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Illinois Department of Central Management Services (CMS)

The State of Illinois' Quality Care Health Plan is a self-insured plan with funding provided through legislative appropriations, State revenue and a small amount of employee premiums. Funding availability is based on State revenue, which fluctuates from month to month. At this time funds remain insufficient to pay claims on a normal schedule, and we cannot estimate when a regular payment schedule will resume. Claim payments will be released according to the claim process date and available funding. CIGNA, the claims administrator, continues to process claims in a timely manner, but release of claims must be held until revenue is available. Late payment interest is paid to healthcare providers on health claims that take longer that 30 days from the receipt of a complete claim submission to pay. If you decide to make arrangements with your out-of-network provider to pay the outstanding balance or establish a payment plan, your provider should reimburse you after they receive payment from CIGNA. It is your responsibility to make reimbursement arrangements with your provider.

Group Insurance Programs
The State of Illinois provides insurance coverage through four separate benefit programs. Coverage is available for program members, including COBRA participants, as well as their dependents. Coverage for members and dependents is based upon meeting program eligibility requirements (see the appropriate Benefits Handbook for requirements).

Click Here for the Group Insurance Programs and Benefits

 

FY 2013 Benefit Choice Period

Click Here for the State Employees Group Insurance Program

The Benefit Choice Period will be May 1 through June 15, 2012, for all members. In an effort to ensure that health carriers are in place for the start of the next fiscal year (July 1, 2012), a decision has been made to enter into emergency contracts with Health Alliance HMO, Health Alliance Illinois and Coventry Health Care HMO. These contracts will be for 90 days with an option to extend for an additional period as needed.

During the annual Benefit Choice Period, members are allowed to make changes to their group insurance coverage, such as add or drop dependent coverage. This year, members should delay making health plan changes until the health carrier contracts have been finalized. Once the Benefit Choice Period end date has been announced, the Benefit Choice Election form will need to be submitted to the agency, university or retirement system by the announced due date. Any elected changes in coverage will be effective July 1, 2012.

Note: The State is in the process of accepting proposals from managed care health plans to provide coverage for FY 2013 and beyond. The decisions regarding these proposals may result in changes to health carriers during FY 2013. If any changes to the health carrier options available occur, a Special Enrollment Period will be held to allow members the opportunity to modify their coverage elections, if desired.


Click Here for the College Insurance Program (CIP)

The Benefit Choice Period will be May 1 through June 15, 2012, for all benefit recipients. In an effort to ensure that health carriers are in place for the start of the next fiscal year (July 1, 2012), a decision has been made to enter into emergency contracts with Health Alliance HMO, Health Alliance Illinois and Coventry Health Care HMO. These contracts will be for 90 days with an option to extend for an additional period as needed.

During the annual Benefit Choice Period, benefit recipients are allowed to make changes to their group insurance coverage, such as add or drop dependent coverage. The CIP Benefit Choice Election form must be submitted to SURS by June 15, 2012. Any elected changes in coverage will be effective July 1, 2012.

Note: The State is in the process of accepting proposals from managed care health plans to provide coverage for FY 2013 and beyond. The decisions regarding these proposals may result in changes to health carriers during FY 2013. If any changes to the health carrier options available occur, a Special Enrollment Period will be held to allow members the opportunity to modify their coverage elections, if desired.

Comptroller's Office
Health Insurance Reserve Fund Details
*Click on "Get Fund Balance" to see the current standings*

 

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