2024 - Benefit Coverage & Plans PEIP
Public Employees Insurance Program (PEIP) Medical insurance coverage is available to benefit-eligible employees working at least 20 hours per week for employees in the following Bargaining Units:
- Educational Assistants
- School and Community Service Professionals (SCSP)
- SUTR Residents
The medical insurance carrier for the members of the bargaining units listed above is the Public Employee's Insurance Program PEIP administered by Innovo. Benefit eligible employees can enroll into coverage within 30 days of their hire date, during Active enrollment or within 30 days of a qualifying status change. Levels of coverage include employee only, employee plus one dependent, and family coverage.
Public Employee's Insurance Program (PEIP)
The PEIP Advantage plans offer the following features:
- A choice of two networks with a uniform, comprehensive set of benefits across all two carriers:
- A choice of three benefit plan design options:
- Advantage High
- Advantage Value
- HSA - compatible
- State-wide tiered network of primary care clinics (PCC):
- Each member chooses a primary care clinic to deliver and coordinate care. Click here for the Primary Care Clinic list
- Benefits for each plan level are based on the cost level of your primary care clinic. Cost levels are shown in the PEIP Medical Comparison Chart shown above.
- Family members may elect different primary care clinics (even in different cost levels), but must enroll with the same carrier.
- Members can change clinics throughout the year by calling their network carrier.
- Referrals are needed for specialist care outside the primary care group. No referrals are needed for emergencies or urgent care. Participant can self-refer to OBGyn, Chiropractic, Routine Vision, Mental Health/Chemical Dependency, provided the practitioner is with the carriers' self-referral network.
- No co-payments are charged for preventive care such as well-child care, immunizations, annual check-ups, cancer screenings, routine eye and hearing exams, etc.
- There is no coverage for non-network services, unless referred or living outside the service area.
PEIP Public Employees Insurance Program Benefit Schedules
Below are the 3 PEIP Advantage Health Plan Benefit Schedules available beginning January 2024 for Educational Assistants, School and Community Service Professionals and Teachers for medical coverage.