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Illinois

Illinois—Find and Compare Plans

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Our Plans

Overview

About Health Alliance Group Plans

Health Alliance offers a variety of plans that fit the needs of your company and your employees. All of our plan options provide you with quality-driven coverage and access to excellent care and service at the right price.

Small Group vs. Large Group

Every group is unique. Your size, industry, needs and budget look different, and we know that. You might be a first-time shopper or an expert who knows your business needs. We'll meet you wherever you're at and no matter your size.

Small Group

In Illinois, small group is defined as two to 50 total employees on your tax and wages.

Large Group

In Illinois, large group is defined as 51 or more total employees on your tax and wages.

Pinpoint Your Needs

Choosing a plan for your group can feel overwhelming. Where do you start? What questions should you ask? You’re not alone in this process. We can help.

How much can you afford?

You and your employees will pay premiums each month. Think about how much your business and your employees can afford as you consider the plans.

A good rule of thumb: Lower premium/higher deductible equals more savings if employees don’t use a lot of health care, while a higher premium/lower deductible equals less expense for big medical emergencies.

Are your employees willing to take on a higher individual risk?

No one likes to think the worst will happen, but individual risk is just that. It’s thinking of the worst-case scenario. To find individual risk, take the medical deductible, add that to the out-of-pocket maximum and that’s the “individual risk.” This is the most your employees will have to pay before Health Alliance will cover their medical costs at 100 percent (Note: This does not include pharmacy costs. Employees may still be responsible for their pharmacy costs after hitting their out-of-pocket max.). The higher the individual risk, the lower the premium.

Are you, as a business, willing to take on more risk?

Employers who are willing—and financially able—to take on a greater risk sometimes choose a self-funded plan. With this setup, employers pay for their employees’ health care. Here’s a way to think about it.

Your business, in a way, is like the insurance company that covers the difference between what your employee is responsible for and the final medical bill. When employees and their dependents have few claims and few expensive illnesses, the self-funded employer saves money on health care costs.

Employers thinking about a self-funded plan must be comfortable accepting and managing risk. For most businesses under 100 employees, this is not an option because too much is unknown.

For every county in Illinois (except JoDaviess), we offer self-funding as an option.

For those who do choose this route, Health Alliance provides a complete self-funding package, with the benefit management and administrative service tools. Most self-funded employers purchase stop-loss insurance to reduce the risk of large individual claims or high claims for the entire plan. Health Alliance provides stop-loss coverage, too—both individual and aggregate (meaning the group’s total)—providing true one-stop service.

If you have questions about self-funding, call 1-800-851-3379, ext. 8024, Monday through Friday, 8 a.m. to 5 p.m.

Do your employees need dental or vision coverage?

You can add dental and vision coverage to your group’s plan. Every plan includes prescription drug benefits, but most dental and vision benefits are “add-ons.” For more information about our add-ons, call us at 1-800-851-3379, ext. 8024, Monday through Friday, 8 a.m. to 5 p.m.   

How many employees and dependents will your plan cover?

You may not know the exact number, but a good estimate will give a more accurate quote.  

Need More Information?

Take a look at everything Health Alliance offers, and if you have any questions along the way, call us at 1-800-851-3379, ext. 8024, Monday through Friday, 8 a.m. to 5 p.m.

Small Group Plans

What are Small Group Plans?

We offer comprehensive coverage and benefit-rich plans to groups with two to 50 total employees.

Plans We Offer

Let’s look at our plans. Remember, if you need help along the way, call us at 1-800-851-3379, ext. 8024, Monday through Friday, 8 a.m. to 5 p.m. Our reps are happy to work with you.

HMO (Health Maintenance Organization) planHealth Alliance HMO plans offer a large provider network and low out-of-pocket costs. HMO plans are ideal for comprehensive coverage and predictable costs.

Structure

  • Only care within the HMO network is covered. Out-of-network coverage is only available in emergencies or with preauthorization.
  • Members pick a Primary Care Physician (PCP) to coordinate all care.
  • For specialty care, a PCP gives a referral to a Health Alliance HMO network specialist.
  • Women can select a Women’s Principal Health Care Provider (specializing in obstetrics, gynecology (or OB/GYN) or family practice) in addition to a PCP.

Think About

  • Our HMO networks are extensive (and always growing) and feature top providers in each of our service areas.
  • A PCP gives attention to overall health and serves as a “go-to” health care partner.
  • Members don’t have to meet a deductible before their coverage kicks in.
  • Flat copayments for office visits and other services keep medical expenses predictable and budget-friendly.

POS (Point of Service) planHealth Alliance POS plans give the stability of an HMO, with the freedom to go out-of-network, too. Coverage level is determined where the member receives care, otherwise known as at the “point of service.”

Structure

  • Coverage is determined where the member receives care. When choosing a Health Alliance network provider, HMO-style benefits apply. When choosing an out-of-network provider, indemnity benefits apply (coverage at a higher price)—except in an emergency or with preauthorization.
  • Members select a Primary Care Physician (PCP) to coordinate medical care.
  • For in-network specialty care, a PCP gives a referral to a Health Alliance in-network specialist. Specialty care without a referral or out-of-network is covered, but at a higher cost to the member.
  • Women can select a Women’s Principal Health Care Provider (specializing in obstetrics, gynecology (or OB/GYN) or family practice) in addition to a PCP.

Think About

  • POS plans are a combination of HMO financial advantages—fixed copayments and an annual out-of-pocket maximum—with the choice of out-of-network care at a limited (indemnity) coverage level.
  • Our POS networks are extensive (and always growing) and feature top providers in each of our service areas.
  • A PCP gives attention to overall health and serves as a “go-to” health care partner.

PPO (Preferred Provider Organization) planGives members the freedom to pick a doctor and hospital without a referral from a Primary Care Provider (PCP). Although members have out-of-network coverage, they pay less when they stay within our extensive PPO network.

Structure

  • PPO members can pick any provider they want, but getting care from an in-network provider ensures coverage at the highest level.
  • Members are not required to select a PCP to coordinate care.
  • Health Alliance does not require PPO members get a referral for specialty care, although some doctors may require it.

Think About

  • The Health Alliance PPO network has thousands of doctors, hospitals and pharmacies throughout the Midwest. Use our provider search to see just how far our network stretches. And remember, if an employee is miles from home, no problem. We provide services linked to getting quality emergency medical care while traveling, through Assist America.
coverage area

Plans in Your County

Check the map for plans in your area. Your business must be headquartered in the county to be eligible for coverage.

HMO, PPO and POS plans

Large Group Plans

What are Large Group Plans?

We offer comprehensive coverage and benefit-rich plans to groups with 51 or more total employees.

Plans We Offer

Of course, you can look through the types of plans we offer and all of our extras. But remember, when you’re ready to start the enrollment process, give us call at 1-800-851-3379, ext. 8024, Monday through Friday, 8 a.m. to 5 p.m. Our reps will work with you to customize a plan.

HMO (Health Maintenance Organization) planHealth Alliance HMO plans offer a large provider network and low out-of-pocket costs. HMO plans are ideal for comprehensive coverage and predictable costs.

Structure

  • Only care within the HMO network is covered. Out-of-network coverage is only available in emergencies or with preauthorization.
  • Members pick a primary care physician (PCP) to coordinate all care.
  • For specialty care, a PCP gives a referral to a Health Alliance HMO network specialist.
  • Women can select a Women’s Principal Health Care Provider (specializing in obstetrics, gynecology (or OB/GYN) or family practice) in addition to a PCP.

Think About

  • Our HMO networks are extensive (and always growing) and feature top providers in each of our service areas.
  • A PCP gives attention to overall health and serves as a “go-to” health care partner.
  • Members don’t have to meet a deductible before their coverage kicks in.
  • Flat copayments for office visits and other services keep medical expenses predictable and budget-friendly.

POS (Point of Service) planHealth Alliance POS plans give the stability of an HMO, with the freedom to go out-of-network, too. Coverage level is determined where the member receives care, otherwise known as at the “point of service.”

Structure

  • Coverage is determined where the member receives care. When choosing a Health Alliance network provider, HMO-style benefits apply. When choosing an out-of-network provider, indemnity benefits apply (coverage at a higher price)—except in an emergency or with preauthorization.
  • Members select a Primary Care Physician (PCP) to coordinate medical care.
  • For in-network specialty care, a PCP gives a referral to a Health Alliance in-network specialist. Specialty care without a referral or out-of-network is covered, but at a higher cost to the member.
  • Women can select a Women’s Principal Health Care Provider (specializing in obstetrics, gynecology (or OB/GYN) or family practice) in addition to a PCP.

Think About

  • POS plans are a combination of HMO financial advantages—fixed copayments and an annual out-of-pocket maximum—with the choice of out-of-network care at a limited (indemnity) coverage level.
  • Our POS networks are extensive (and always growing) and feature top providers in each of our service areas.
  • A PCP gives attention to overall health and serves as a “go-to” health care partner.

PPO (Preferred Provider Organization) planGives members the freedom to pick a doctor and hospital without a referral from a Primary Care Provider (PCP). Although members have out-of-network coverage, they pay less when they stay within our extensive PPO network.

Structure

  • PPO members can pick any provider they want, but getting care from an in-network provider ensures coverage at the highest level.
  • Members are not required to select a PCP to coordinate care.
  • Health Alliance does not require PPO members get a referral for specialty care, although some doctors may require it.

Think About

  • The Health Alliance PPO network has thousands of doctors, hospitals and pharmacies throughout the Midwest. Use our provider search to see just how far our network stretches. And remember, if an employee is miles from home, no problem. We provide services linked to getting quality emergency medical care while traveling, through Assist America.
coverage area

Plans in Your County

Check the map for plans in your area. Your business must be headquartered in the county to be eligible for coverage.

HMO, PPO and POS plans available 

Group Pharmacy Plans

Group Pharmacy Plans

Whether they’re for strep throat or part of a disease management plan, medicines help keep you and your employees healthy and active. Our pharmacy benefits give the highest-quality meds at prices that won’t empty the bank account.

The plans work on a tier-system—think of "tiers" as steps. For low "steps" (or tiers), members pay the lowest copayment. As they take a step up, costs will increase.

2014 Pharmacy Plans

Take a look at our pharmacy plans for 2014. You’ll want to find the "pharmacy plan type" in the plan’s description (at the very end of the long name) and match it below.

Remember, if you’re looking for group coverage for more than 50 total employees, call us at 1-800-851-3379, ext. 8024, Monday through Friday, 8 a.m. to 5 p.m. Our reps are happy to work with you to customize a plan.

Be sure to check out our Pharmacy section, too. It's packed with helpful definitions and explanations about our pharmacy benefits and programs.

Small Group Pharmacy Plans
Pharmacy Plan TypeWhat Do They Mean?
Tier 1/Tier 2/Tier 3/Tier 4/Tier 5/Specialty

Rx1

$7/$25/$50/$100/$150/50%

Rx2

$7/$35/$70/$140/$210/50%

Rx3

$10/$40/$80/$200/$300/50%

Rx5

Meet a $250 pharmacy deductible, then $10/$40/$80/$200/$300/50%

RxDed

Meet your medical deductible first, then we pay 100 percent of your pharmacy costs

Save With Pharmacy Extras

We know health is important to you and your employees—and so is saving money. That’s why we created pharmacy savings programs. They’re easy to use and can save you and your employees a lot.

Rxtra

Save money simply by choosing a Preferred or Preferred Plus pharmacy. Members don’t have to cut, clip or remember a coupon—they just show their Health Alliance member ID card at a Preferred pharmacy and save.

Preferred Plus pharmacies are everywhere. You don’t have to drive across town or to another city to save on your prescriptions. Preferred Plus pharmacies include Dierbergs, Kmart, Kroger, Walmart, Sam’s Club, Osco, Schnucks and many more. We posted a list of pharmacies and their savings levels for members at YourHealthAlliance.org, on the Forms and Resources page.

Mail Order

Our Mail Order program brings savings to your doorstep. You get a 90-day supply of your meds—delivered from a trusted pharmacy—for a discounted price.

Retail 90

Do you prefer to pick up your meds from a neighborhood pharmacy? Order a 90-day supply through a participating Retail 90 pharmacy and save.

DailyMed

For members who take multiple medications, DailyMed delivers clearly labeled, pre-sorted packages to your home. DailyMed takes away pill sorting and gives you peace of mind, knowing you’ve taken the right meds at the right time.

My Drug Benefit

Members can view their pharmacy claims and cost-sharing information at YourHealthAlliance.org. While they’re there, members can also research drug information and compare costs.

If you have any questions about our pharmacy plans, call our Pharmacy Department at 1-800-851-3379, option 4, Monday through Friday, 8 a.m. to 5 p.m.

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We're happy you found a plan that fits your needs. To get a quote or start the enrollment process, press "Continue." You'll be asked some questions about yourself to make sure you get the right quote. Before you go, be sure to write down the plan name you're interested in. You'll need these details to search our marketplace.

If you have questions along the way, call us. Our reps are happy to help.

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Employer Group Inquiry

Interested in a plan? We're happy to hear. Please complete this form, and we'll be in touch soon. If you have any immediate questions, give us a call at 1-800-851-3379, ext. 8024, Monday through Friday, 8 a.m. to 5 p.m.

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