Term Disability
View information for Terminated Vested
View information for Survivors

 Other Enrollment Periods

Other Enrollment Periods

Outside of Open Enrollment, active employees may enroll themselves and/or their dependents, and non-active subscribers may enroll new dependents, when one of the following occurs:

  • Life events – Marriage, Birth or Adoption (or placement of adopted child)
    Enrollment is available within 31 days of the event. Medical plans may be changed when adding dependents due to a life event. If changing medical plans, any amounts paid toward the deductible and out-of-pocket maximum will transfer to the new plan.
  • Loss of employer-sponsored group coverage
    An employee and their dependents, and non-active subscriber's dependents, may enroll within 60 days if they involuntarily lose employer-sponsored coverage for one of the following reasons:
    • Medical, dental, or vision plan terminates
    • Eligibility for coverage ends
    • Employer contributions toward the plan end
    • COBRA coverage ends
    Medical plans may be changed when adding dependents due to a loss of employee-sponsored group coverage. If changing medical plans, any amounts paid toward the deductible and out-of-pocket maximum will transfer to the new plan.
  • Loss of MO HealthNet or Medicaid status
    Enrollment is available within 60 days of loss. Medical plans may be changed when adding dependents due to a loss of MO HealthNet (or Medicaid) status. If changing medical plans, any amounts paid toward the deductible and out-of-pocket maximum will transfer to the new plan.
  • Qualified Medical Child Support Order (QMCSO)
    Enrollment is available within 60 days of the court order.

View Change or Cancel Coverage for information on how to handle specific enrollment and change events.

Termination of Coverage

Unless stated otherwise, coverage will terminate on the last day of the month in which one of the following events happen:

  • Subscriber employment ends, regardless of whether subscriber quits or is fired
  • Divorce or legal separation from the subscriber
  • Child reaches age 26
  • Failure to pay required premiums (see Premium Payments section below). In some cases coverage termination may be retroactive.
  • An act of fraud as prohibited by the terms of the plan or coverage. In some cases coverage termination may be retroactive. For more information, refer to Code of State Regulations
  • Threatening or committing violent acts against MCHCP or an employee of MCHCP

Coverage cannot be terminated on the basis of health status or the exercise of rights under MCHCP's appeal procedures.

Premium Payments

Active employee premiums are paid through payroll deduction. Extra deductions may be taken to pay for coverage depending upon the date of enrollment and the effective date of coverage. Retiree premiums are paid through benefit check deduction.

Subscribers whose premiums are not deducted from payroll or benefit check will be direct billed. Most direct billed premium payments are due on the 15th of each month. If the subscriber fails to make the necessary premium payments, coverage may terminate on the last day of the month for which full premium payment was received. The subscriber is responsible for claims submitted after the termination date.

Back to Top