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   Insurance Latest News Archive   


The Supreme Court of Illinois has issued a ruling in the Kanerva vs. Weems court case regarding retiree health insurance premiums. We are aware that many people have questions about the impact this will have on current retirees. CMS is currently reviewing the ruling and will have more information at a later time. 07/03/14


In anticipation of the FY2016 Benefit Choice Period, several Benefit Fairs have been scheduled at various locations throughout the state. These fairs are open to all active and retired members. Representatives from the State-sponsored vendors will be present at each fair to address any questions or concerns you may have. Please note: Although the fairs are open to retirees, because the TRAIL Medicare Advantage open enrollment period is in the fall, these fairs will not be attended by the Medicare Advantage 'TRAIL' vendors. 04/27/15


In anticipation for the FY2015 Benefit Choice Period, several Benefit Fairs have been scheduled at various locations throughout the state. These fairs are open to all active and retired members. Representatives from the State-sponsored vendors will be present at each fair to address any questions or concerns you may have. Please note: Although the fairs are open to retirees, because the TRAIL open enrollment period is in the fall, these fairs will not be attended by the TRAIL vendors. 04/24/14


Significant Changes to the Retail Maintenance Pharmacy Network effective September 20, 2010. The Retail Maintenance Pharmacy Network for the Quality Care Health Plan, Health Alliance Illinois, Humana-Winnebago and HealthLink OAP will be changing effective 09/20/10.


Early Retirement Reinsurance Mailing. Effective November 29, 2010, members and dependents were mailed a letter mandated by the federal government regarding reimbursement to plan sponsors for healthcare benefits paid to early retirees.


Patient Protection and Affordable Care Act (PPACA) Notices. 05/05/11


Preventive Services Covered under the Affordable Care Act effective July 1, 2011. 05/12/11


Effective June 1, 2011, in accordance with Public Act 96-1513, members will be permitted to add a civil union partner and/or their children to their coverage. 05/20/11


Effective June 1, 2011, in accordance with Public Act 96-1513, members will be permitted to add a civil union partner and/or their children to their coverage. 05/20/11


The Executive Ethics Commission ruling has been released. The managed care plans that will be in effect for the FY 2012 Benefit Choice Period will be HMO Illinois, HealthLink OAP, PersonalCare OAP and Blue Advantage. 05/24/11


Special Enrollment Period Update. In order to address any member concerns, CMS has committed to a Special Enrollment Period prior to the end of the calendar year. 06/07/11


HealthLink OAP Network Update. St. Margaret’s PHO in Spring Valley has signed a Tier I agreement with HealthLink OAP. 06/09/11


On Friday, June 10, 2011, a trial judge for the Sangamon County Circuit Court entered an order prohibiting any further State action in the awarding or signing of self-insurance contracts by the State of Illinois. 06/12/11


FY12 Benefit Choice Enrollment Period ended Monday, June 20, 2011. CMS is still committed to a special enrollment period for healthcare provider changes only; however, at this time the dates have not been determined. Once dates have been set, information will be provided to you and will also be available on our website.


Important Message - Special Enrollment Period Finalized. The Chief Procurement Officer held a hearing today and approved the extension of contracts for all current 90-day emergency managed care vendors through the remainder of the fiscal year, June 30, 2012, for the health plans administered by the Department of Healthcare and Family Services (DHFS) and the Department of Central Management Services (CMS). 08/31/11


Special Enrollment Period will be held from October 10, 2011 through October 28, 2011.


The Commission on Government Forecasting and Accountability (COGFA) held a hearing on August 16, 2011, to consider a request by the State to continue to offer self-insured managed care plans. At the end of that hearing, COGFA voted to authorize the State to continue to offer the self-insured managed care plans through June 30, 2012.


On Thursday, November 15, the award resulting from the supplemental fully-insured HMO RFP was posted. 11/26/12


The following vendors have signed a 90-day contract, which will be effective July 1st: Health Alliance HMO, Health Alliance Illinois, HealthLink OAP, PersonalCare HMO, and PersonalCare OAP. These options are in addition to HMO Illinois, BlueAdvantage HMO and the Quality Care Health Plan (administered by CIGNA), which are also available.


Special Enrollment Period Update. In order to address any member concerns, CMS has committed to a Special Enrollment Period prior to the end of the calendar year.


Cummins vs the State of Illinois. Challenges the State’s past exclusion of prescription contraceptives from its State Employees’ Health Plan.


Quality Care Health Plan Changes. These changes are the result of discussions and agreement between the Department of Central Management Services, the Department of Healthcare and Family Services and the various bargaining unit entities which represent State employees covered under the Group Insurance Program.


The State of Illinois has selected four managed care plans to provide benefits to state employees, dependents and retirees starting July 1.


Long-Term Care Coverage Notification. MetLife has informed CMS that they have decided to discontinue the sale of Long-Term Care (LTC) insurance products (includes Employer Group and Individual - including Multi-Life).


The current emergency contracts with Health Alliance HMO, Health Alliance Illinois and Coventry HMO have been extended until the supplemental managed care procurement is completed, not to exceed June 30, 2013. Check back for more information once the procurement is finalized.


REMINDER: Medicare-eligible individuals enrolled in the State Employees Group Insurance Program have prescription drug coverage that is on average as good as, or better than, the standard Medicare prescription drug coverage (Medicare Part D) and should not enroll in a Medicare Part D plan during this Medicare Part D open enrollment season, unless you qualify for low-income/extra-help assistance.  10/17/12


On August 24, 2012, Governor Quinn signed into law SB 3240 that allows State of Illinois members and their covered dependents to assign their health and dental benefits to out-of-network providers.  09/28/12


SB 1313 modifies the premium payments for retiree healthcare, allowing the Director of CMS to set the premiums that are paid.  This letter referenced during the debates in the House and the Senate is for your information. At this time, SERS has no further information regarding the payment of premiums by retirees. As information becomes available, it will be posted on this website.


FY 2014 Benefit Fairs have been scheduled at various locations throughout the State. All members of the Group Insurance Program, including active state and university employees, retirees and survivors can attend. The State-sponsored vendors for Health, Dental, Vision and Life plans will be available to answer questions.


Notice Regarding QCHP and QCDP Claim Payment Delay


Effective April 2nd, Express Scripts acquired Medco Health
Solutions. Members will continue to receive medications without changes to the plan or network.  04/04/13


Effective July 1, 2013, Public Act 98-0019 extends the financial incentive to non-Medicare annuitants of all five state retirement systems (SERS, SURS, TRS, JRS and GARS) and increases the amount of the opt-out financial incentive for annuitants with over 20 years of service to $500. Survivors are not eligible for the opt-out incentive. 07/01/13


It has come to our attention that HealthLink OAP inadvertently sent new health insurance ID cards to all individuals who were ever a dependent in the past on the HealthLink OAP member's coverage. 7/09/13


Walgreens pharmacies have now joined the State of Illinois Express Scripts Maintenance (90-day) Network. The Maintenance Network allows plan participants of HealthLink OAP, Coventry Health Care OAP and the Quality Care Health Plan to receive a 90-day supply of maintenance medication through any Walgreens retail pharmacy for only 2 1/2 copayments. The Maintenance Network listing has been updated to indicate that all Walgreens pharmacy locations nationwide are now in the 90-day network. 07/19/13


The State of Illinois requested bids for a State-Sponsored Medicare Plan on June 21, 2013.


The Department of Central Management Services (CMS) announced today that the Medicare Advantage procurement has concluded and contracts are being awarded to the winning vendors. 10/02/13


The enrollment period for the Medicare Advantage plans has been set for November 12 through December 6, 2013. The effective date of the new plan will be February 1, 2014. 10/09/13


Attention Retirees and Survivors Newly-Eligible for the State-sponsored Medicare Advantage Plans: UnitedHealthcare mailed a book of plan information entitled, “2015 Plan Guide” to all newly-eligible members as well as all TRAIL members enrolled in a Medicare Advantage HMO plan. The book was part of an envelope of marketing materials sent by UHC on October 2, 2014. On page 59 of the book is a page entitled “Enrollment Instructions”. This page states that the member does not need to complete an Enrollment Request Form. This statement is INCORRECT. State of Illinois group insurance members who are eligible for the State’s Medicare Advantage plans through TRAIL for the first time (most of whom turned age 65 within the past year) DO need to return the State’s Medicare Advantage ‘TRAIL’ enrollment form. Members should look for the TRAIL enrollment form in an enrollment kit being mailed from the Department of Central Management Services October 9, 2014. Members currently enrolled in one of the TRAIL plans who do not wish to change their MAPD plan do not need to complete the enrollment form. 10/08/14


The TRAIL Open Enrollment Period will be October 15 through November 15, 2014. Enrollment kits will be mailed October 9th to members eligible for TRAIL Medicare Advantage coverage. Informational seminars will be held state-wide to give eligible members an opportunity to learn more about the plans offered by the State. The 2014 Seminar Schedule provides a list of the dates, times and locations of the seminars. 10/06/14


Beginning with the October benefit month, the premium that a Medicare-eligible retiree, annuitant or survivor pays for the Medicare Advantage with Prescription Drug (MAPD) plan will change from 2% of their annuity to 0% of their annuity. Individuals with less than 20 years of service are responsible for an additional amount which is calculated based upon the cost of the selected coverage. 10/05/14


A website has been created which contains information regarding the Kanerva Health Insurance Refund http://kanervahealthinsurancerefund.com/ class action, including case filings, notices, important dates and more. Additionally, the website includes information on who to contact with any questions or to obtain additional information relating to the Kanerva case. 02/03/15


Effective July 1, 2015, CVS/caremark is the new prescription benefit manager (PBM) for the self-insured health plans of the Quality Care Health Plan (administered by Cigna), Coventry OAP and HealthLink OAP.


Notice Regarding Budget Impact on Group Insurance. 9/18/15


FAQ's regarding the impact of the budget impasse on State employee and retiree group insurance coverage. 09/25/15


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