Medical insurance is one of your most important benefits. When you enroll in one of the BlueCross
BlueShield of Illinois medical plans offered by Naperville Community Unit School District 203 you have peace of mind knowing that you can pay for medical services if you need them for you or your family. Prime Therapeutics (BlueCross BlueShield’s prescription partner) administrates the Prescription Drug plan, providing you a single ID card for Medical and Prescription Drug coverage. District 203 is pleased to offer four distinct Medical/Rx plans from BlueCross BlueShield of Illinois for employees to choose from:
Platinum PPO – This traditional PPO plan features a low deductible, co-insurance, and copays for office visits and prescriptions. This plan is Grandfathered so it is not required to comply with all of the features of the Affordable Care Act including covering preventive care without cost sharing and limiting the amount paid out-of-pocket. As such, with the Platinum PPO plan only the first $500 of preventive care per individual per calendar year is covered at 100% with no deductible or copay, the remainder is subject to 80% after deductible, and there is no limit to Medical and Prescription copay accumulation.
Platinum PPO Limited Network - This plan combines the conventional deductible, co-insurance, and copay structure of a traditional PPO plan with the claims savings that come from using a narrow network. This plan utilizes the BlueChoice network, instead of the PPO network used by the Platinum PPO and Gold HDHP plans, which is smaller but features greater average discounts and lower negotiated fees In-Network. To fully take advantage of this plan, it is important to confirm In-Network status with your provider every time services are rendered. To find a provider in BlueCross BlueShield’s BlueChoice Network, visit BCBSIL.com or call 1.800.458.6024. In addition, this plan features a lower premium than the Platinum PPO, and like the Gold HDHP is Non-Grandfathered so it complies with the Affordable Care Act’s requirements of In-Network preventive care covered 100% with the deductible waived and annual maximum out-of-pocket limits.
Gold HDHP – This high deductible health plan features the same PPO network as the Platinum plan but with 100% coverage In-Network after the deductible is satisfied. This plan is Non-Grandfathered so it complies with the Affordable Care Act’s requirements of In-Network preventive care covered 100% with the deductible waived and annual maximum out-of-pocket limits. This plan includes a Health Savings Account with employer contributions, described further on page 16. In addition, this plan has a lower annual premium than the Platinum PPO.
Gold HDHP Limited Network - This plan combines the traditional HDHP structure with the claims savings that come from using a narrow network. This plan, like the Platinum PPO Limited Network plan, utilizes the BlueChoice network. In addition, this plan features a lower premium than all other offered plans, and like the Gold HDHP is Non-Grandfathered so it complies with the Affordable Care Act’s requirements of In-Network preventive care covered 100% with the deductible waived and annual maximum out-of-pocket limits.
- Limited Network - To find out if a doctor is in the Limited Network click on the link above. Important: Do not log into your current account if you are trying to search for a doctor in the Limited Network.
Dependent Verification Required DocumentationYou are required to verify eligibility for any dependents that are added to your benefits for the first time. Dependents will not be enrolled if you fail to provide proper documentation within the 31 days of enrollment. Eligible dependents are spouses, civil union partners, and children (biological, adopted and those for whom you have legal guardianship and accompanying documentation) under age 26. You will be required to provide verification documents to the Employee Benefits Coordinator in the District 203 Business Office.Acceptable documentation is as follows:
- A copy of your Marriage or Civil Union Certificate OR a copy of your most recent Joint Federal Income Tax Return;
- A copy of the Birth Certificate for each dependent to be covered under the plan, excluding your spouse, OR Adoption Certificate or Court Order