On Friday, June 10, 2011, a Sangamon County judge issued an order prohibiting any further State action in the awarding of the two self-insured Open Access Plans, i.e. HealthLink OAP and PersonalCare OAP, and leaves State employees, including employees of the University of Illinois, with no Open Access Plan options after June 30th.
As of June 13, 2011, the only plan choices effective for July 1 are HMO Illinois, Blue Advantage HMO, and Quality Care Health Plan. All employees in one of the discontinued plans (including current HealthLink OAP and PersonalCare HMO members, as well as Humana and Health Alliance members) will need to make a plan selection or will be defaulted into the Quality Care Health Plan. If you live in a county where there is no HMO coverage, and you elect or are defaulted into Quality Care, you will be charged a special rate that has not yet been determined. Please continuing reading for more information!
WHAT TO DO NOW:
YOU MUST STILL MAKE A CHOICE BY THIS FRIDAY, JUNE 17. Unless mitigating measures are taken by the state, your choice will now be as follows:
If you live in a county with the HMO Illinois and Blue Advantage HMO options, you may choose:
1. HMO Illinois
2. Blue Advantage HMO
3. Quality Care Health Plan (QCHP)
4. If available in your county, you may select PersonalCare OAP, but with the understanding that you will be defaulted to QCHP as of July 1, if no changes are made by the state.
5. If available in your county , you may select HealthLink OAP, but with the understanding that you will be defaulted to QCHP as of July 1, if no changes are made by the state.
If you live in a county WITHOUT the HMO options:
1. Quality Care Health Plan (QCHP)
2. You may select PersonalCare OAP, but with the understanding that you will be defaulted to QCHP as of July 1, if no changes are made by the state.
3. You may select HealthLink OAP, but with the understanding that you will be defaulted to QCHP as of July 1, if no changes are made by the state.
You also have the option to opt-out of state health insurance coverage with proof of other creditable coverage. The documentation of such proof must be provided to the UPB Benefits Services by June 27, 2011.
The deadline remains at June 17 for making Flexible Spending Account (MCAP or DCAP) enrollments as well.
WHAT COULD HAPPEN:
The State is reviewing its options to enter into emergency contracts to ensure managed care coverage across the state. Until such time as the trial court's order is reversed or superseded or emergency contracts can be completed, the only enrollment options for members are as stated above. Unless emergency contracts can be entered into or the trial court's order is reversed or superseded before July 1, any member not enrolled in either HMO Illinois or BlueAdvantage HMO will be automatically defaulted into the Quality Care Health Plan effective July 1, 2011.
STATEMENT FROM CMS:
The state's department of Central Management Services (CMS) stated on their website, "The State is appealing this decision immediately. We are greatly disappointed with the court's decision and with the resulting uncertainty and current, limited options it causes for our members. We assure you that we will take whatever steps that we can to provide managed care options to you for the 2012 plan year."
MORE INFORMATION:
University Payroll & Benefits and University Human Resources are staying in touch with CMS and watching for any developments. If conditions change, we will communicate to you as soon as possible.
Watch NESSIE's home page for the latest Benefit Choice news and announcements.
CMS will also be updating their Benefit Choice websiteas information becomes available.
If you have any questions about your benefit plans or do not have access to a computer, please contact your campus UPB Benefits Services office or send e-mail to benefits@uillinois.edu.
UPB Benefits Services - Urbana: (217) 333-3111
UPB Benefits Services - Chicago: (312) 996-6471
UPB Benefits Services - Springfield: (217) 206-7144
UPB Benefits Services (Toll-Free): 866-669-4772, Select Option #1
Dependent and OPT OUT Documentation fax: (217) 244-3135
