Table of Contents ONLINE ENROLLMENT PLATFORM Benefit Choice Period .............1 Making benefit elections is simple through the MyBenefits website. What is Changing . 1 Follow these steps: What is Available in Your Area . 2 1. Go to MyBenefits.illinois.gov. Monthly Contributions . 3 2. In the top right corner of the home page, click Login. Adding a Dependent . 4 3. If you are logging in for the first time, click Register in the bottom Opt-Out . 4 right corner of the login box and follow the prompts. You will need Qualifying Changes in Status . .4 to provide your name as printed on the Benefit Choice materials mailed to your home. Transition of Care after 4. Enter your login ID and password. After logging in and landing on Health Plan Change . .4 the welcome page, explore your benefit options by clicking on the Health Plans . 5 benefit tiles. HMO Benefits . .5 5. After exploring your benefit options and determining which Open Access Plan (OAP) Benefits . 6 benefits you would like to elect, click on the Benefit Choice Event, Quality Care Health Plan located on the Welcome page. (QCHP) Benefits . 7 Consumer Driven Health Plan Need Help? (CDHP) Benefits . 8 AVA, the interactive digital assistant, is available online at Health Savings Accounts (HSA) and MyBenefits.illinois.gov Flexible Spending Accounts (FSA) . .9 Or HSA . 9 Contact MyBenefits Service Center (toll-free) MCAP . .10 844-251-1777, or 844-251-1778 (TDD/TTY) with inquiries. DCAP . .10 Representatives are available Monday – Friday, 8:00 AM - 6:00 PM CT. Vision .........................11 Dental . 12 Medicare Requirements ..........13 WHAT YOU NEED TO DO Total Retiree Advantage 1. Go to MyBenefits.illinois.gov to review your benefit options. Illinois (TRAIL) . 13 2. Choose the benefits you’d like to elect at MyBenefits.illinois.gov between May 1-June 1, 2021. Wellness . 14 3. Consider going paperless. Provide, or update your email Be Well Illinois . 14 address at MyBenefits.illinois.gov to receive quick responses and Employee Assistance Program notifications through electronic communications. (EAP) & Personal Support 4. Take advantage of your new benefits which will become effective Program (PSP) . .14 July 1, 2021. Smoking Cessation . 14 Weight-Loss . 14 Note: If you are not currently enrolled in benefits due to previous nonpayment of premiums, contact the Premium Collection Unit to Contacts.......................15 discuss your enrollment options 217-558-4783. Federally Required Notices . .16 DISCLAIMER Monthly health insurance contributions are based on your March 1st salary, or initial salary for new hires. Your monthly contribution amount reflected within this site is based on the salary reported on your paycheck for the first pay period in March, and will be adjusted as necessary, if updated information is provided. Benefit Choice Period Elect Your Benefits May 1 - June 1, 2021 TAKE ACTION! Here is a quick view of benefit changes for the coming plan year. Action is ONLY required if you intend to enroll or re-enroll in a Flexible Spending (MCAP/DCAP), or Health Savings account. If you wish to keep your current coverage as is, no action is required. What’s New The followi ng Benefit Changes effective July 1, 2021 Premium Changes Contribution amounts will vary based on the member's salary and chosen health plan (see page 3). Dental Only Coverage Beginning July 1, 2021, employees now have the option to enroll in Dental Only coverage. However, if you enroll in health coverage and choose dental coverage, dependents must mirror the coverage of the member. Health Plan Availability New this fiscal year, effective July 1, 2021, members now have the option of choosing from three OAP plans. We are pleased to announce that these Open Access Plans (OAP) will now be offered by Aetna, Healthlink and Blue Cross Blue Shield. Please check the map on Page 2 for coverage availability. HealthLink Service Area Outside of Illinois HealthLink members will continue to have network access in Missouri, Arkansas, Indiana, Kentucky, Ohio and Wisconsin. HealthLink members will no longer have access in other areas such as Florida or Texas. Behavioral Health For those enrolled in the Quality Care Health Plan (QCHP) and the Consumer Driven Health Plan (CDHP), your behavioral health provider network and claims will now be administered by Aetna. Please make sure to review the Aetna provider directory to ensure your provider is in-network, or contact Aetna (see page 15 for contact information) to discuss transition of care. Medical Care Assistance Plan (MCAP) & Dependent Care Assistance Plan (DCAP) For FY2022, the IRS has extended and added to the temporary COVID-19 flexibility for MCAP and DCAP (per the guidance of Notice 2021-15): • Any unused funds from your MCAP/DCAP account will be rolled over as long as you re-enroll in that program. • Additional election flexibility allowed, contactMyBenefits.illinois.gov . The American Rescue Plan has increased DCAP contributions to $5,250 for the FY22 plan year. You must enroll or re-enroll in a Flexible Spending Account each plan year. The MCAP benefit is not available if enrolling in an HSA. MyBenefits.illinois.gov SEGIP 1 What is Available in Your Area in FY22 Review the following map and charts to identify plans available in your county. Then, review your monthly contribution and plan benefits to determine which plan is best for you. BlueAdvantage HMO HMO Illinois Aetna OAP Blue Cross Blue Shield OAP Tiers I, II & III HealthLink OAP Tiers I, II & III Consumer Driven Health Plan (CDHP) Quality Care Health Plan (QCHP) Aetna HMO Health Alliance HMO Aetna OAP Blue Cross Blue Shield OAP Tiers I, II & III HealthLink OAP Tiers I, II & III (Except Ford County) Consumer Driven Health Plan (CDHP) Quality Care Health Plan (QCHP) Aetna HMO Health Alliance HMO Aetna OAP (Gallatin County has Tiers II & III Only) Blue Cross Blue Shield OAP Tiers II & III Only HealthLink OAP Tiers I, II & III Consumer Driven Health Plan (CDHP) Quality Care Health Plan (QCHP) Aetna HMO Health Alliance HMO Aetna OAP Blue Cross Blue Shield OAP Tiers II & III Only Consumer Driven Health Plan (CDHP) Quality Care Health Plan (QCHP) Aetna HMO BlueAdvantage HMO Health Alliance HMO HMO Illinois Aetna OAP Blue Cross Blue Shield OAP Tiers I, II & III HealthLink OAP Tiers I, II & III (Except Scott County) Consumer Driven Health Plan (CDHP) Quality Care Health Plan (QCHP) *Aetna HMO BlueAdvantage HMO Health Alliance HMO HMO Illinois Aetna OAP Blue Cross Blue Shield OAP Tiers II & III Only HealthLink OAP Tiers I, II & III (Except Stark County) Consumer Driven Health Plan (CDHP) Quality Care Health Plan (QCHP) *Aetna HMO BlueAdvantage HMO Health Alliance HMO HMO Illinois Aetna OAP Blue Cross Blue Shield OAP Tiers II & III Only HealthLink OAP Tiers II & III Only Consumer Driven Health Plan (CDHP) Quality Care Health Plan (QCHP) * Please be aware that some counties in the green and striped purple areas do not have provider coverage for either HMO Illinois or BlueAdvantage HMO; members in these counties may have access to the aforementioned health plan providers in a neighboring county. Please check with your provider for details. 2 FY2022 Benefit Choice Options Monthly Contributions The State shares the cost of health coverage with you. While the State covers the majority of the cost, you must make monthly contributions determined by your annual salary. The following charts outline monthly contribution rates for full-time members. Part-time members are required to pay a percentage of the State’s portion of the monthly contribution in addition to their own. Special rules apply for non-IRS dependents (see MyBenefits.illinois.gov for more information). Employee Aetna Blue Health HMO Aetna BCBSIL* HealthLink CDHP* QCHP* Annual Salary HMO Advantage Alliance Illinois OAP OAP OAP HMO HMO $0 to $30,200 $107 $83 $107 $87 $101 $101 $114 $85 $120 $30,201 - $45,600 $126 $102 $126 $106 $120 $120 $133 $104 $139 $45,601 - $60,700 $145 $121 $145 $125 $139 $139 $152 $123 $157 $60,701 - $75,900 $163 $139 $163 $143 $157 $157 $170 $141 $176 $75,901 - $100,000 $182 $158 $182 $162 $176 $176 $189 $160 $195 $100,001 - $125,000 $235 $211 $235 $215 $229 $229 $242 $213 $248 $125,001 & Over $268 $244 $268 $248 $262 $262 $275 $246 $281 Members who retire, accept a salary reduction, or return to State employment at a different salary may have their monthly contribution adjusted based upon the new salary. This applies to members who return to work after having a 10-day or greater break in State service after terminating employment. This does not apply to members who have a break in coverage due to a leave of absence. Dependent Monthly Health Plan Contributions In addition to monthly contributions for their own health coverage, members must make additional monthly contributions for dependents they cover. Dependents must be enrolled in the same plan as the member. The Medicare dependent monthly contribution applies only if Medicare is primary for both Parts A and B. Number of Aetna Blue Health HMO Aetna BCBSIL* HealthLink CDHP* QCHP* Dependents HMO Advantage Alliance Illinois OAP OAP OAP HMO HMO 1 Dependent $177 $141 $177 $145 $168 $168 $185 $153 $272 2+ Dependents $222 $177 $223 $184 $213 $213 $238 $197 $310 1 Medicare A & B $154 $120 $153 $124 $145 $145 $161 $130 $165 Primary Dependent 2+ Medicare A & B $196 $155 $197 $161 $187 $187 $208 $171 $226 Primary Dependents DISCLAIMER Retiree, annuitant, and survivor contributions for all health plan options will be in accordance with the levels set forth above in FY22. For future years, the State reserves the right to designate the plan options which constitute the basic program of health benefits and to require additional contributions in accordance with the law for any optional coverage elected by an annuitant, retiree, or survivor.