To: HMO Illinois Participants (Chicago and Urbana)
From: James P. Davito, Director Benefits Services, University Payroll and Benefits (UPB)
Subject: Medical Group Rush Health Associates #332
One of the large medical groups currently available in HMO Illinois is Rush Health Associates #332 (Rush). This communication is intended for those of you who have selected Rush as your medical group provider. Their contract with Blue Cross/Blue Shield (BC/BS) HMO Illinois is due to terminate on December 31, 2010. If Rush and BC/BS do not reach an agreement to extend their contract, you will need to make a change effective January 1, 2011.
If Rush and BC/BS contract ends on December 31, 2010, you will have 2 options -
1. BC/BS has sent letters advising participants who have chosen Rush as their medical group selection, to select a new contracting medical group and notify BC/BS Member Services (telephone # 800-868-9520) by December 8, for a smooth transition. If you take no action with BC/BS, they will automatically assign you to a new contracting medical group.
2. Once it has become final that your medical group terminated from your BC/BS HMO Illinois plan, you will also have the opportunity (for 60 days from January 1, 2011) to switch to the State's Quality Care Health Plan, by using NESSIE. Go to https://nessie.uihr.uillinois.edu/cf/benefits/index.cfm?Item_ID=20 and select "Change health plans" and the following "Qualifying Event" - Change in Health Plan Due to Primary Care Physician Leaving the Network. Please note that the effective date of this health plan change will be the date of the event or the date of the request, whichever is later. The documentation required for this health plan change is a copy of the letter you receive from BC/BS stating that Rush providers have left their network. Documentation can be faxed to your campus UPB Benefits Services office.
If Rush and BC/BS extend their contractual arrangement into 2011 -
As a participant in HMO Illinois you can change your medical group selection at any time, so you will be able to choose or change to any eligible medical group in the HMO Illinois network. Since your medical group selection (Rush) would still be available in your HMO Illinois plan, you will not have the opportunity to switch to the State's Quality Care Health Plan.
If you have any questions, please contact your campus UPB Benefits Services office or send email to benefits@uillinois.edu.
UPB Benefits Services - Chicago
Phone: 312-996-6471
Fax: 312-996-5733
UPB Benefits Services - Urbana
Phone: 217-333-3111
Toll-Free: 866-669-4772, Option 1
Fax: 217-244-3135
