Are you enrolled in the Quality Care Health Plan and concerned with the delay in payments to your healthcare providers? The State of Illinois is still experiencing an unprecedented funding situation which has significantly impacted the State Employees’ Group Insurance Program. Please see below for a list of frequently asked questions that may guide you or assist with your concerns.
Where can I view information on the claims payments that are being released?
The Department of Central Management Services (CMS) posts the dates CIGNA is currently releasing for claims payments on their website at http://www2.illinois.gov/cms/Employees/benefits/StateEmployee/Pages/QCHPQCDPClaimPaymentDelay.aspx.
Who can I contact for concerns regarding claims payments?
You may email CMS Member Services at CMS.WebsiteBenefits@illinois.gov or call 217-558-4486.
Should I pay the bill I am receiving from my healthcare provider?
It is ultimately your responsibility to make reimbursement arrangements with your provider. If you make arrangements to pay the bill, the healthcare provider will reimburse you once payment is received from CIGNA.
How would I go about expressing my concerns about the claims delays and how this delay is affecting me?
You may complete a Feedback Form at http://www2.illinois.gov/cms/ClientRelations/Pages/Feedback.aspx.
What can I do if my healthcare provider is asking for payment in full upfront for services (i.e., MRI, Surgery) that I cannot afford?
Please contact CMS Member Services by email at CMS.WebsiteBenefits@illinois.gov or call 217-558-4486.
What are my options if this plan is not a good fit for me?
You may change your health plan during Benefits Choice which begins May 1 and continues through May 31 with an effective date of July 1. You may wish to consider whether a managed care plan, a Health Maintenance Organization (HMO) or an Open Access Plan (OAP), would meet your needs. CMS is holding Vendor Fairs late April through May where you will be able to talk to the different health vendors and have your questions answered. For more information on the Vendor Fairs please visit http://www2.illinois.gov/cms/Employees/benefits/StateEmployee/Documents/FY%202014%20Benefit%20Fairs.pdf. UPB Benefits Services is also available to answer your questions.
Please contact your campus UPB Benefits Services office with any questions.
Email – firstname.lastname@example.org
Urbana – 217-333-3111
Chicago – 312-996-6471
Springfield – 217-206-7144