TRIP – State-Sponsored Medicare Advantage Plan

TRIPThe Illinois Department of Central Management Services (CMS) recently announced that the Medicare Advantage procurement has concluded and contracts are being awarded to the winning vendors. All members who will be offered a Medicare Advantage plan option, whether they live in Illinois or in another state, will have access to a nationwide Medicare Advantage PPO plan. Certain members residing in Illinois, depending on residential county, will also have access to a Medicare Advantage HMO plan. It is the Department’s intent to award the following contracts:

  • Aetna Life Insurance Company – a Medicare Advantage HMO Plan;
  • Humana Health Plan – a Medicare Advantage HMO Plan;
  • Humana Benefit Plan – a Medicare Advantage HMO Plan for the counties of Livingston and Knox; and
  • United Healthcare – a nationwide Medicare Advantage PPO

Although it is the intent of CMS to award to the winning vendors, the award process includes a 7-day dispute period which will end next Wednesday, Oct. 9th. Impacted members will be sent letters from CMS regarding the procurement and the next steps they need to take regarding their health insurance coverage. More than one mailing will likely be sent as additional information is finalized and enrollment/seminar dates are scheduled.

Once all matters are finalized, the letter(s) will, at a minimum, include the following information:

  • Plan design, including copayment amounts, deductibles and coinsurance percentages
  • Provider networks
  • Enrollment dates
  • Effective date of the new coverage
  •  Monthly premiums
  • Opt out information
  • Seminar dates, locations and times

Members who receive the letter and do not want to elect one of the new Medicare Advantage plan options will be instructed on how to opt out of their current health plan. Impacted members who do not elect one of the new Medicare Advantage plans offered will have their coverage terminated.

As there are certain formalities that must be followed before the procurement is finalized, limited information remains available, both in the CMS Benefits Office and with the selected vendors.

Please check back to the following website often as information will be posted there once it is known:
http://www2.illinois.gov/cms/Employees/benefits/Teachers