Open Enrollment - June 17th - June 24th
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June 17th
– June
24th
Thinking forward.
Open
Enrollment
2021
Overview of 2021 Benefits
Medical – BlueCross BlueShield of IL
3 plans to choose from
Health Savings Account – AmeriFlex
Flexible Spending Accounts – AmeriFlex
Dental – BlueCross BlueShield of IL
Vision – BlueCross BlueShield of IL (Transition from
Dearborn National with EyeMed network)
2
Special Enrollment
The only other time of year, when you can add yourself or dependents to the
plan, is if you experience a qualifying life event.
Some examples of qualifying life events are:
– Marriage/Divorce
– Birth/Adoption
– Death
– Loss of Coverage
– Loss of eligibility status
– Change of residency that affects provider availability
You must notify HR within 31 days of the qualifying life event. The change will
be effective on the date of the event.
Please take time to carefully consider the benefits offered for
1/1/2021 - 12/31/2021.
3
Thinking forward. Medical
Medical Plan Highlights
Three plans to choose from:
– BlueAdvantage HMO: network benefits only, no deductible,
copayments apply, required to select Medical Group to coordinate
all care, including referrals
– PPO: in and out-of-network benefits, deductible, coinsurance, and
copayments apply
– BlueEdge HSA: in and out-of-network benefits, everything subject
to deductible (except for preventive care), eligible for Health
Savings Account
5
2021 Medical Plan Comparison
BAHMO Plan PPO Plan BlueEdge HSA Plan
Benefits In-Network Benefits Only In-Network Out-of-Network In-Network Out-of-Network
Annual Deductible $400 Single Combined in/out- $2,800 Single $5,200 Single
None
(Always re-sets on January 1 st) $800 Family of-network $5,600 Family $10,400 Family
Coinsurance 100% 80% 70% 100% 80%
Annual Out-of-Pocket Max $1,500* Single $1,400** Single $2,400** Single $2,800*** Single $10,400*** Single
(Always re-sets on January 1 st) $3,000* Family $3,800** Family $6,800** Family $5,600*** Family $20,800*** Family
PCP: $20 PCP: $20 Deductible, Deductible, Deductible,
Physician Services Specialist: $20 Specialist: $20 then 70% then 100% then 80%
Virtual Visits: N/A Virtual Visits: $20 (V.V. N/A) (includes V.V.) (V.V. N/A)
Deductible, Deductible,
Preventive Care 100% 100% 100%
then 70% then 80%
Emergency Room $100 copay $100 copay Deductible, then 100%
Retail Rx (34 day) – Covered at 75%
Deductible, Deductible,
Generic / Formulary / Non- $10 / $20 / $35 $10 / $20 / $35 after copay
then 100% then 100%
Formulary $10 / $20 / $35
Mail Order Rx (90 day) – Deductible,
Generic / Formulary / Non- $20 / $40 / $70 $20 / $40 / $70 N/A N/A
Formulary then 100%
RX Out-of-Pocket Max $1,000 Single $1,000 Single
Combined with medical
(Prescription copays only) $2,000 Family $3,000 Family
Blue Advantage HMO Participating Provider Organization Participating Provider Organization
Network
[ADV] [PPO] [PPO]
*includes office visit & ER copays
**includes deductible, coinsurance, office visit and ER copays
6
***includes deductible and coinsurance
Preventive Coverage
What’s covered?
– Recommended routine gender and
age-specific preventive care and screenings –
such as physical and ob-gyn exams, mammograms
and other cancer screenings, well-child care and
immunizations – both facility and professional services
– Coverage provided in-network at 100% with
no copay, no deductible. Out-of-network
benefits may vary.
IMPORTANT to remember: Lab tests related to a condition such as
diabetes or asthma – are not considered preventive and are covered
under applicable deductible and coinsurance levels.
Stay Healthy by Getting Regular Check-ups
7
Medical Premium Rates (monthly)
Coverage Tier BAHMO Plan PPO Plan BlueEdge HSA Plan
Employee Only $93.65 $111.48 $94.76
Employee + Spouse $310.47 $369.61 $314.17
Employee + Child(ren) $297.94 $354.69 $301.49
Family $460.96 $548.76 $466.45
OLCHS also contributes
$500 single / $1,000 family
into BlueEdge HSA
participants’ Health Savings
Account (HSA) with
AmeriFlex.
8
HSA 101
A Quick Overview of
Health Savings Account Basics
HDHP and HSA 101
There are 2 components:
High Deductible Health Savings
+
Health Plan (HDHP) Account (HSA)
10HSA Key Features
Triple Tax Uses Features
Advantages Pay for out-of-pocket Medical, dental and
healthcare expenses for vision expenses
TAX-FREE
you and your family No “use it or lose it”
– Contributions rule–account balance
• Build a nest egg for
– Withdrawals for future healthcare rolls over year after year
eligible healthcare expenses Portable–account is
expenses • Retirement savings yours if you change
– Interest and strategy for both plans, retire or change
earnings healthcare and living jobs
expenses Account balance earns
interest
11Sample Qualified HSA Expenses
Find a detailed list of qualified expenses by clicking here
Deductibles, Dental treatment Eye exams,
coinsurance and Prescription drugs such as fillings, eyeglasses and
copayments braces, extractions contacts
Premiums for
COBRA and Hearing aids qualified long term
Acupuncture care insurance
Medicare premiums including batteries
(dollar limits may
apply)
12Are you eligible for an HSA?
Must be enrolled in an HDHP
May not have a general purpose flexible spending account (FSA) or
be eligible to use one (such as spouse’s FSA)
Limited purpose FSA (dental and vision only) allowed
Cannot be claimed as another person’s tax dependent
Cannot be enrolled in Medicare, Medicaid or Tricare
Cannot be enrolled in any other non-HDHP health coverage
13HSA Contribution Maximums
Pre-tax payroll contributions
Change contributions at any time without a qualifying life event
Funds are available as they are contributed into the account
IRS Contribution Limits: $3,600 single / $7,200 family
Coverage Tier Company Contributes You May Contribute Up To
Single $500 $3,100
Family $1,000 $6,200
“Catch-up” $1,000 extra contribution
If employee and spouse are both 55+,
Contributions you can each contribute an additional
(individuals age 55+)
$1,000 into separate accounts• • •
+ -
= =
+
Because he’s spending
tax-free money, his HSA saved him up
to 30% on healthcare expenses.Prescription Drugs
17Prescription Drug
Benefit
Retail Pharmacy Network
• Major pharmacy chains
(Walgreens, Walmart, Osco
Drug, etc.) PPO and HSA
members: CVS is out-of-
network, even in Target stores.
CVS is in-network for HMO only.
• Pharmacy search available
online
Home Delivery (Mail Order)
• Up to a 90-day supply
• Convenience and savings
18MyPrime.com
Single sign-on from Jane Doe
Blue Access for Members to: SM
• Locate a pharmacy
• Find drugs/drug list
• View prescription claim history
• Create personal drug list
• Learn about specific drugs
– Rx cost calculator
– Health information
MyPrime.com is an online resource offered by Prime Therapeutics.
Prime Therapeutics LLC, a separate company, is a pharmacy benefit management company. Blue Cross and Blue Shield of Illinois (BCBSIL) contracts with Prime
Therapeutics to provide pharmacy benefit management and other related services. In addition, contracting pharmacies are contracted through Prime Therapeutics.
The relationship between BCBSIL and contracting pharmacies is that of independent contractors. BCBSIL, as well as several independent Blue Cross and
Blue Shield Plans, has an ownership interest in Prime Therapeutics.
19Pharmacy Tools in the BCBSIL App
MEMBER NAME
Birthdate: Jan 1, 1990
Screen images are for illustrative purposes only. 20Home Delivery
Prescriptions
Your pharmacy benefit includes mail service
of your maintenance medications from
AllianceRx Walgreens Prime.
• Register online at
alliancerxwp.com/home-delivery
or by phone at 877-357-7463
• Once registered, ask your doctor to submit
your prescription electronically or by fax
• Transfer your existing prescription from
a retail pharmacy online or by phone
Prime Therapeutics LLC, a separate company, is a pharmacy benefit management company. Blue Cross and Blue Shield of Illinois (BCBSIL) contracts with Prime
Therapeutics to provide pharmacy benefit management and other related services. In addition, contracting pharmacies are contracted through Prime Therapeutics.
The relationship between BCBSIL and contracting pharmacies is that of independent contractors. BCBSIL, as well as several independent Blue Cross and
Blue Shield Plans, has an ownership interest in Prime Therapeutics.
Prime Therapeutics has an ownership interest in AllianceRx Walgreens Prime, a central specialty and home delivery pharmacy.
21Thinking forward.
Online Tools & Health
ResourcesSign Up for Blue Access for Members SM
Go to bcbsil.com
and log in to Blue
Access for Members
via web or mobile
Click Register Now
if you are a new user
To register you
will need your
identification number
on the front of your
ID card OR you can
call the Customer
Service number on
the back of the card.
Screen images are for illustrative purposes only. 23Accessing the Provider Finder ®
1. Log in to Blue Access for Members SM
Or access
2. Click the Doctors & Hospitals tab Provider Finder
through the
3. Then select “Find a Doctor or Hospital”
BCBSIL App.
Screen images are for illustrative purposes only. 24Inside Provider Finder ® • Look up expected out-of-pocket costs for 1,600 specific procedures* Also available • Quality designations for facilities and physicians on the mobile app • Enhanced provider demographics • Customizable search, maps and directions • Patient reviews on physicians *Cost information available for most plans Screen images are for illustrative purposes only. 25
Cost Estimate: MRI of the Brain
Out-of-pocket costs change depending
on the provider you choose. Estimated cost range
6789 Western Pkwy Ste 101, Chicago, IL 60612
Phone: 312-555-1111
4213 Main St Ste 100, Chicago, IL 60612
Estimated cost by
provider and facility
Screen images are for illustrative purposes only. 26Get Care When and Where You Need It • Whether you’re at home or traveling, access to an independently contracted, board-certified doctor is available 24/7. • You can speak to an MDLIVE doctor immediately or schedule an appointment for a time that works for you. • MDLIVE doctors can help treat many non- emergency conditions. • A virtual visit may be a better alternative to the emergency room or urgent care center. • PPO Plan - $20 copay • BlueEdge HSA Plan – 80% after deductible; avg. medical cost $44 and avg. behavioral health cost $80-$175 MDLIVE, a separate company, operates and administers the virtual visits program for Blue Cross and Blue Shield of Illinois and is solely responsible for its operations and that of its contracted providers. 27
How Virtual Visits Work
CONNECT
Access where mobile app, online
video or telephone service is
available
INTERACT
Real-time consultation with an
independently contracted, board-
certified doctor or therapist
DIAGNOSE
Prescriptions sent to a pharmacy
of your choice (when appropriate)
To register, you’ll need to provide your first and last name, date of birth and
BCBSIL member ID number.
To register, you’ll need to provide your first and last name, date of birth
and BCBSIL member ID number. 2824/7 Nurseline
Advice anytime.
Advice isn’t just needed
from 9 to 5.
Round-the-clock health and wellness
advice from licensed nurses
Plus, you can also listen to more than
1,000 health topics
Call the number on the back
of your ID card.
Available in English and Spanish
29Special Beginnings ® • Provide information about having Expectant mothers a healthy pregnancy and baby and babies get off • Share information about high-risk to a healthy start conditions, such as gestational with prenatal and diabetes and preeclampsia postnatal education • Help you plan your care and support with your doctor • Option to receive text messages on baby development Special Beginnings is not a substitute for professional medical guidance. Regular visits are important for your care. With your consent, the information we receive from you is shared with your physician to coordinate your care. Be sure to discuss any health concerns with your physician. 30
Blue365 ®
Member Discount Program
Member discounts • Exclusive health and wellness deals
from national and local retailers
simply for being a
• Save money on gym memberships,
BCBSIL member vision exams and services, hearing aids,
fitness devices and nutrition-related services
• Log in to Blue Access for Members SM
and click “Member Discount Program”
in Quick Links to view your
available discounts and to
register for weekly emails
Blue365 is a discount program only for BCBSIL members. This is NOT insurance. Some of the services
offered through this program may be covered under your health plan. Employees should check their
benefit booklet or call the Customer Service number on the back of their ID card for specific benefit
facts. Use of Blue365 does not change monthly payments, nor do costs of the services or products
count toward any maximums and/or plan deductibles. Discounts are only given through vendors that
take part in this program and are subject to change. BCBSIL does not guarantee or make any claims or
recommendations about the program’s services or products. Members should consult their doctor before
using these services and products. BCBSIL reserves the right to stop or change this program at any
time without notice.
Screen images are for illustrative purposes only. 31Member Wellness Portal
Well onTarget Highlights ®
• Health Assessment
• Member dashboard
• Digital self-management programs
• Trackers and tools
• Interactive symptom checker
• Health and wellness content
• Text message alerts
• Blue Points rewards* SM
• Fitness Program
The newly designed portal
• Tracking for fitness and nutrition includes recommended
activities that make up your
and also device integration Personal Member Journey.
• Personal wellness challenges
• Mobile app (AlwaysOn)
The Fitness Program is provided by Tivity Health™ Services, LLC, an independent contractor which administers the Prime® Network of fitness centers.
The Prime Network is made up of independently-ow ne d and managed fitness centers. Prime is a registered trademark of Tivity Healt h, Inc. Tivity Health
is a trademark of Tivity Health, Inc.
Blue Cross®, Blue Shield® and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Ass ociation,
an association of independent Blue Cross and Blue Shield Plans.
*Blue Points program rules are subject to change without prior notice. Member agrees to comply with all applicable federal,
state and local laws, including making all disclosures and paying all taxes with respect to their receipt of any reward.
Screen images are for illustrative purposes only. 32Blue Points Program SM
Reward Yourself!
• Earn points for multiple wellness and
fitness activities, completion of Health
Assessment, online programs and more
• Redeem points in the Shopping Mall
for a variety of items
Blue Points Program Rules are subject to change without prior notice. See the Program Rules on the Well onTarget Member Wellness Portal for more information.
Member agrees to comply with all applicable federal, state and local laws, including making all disclosures
and paying all taxes with respect to their receipt of any reward.
Screen images are for illustrative purposes only. 33Well onTarget ®
Fitness Program
You don’t eat the same • Mix and match fitness locations
food every day.
• No contract and no obligation
Why work out at the
• Unlimited access to thousands of
same fitness location participating fitness locations
every single time?
• Different plan options to best fit member
needs and preferences
• Just log in to Blue Access for Members SM
and click “Fitness Program” in Quick
Links to reach the enrollment page
Available to members and their covered dependents (age 18 and older).
The Fitness Program is provided by Tivity Health®, an independent contractor which administers the Prime Network
of fitness centers. The Prime Network is made up of independently-o wn ed and managed fitness centers. 34Flexible Gym Network
A choice of gym networks to fit budgets Selecting Options
and preferences.* • You can select an option based
Plan Options Base Core Power Elite
on your preference. Once you
pay, you’ll have access to all
Monthly fee $19 $29 $39 $99 locations within the purchased
plan and those at the lower
Gym* facility 3,000 7,500 12,000 12,400
network size price too.
$19 initiation fee
• The Elite plan will have the
option to select one home
• Studio Class Network: Boutique-style classes and elite gym and access to all
specialty gyms are pay-as-you-go with 30% off
every 10th class.
other gyms.
• Family Friendly: Expands gym network access to • You have the option to change
your covered dependents at a bundled price discount. your Elite home gym monthly.
Member pays only one enrollment fee per family.
• Convenient Payment: Monthly fees are paid via
automatic credit card or bank account withdrawals.
*Represents possible network locations. Check local listings for exact network options as some
locations may not participate. Network locations are subject to change without notice.
Taxes may apply. Individuals must be at least 18 years old to purchase a membership. 35Thinking forward. Flexible Spending Accounts
Flexible Spending Accounts (FSA) A flexible spending account (FSA) is like a spending account for healthcare that can help you save up to 30% on taxes. You decide how much money you want to set aside at the beginning of the year. A Healthcare FSA allows you to be reimbursed for eligible medical, dental and vision expenses. 100% of your election is available for use on January 1 st. A Limited Purpose FSA, for those who open and contribution to a Health Savings Account (HSA), allows you to be reimbursed for eligible dental and vision expenses. 100% of your election is available for use on January 1st . A Dependent Care FSA allows you to be reimbursed for eligible daily care of an eligible child under age 13, elderly parents, or other dependents that are unable to care for themselves. Funds are available throughout the year as you contribute via payroll deduction.
Limited Purpose FSA
LPFSA Eligibility
You (or your spouse if covered under your medical plan) cannot have any funds in a
Healthcare FSA if you enroll in the HDHP/HSA Plan
Instead, you may elect a Limited Purpose FSA to be used for eligible dental and vision
expenses only.
If you made a Healthcare FSA election in 2020, elect and open a new HSA for 1/1/21, you will
need to empty your FSA by 12/31/20 to have a $0.00 balance. Otherwise, you cannot open an
HSA until after April 1, 2021.
Benefits of a LPFSA
1. Allows you to save money on taxes for your qualified dental and vision expenses in the
current plan year
2. Cash flow – funds are available day 1, while HSA funds are as they’re deposited
3. Helps you save the money in your HSA for future health care expenses & additional “401(k)”
38FSA Contribution Maximums
The IRS determines the maximum amount you can contribute toward your FSA in a
calendar year.
You may only change your FSA election mid-year if you have a corresponding qualifying
life event (e.g. birth, marriage, divorce, death, loss of coverage, change in day care
provider, etc.)
Account Type Annual Contribution Maximum
Healthcare FSA
For those enrolling in the PPO or HMO medical plan, or $2,750
waiving coverage
Limited Purpose FSA
$2,750
For those enrolling in the HDHP/HSA medical plan
Dependent Care FSA $5,000 (filing jointly)
For those enrolling in any medical plan or waiving coverage $2,500 if filing taxes separately
All FSA plans are “use-it-or-lose-it”, but include a 2½ month grace period, allowing
you to incur claims until March 15th of the following year and submit them until March 31 st .
Please take this into consideration when making your annual election.MyAmeriFlex
MyPlanConnect
Hassle-free claims
reimbursement.
With MyPlanConnect, your healthcare
FSA charges are connected with your
medical insurance Explanation of Benefits
(EOB). Through this integration, AmeriFlex ACTION REQUIRED!
detects use of your FSA debit card and
automatically matches your purchase with To set up this connections, login to
your insurance EOB. the AmeriFlex member convenience
portal and click the link for
MyPlanConnect can verify the eligibility of MyPlanConnect.
a claim without the need for you to submit
supporting documentation (substantiation). Follow the applicable steps, where
you will link out and login to the
BlueCross member portal,
BlueAccess for Members, to connect
your claims activity.Thinking forward. Dental
Dental Plan Highlights
Dental HMO Plan Dental PPO Plan
Benefits
Network Only; Primary Dentist Req’d. In-Network Out-of-Network
$100 single $100 single
Deductible None
$200 family $200 family
Calendar Year The maximum the Plan will pay per year per person
Unlimited
Maximum $2,000
Preventive Services See copay schedule 100% 100% of U&C* Fee
80% 80% of U&C* Fee
Basic Services See copay schedule
after deductible after deductible
50% 50% of U&C* Fee
Major Services See copay schedule
after deductible after deductible
Dependent Child to
Dependent Child to
Adult & Child to age 19 age 26
Orthodontic Services age 26
$1,500 copay 50% of U&C* Fee
50% after deductible
after deductible
Orthodontia Lifetime
N/A $1,000 $1,000
Maximum
Network BlueCare Dental HMO BlueCare Dental PPO
*based on a percentage of the Usual and Customary (U&C) charges
43Dental Premium Rates (monthly)
Coverage Tier Dental HMO Plan Dental PPO Plan
Employee Only $4.85 $5.94
Employee + Spouse $16.03 $24.22
Employee + Child(ren) $17.65 $23.24
Family $26.62 $35.96
44Thinking forward. Vision
Vision Plan Highlights
In-Network Out-of-Network In-Network Out-of-Network
Exam (once every 12 months) Frames (once every 24 months)
$150 retail allowance
$10 copay $30 allowance $75 allowance
(20% off balance)
Lenses (Any one option) Contacts
Lenses or Contacts are limited to once every 12 months Lenses or Contacts are limited to once every 12 months
Single Vision Conventional
$150 allowance;
$10 copay $25 allowance $120 allowance
15% off balance
Bifocal Disposable
$10 copay $40 allowance $150 allowance $120 allowance
Standard Progressives Medically Necessary
$75 copay $40 allowance 100% covered $210 allowance
Coverage Tier Monthly Vision Rates
Employee Only $0.92
Find an in-network provider at:
Employee + Spouse $3.00
www.dearbornnational.com/vision
Employee + Child(ren) $3.16
Family $4.65 46Member Perks
More bang for your buck
Special offers page on
eyemed.com
Lots of great discounts and deals
directly from manufacturers
Helps you save even more on eye
exams, frames and lenses,
contacts and more
Get provider-specific deals (close
to where you live) tied directly
into our provider locator
Access to affordable hearing care
discounts through
Call 1-844-526-5432 to find
a hearing care provider to
schedule a hearing exam
47Important Deadlines and Instructions
What you need to do:
If you wish to enroll or make any changes to your current BCBSIL Medical, Dental and/or
Vision elections:
– Complete the BCBS enrollment/change form and return to the Business Office by
Friday, Dec. 11th by 3:30pm
– Complete the AmeriFlex Health Savings Account Contribution Form with your annual &
per pay period HSA contribution election and return to the Business Office by
Friday, Dec. 4th at 3:30pm
– New BCBS ID cards will be mailed 2-3 weeks from the date of enrollment.
If you wish to make a Flexible Spending Account (FSA) election for 2021,
(Remember: Current elections do NOT carryover!)
– Complete the AmeriFlex FSA enrollment form and return to the Business Office by
Friday Dec. 4th at 3:30pm
– Remember to check the “Limited Purpose FSA” if you also open a Health Savings
Account (HSA).
Review your first payroll statement in 2021 for adjusted premium and HSA or FSA
contribution deductions.
48June 17th
– June
24th
Thinking forward.
Questions??You can also read
