University of Illinois Logo University of Illinois Urbana-Champaign University of Illinois Chicago University of Illinois Springfield
Home Search Help
N E S S I E   Home > Benefits > Health >  


Eligibility
QCHP
PPACA
MCP
   HMO
   OAP
Similarities
Dependents
FAQs
Cost
Resources
State Enrollment
Part-time Employees


Medicare

Adoption

Providers

Civil Union & Domestic Partner

Forms

Travel Assistance

Benefits Summary

Savings Bonds

Health

Dental

Vision

Campus Contact

Life

AD&D

UPB Contacts

LTD

LTC

FSA

403(b), 457, SURS

403(b) Online Enrollment

Domestic Partner

COBRA

Qualifying Event/ State Plan Changes

Benefit Choice

Employee Assistance

Recreation / Wellness

Shared Benefits



Contacts
HR Forms
Human Resources
  Urbana
  Chicago
  Springfield
EEO


Health Insurance

Frequently Asked Questions About Health Insurance

What types of health plans are available?
When can I start making appointments with my physician?
Where can I find the provider listings for my health plan?
My spouse is losing his/her job and won't have insurance. When can I add him/her to my health insurance?
How do I change health plans?
Are there preexisting condition limitations if I change health plans?
What happens to my health insurance in the event of a layoff, illness or other types of leave?
What happens to my health insurance during a period of personal leave without pay?
What happens to my health insurance when I retire?
What happens to my health insurance when I resign or my appointment ends?

Dependent Coverage
All employees electing dependent coverage must provide supporting documentation of dependent status (i.e. marriage license, birth certificate, etc.).
We will be having/adopting a child soon. How do I add this child to my health, dental, and life insurance coverage?
When can my dependents be added to my health, dental, and vision plans?
How long can my child be insured as my dependent?


What types of health plans are available?
You have the choice of two different types of plans: a traditional Indemnity plan called the Quality Care Health Plan, or a Managed Care Plan. This allows you to choose the plan that best meets the needs of you and your family. Depending on your location, you will have the choice among the following Managed Care Plans: Health Maintenance Organization (HMO); and Open Access Plan (OAP) - combines the flexibility features of Indemnity with the cost savings of a Managed Care Plan based upon a tier network program. With both the Quality Care Health Plan and the Managed Care Plan, you share in the cost of the premium for your coverage based upon your salary.

When can I start making appointments with my physician?
You may begin making appointments with your physician on your first day of employment. Your coverage becomes effective that day; however, you will not receive your insurance cards for approximately two weeks after you have submitted your enrollment paperwork. If you see your physician before you receive your card, make the office aware of your insurance plan carrier.

Where can I find the provider listings for my health plan?
You will find the provider listings in your health plans Provider Directory book. If you did not receive one with your benefits information at Benefits Orientation, view the Health Insurance Resources/Links page for links to the health plan websites.

My spouse is losing his/her job and won't have insurance. When can I add him/her to my health insurance?
You may add your spouse to your insurance within 60 days of the qualifying event, in this case, the termination of employment. If you do not add your spouse within this time frame, you must wait until the next Benefit Choice open enrollment period, which is typically during the month of May.

How do I change health plans?
Each year during the Benefit Choice open enrollment period, typically during the month of May, you may elect to change your health plan carrier, to be effective the following July 1. At any other time, a change may be made within 60 days of a qualifying event. Examples of a qualifying event include: a birth, adoption, change in marital status, death of spouse or dependent, or change in spouse employment status.

Are there preexisting condition limitations if I change health plans?
Preexisting condition limitations no longer apply. Any condition for which you are receiving treatment prior to your coverage change will be covered immediately by your new plan.

What happens to my health insurance in the event of a layoff, illness or other types of leave?
Your health insurance may be continued during seasonal layoff, illness, family and medical or educational leaves without pay. The State contribution continues to be paid and the employee is billed monthly by the UPB Benefits Services office for any insurance premium formerly deducted from the paycheck.

Premium bills are mailed to the home addresses of employees off the payroll. The first bill will arrive at about the same time as the first paycheck is missed and then monthly thereafter. The bill will be itemized and is due within 10 days. Failure to pay a premium bill will result in termination of the health, dental, and vision coverage until the member returns to work. Re-enrollment in some plans will be subject to evidence of good health.

What happens to my health insurance during a period of personal leave without pay?
Members on personal leave without pay may continue coverage for up to 24 months subject to the member's payment of 100% of the premium, which includes the employer contribution. Employees on personal leave will receive monthly premium bills from the UPB Benefits Services office. Premium bills are mailed to the home addresses of employees off the payroll. The first bill will arrive at about the same time as the first paycheck is missed and then monthly thereafter. The bill will be itemized and is due within 10 days. Failure to pay a premium bill will result in termination of the health, dental, and vision coverage until the member returns to work. Re-enrollment in some plans will be subject to evidence of good health.

What happens to my health insurance when I retire?
When you retire and begin receiving a monthly annuity from the State Universities Retirement System (SURS), your State health insurance records are transferred to the retirement system. Your cost of insurance depends upon your date of retirement and your years of service. The State contribution is based on your years of service at a rate of 5% per year of service. For example, if you retire with 10 years of service, you will receive a 50% contribution toward the cost of your coverage. If you retire with 20 or more years of service, you will qualify for 100% of the employer contribution. Unpaid premiums are deducted from the monthly retirement annuity check.

What happens to my health insurance when I resign or my appointment ends?
Coverage ends at midnight on the date your appointment ends. Persons leaving employment at the University are entitled to continue the health coverage for up to 18 months under a Federal law referred to as COBRA. Cost of coverage is borne fully by the employee. There is no State contribution toward COBRA coverage. Notice of the COBRA Continuation Option is sent to employees by Central Management Services (CMS) soon after their resignation or appointment ending date.

Dependent Coverage
All employees electing dependent coverage must provide supporting documentation of dependent status (i.e. marriage license, birth certificate, etc.). Please see Dependent Documentation Requirements and Deadlines.

We will be having/adopting a child soon. How do I add this child to my health, dental, and life insurance coverage?
You may add a dependent to your health, dental, and life insurance within 60 days of the date of birth or adoption. Benefits coverage changes are effective the latest day of the date the request for change was signed, or the date the event occurred. Coverage for newborns and adopted newborns may be retroactive to the date of birth if the coverage request was made within 60 days of birth.

You may add a dependent through the State Plan Changes selection in the Benefits section of NESSIE.

When can my dependents be added to my health, dental, and vision plans?
New employees may add a spouse and/or dependents within the first 10 days of employment with guaranteed acceptance into the plans. Thereafter, the guaranteed enrollment periods are the annual Benefit Choice period, typically in May with changes effective the following July 1, or within 60 days of a qualifying event. Examples of a qualifying event include: birth, adoption, change in marital status, death of spouse or dependent, and/or change in spouse employment status. All employees electing dependent coverage must provide supporting documnetation of dependent status (i.e. marriage certificate, birth certificate, etc.).

How long can my child be insured as my dependent?
Children may remain insured as dependents up to their twenty-sixth birthday. Certification of a child's status as "Disabled" or "Other" is required annually. Certification of a child's status as a "Veteran Adult Child" is required annually when the child is age 26 or older. Failure to return the certification form to the campus UPB Benefits Services office will result in termination of the dependent's health, dental, and vision coverage.

Children who cease to be eligible as dependents may continue coverage on their own by paying the full cost for up to 36 months under a Federal law referred to as COBRA. It is the member's responsibility to notify the campus UPB Benefits Services office if the dependent ceases to be eligible for benefits.


Maintained by University Human Resources | Contact Information | Last Update: 05-January-2012 | ID: 66