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Benefits
General Information by Provider for Current Employees
This information is applicable to positions with full benefits.
Self-Insured Medical PPO
UMR
Claims are mailed to:
Claims Administration
PO Box 30533
Salt Lake City, UT 84130-0533
Customer Service: (800) 533-6654
Plan Highlights:
- $300 in-network deductible per person/year — $900 in-network deductible per family / year
- $500 out-of-network deductible per person/year — $1500 out-of-network deductible per family / year
- Co-Insurance employee responsibility — 10% for in-network services / 30% out-of-network after deductible
- $2200 maximum out of pocket, after deductible
Prescriptions: $5 generic / $20 non-formulary / $30 formulary
For a complete plan summary, click here.
Network for Self-Insured PPO Medical Plan:
United HealthCare
Vision Benefits for Self-Insured Medical Participants:
Vision Service Plan
Customer service: (800) 877-7195
HMO Illinois and BlueAdvantage
Customer Service: (800) 892-2803
Plan Highlights:
- $15/co-pay, $50 ER co-pay
- Prescriptions: $5 generic / $20 non-formulary / $30 formulary
Vision benefits through Davis Vision. Contact them at their customer service number at 1-877-393-8844, click here to visit their website, or contact bcbsil HMO Member Services at 800-892-2803.
Links
- Complete BlueAdvantage plan summary
- Complete HMO Illinois plan summary
- General summary of the HMO plans
Dental Plan
UMR
Claims are mailed to: Claims Administration, PO Box 30533, Salt Lake City, UT 84130-0533
Customer Service: (800) 533-6654
Plan Highlights:
- Six-month cleanings covered 100%
- $50 deductible
- Routing and Customary Work Covered 80%
- Major Work Covered 50%
- $1,500 Annual Max/Per Person
For a complete plan summary, click here.
Flexible Spending Section 125
UMR
Claims are mailed to: Claims Administration, PO Box 2708 - Dayton, OH 45401-2708
Customer Service: (877) 310-3539
State Universities Retirement System (SURS)
Consolidated Omnibus Budget
Reconciliation Act of 1985 —
Public Law 99-272, Title X (COBRA)
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