Coronavirus (COVID-19) Important Information
In response to COVID-19, the Illinois Department Central Management Services' (CMS) Bureau of Benefits (Benefits) is working to mitigate any adverse health and financial impacts to our members who may be affected, either directly or indirectly. We are committed to ensuring that our members do not experience any issues regarding access to care and have appropriate resources readily available.
Benefits continues to provide uninterrupted service to our members. We suggest you take advantage of MyBenefits.illinois.gov, or MyBenefits Service Center (toll-free) 844-251-1777 from 8:00 AM – 6:00 PM CT, Monday through Friday to address your benefit and enrollment questions. If you have a concern that cannot be addressed by MyBenefits, please contact CMS at (toll-free) 800-442-1300, select the appropriate option and leave a message. A representative will return your call within 24 hours Monday through Friday.
The State of Illinois' response to Coronavirus (COVID-19) can be found at the following sites, including new information on COVID-19 vaccination:
For more additional information related to COVID-19, we encourage members to refer to the US Centers for Disease Control and Prevention and World Health Organization websites for the most current information.
Click the links below for more information:Employee Assistance and Support ProgramsCOVID-19 Benefit Update – All Benefit Choice and TRAIL MAPD PlansFlexible Spending Accounts (FSAs)Health Plan AdministratorsAdditional Plan Information
COVID-19 Benefit Update
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COVID-19
- COVID-19 diagnostic test and exam: Covered at 100%; no member cost share
- COVID-19 vaccination: Covered at 100%; no member cost share
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Visit a doctor from home
- Many health plans are covering in-network Telehealth Services* (electronic or telephonic) at 100%; no member cost share
*Consumer Driven Health Plan enrollees must first meet their deductible unless the service is deemed preventive, per IRS rules.
- For specific questions related to your coverage, please contact your plan administrator directly. Plan administrator information, including links to COVID-19 information and resources, is listed below for your convenience.
Flexible Spending Accounts (FSAs)
In accordance with recent IRS guidance, CMS is updating Medical Care Assistance Program (MCAP) and Dependent Care Assistance Program (DCAP) rules.
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The CARES Act expands the FSA eligible expense list to include over-the-counter medicines and menstrual products, retroactively to January 1, 2020.
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Extension of FY20 MCAP and DCAP funds as of June 30, 2020 will not be forfeited. You may submit claims incurred through December 31, 2020.
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Enrollment or increases to FY21 MCAP allowed through December 31, 2020 with no "qualifying change in status."
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All changes to FY21 DCAP allowed through December 31, 2020 with no "qualifying change in status."
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Rollover for unused FY21 MCAP funds into FY22 will increase to $550.00.
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Dependent Care Assistance Program (DCAP) – A significant change in the cost of dependent care is a qualifying event to change your DCAP election. Visit MyBenefits.illinois.gov and utilize the Self-Service tools, or call MyBenefits Service Center (toll-free) at 844-251-1777 and request a Significant Change in Daycare Provider Costs event. You will be required to provide documentation or a written statement explaining the change for the event to be processed.
Flexible Spening Accounts (FSAs)
In accordance with recent IRS guidance, CMS is updating Medical Care Assistance Program (MCAP) and Dependent Care Assistance Program (DCAP) rules.
-
The CARES Act expands the FSA eligible expense list to include over-the-counter medicines and menstrual products, retroactively to January 1, 2020.
-
Extension of FY20 MCAP and DCAP funds as of June 30, 2020 will not be forfeited. You may submit claims incurred through December 31, 2020.
-
Enrollment or increases to FY21 MCAP will be allowed through December 31, 2020 with no "qualifying change in status."
-
All changes to FY21 DCAP will be allowed through December 31, 2020 with no "qualifying change in status."
-
Rollover for unused FY21 MCAP funds into FY22 will increase to $550.00.
-
Dependent Care Assistance Program (DCAP) – A significant change in the cost of dependent care is a qualifying event to change your DCAP election. Visit MyBenefits.illinois.gov and utilize the Self-Service tools, or call MyBenefits Service Center (toll-free) at 844-251-1777 and request a Significant Change in Daycare Provider Costs event. You will be required to provide documentation or a written statement explaining the change for the event to be processed.
View up to date information on how Illinois is handling the Coronavirus Disease 2019 (COVID-19) from the
Illinois Department of Public Health
Affordable Care Act tax Forms 1095-B and 1095-C
Per IRS guidance, Forms 1095-B and 1095-C are for record keeping purposes only and are not required to be filed with a participant’s 2019 tax return. The forms are currently being mailed through MyBenefits and should be received by March 2, 2020 per IRS requirements. Please note: You do not need this form to file your taxes. The forms are proof of the 2019 offer and enrollment in health insurance coverage. The information on these forms indicates that the participant and any spouse or dependent were offered coverage and the respective enrollments, if any, for each month during 2019. 1095 FAQs
State of Illinois and AFSCME Agreement Ratified:
- A new agreement between the State of Illinois and AFSCME was ratified on June 22, 2019.
- The contract amends the group health insurance contribution amounts for Members and their Dependents effective July 1, 2020. Contribution amounts will vary based on the Member's salary band and the chosen health plan.
Amended: January 13, 2020
Affordable Care Act tax Forms 1095-B and 1095-C
Per IRS guidance, Forms 1095-B and 1095-C are for record keeping purposes only and are not required to be filed with a participant’s 2018 tax return. The forms are currently being mailed through MyBenefits and should be received by March 4, 2019 per IRS requirements. Please note: You do not need this form to file your taxes. The forms are proof of the 2018 offer and enrollment in health insurance coverage. The information on these forms indicates that the participant and any spouse or dependent were offered coverage and the respective enrollments, if any, for each month during 2018. 1095 FAQs
Archived Notices
The State offers several health plan options that include prescription benefits. Other benefits included in the benefit plans are vision, dental, life insurance coverage and behavioral health coverage. Outside the Benefit Choice enrollment period, members may change coverage elections only when a
qualifying change in status occurs.
All available benefit plans and programs are explained in detail in the Member Handbook and Benefit Choice Options Booklet. Also included are amendments that update the handbook and a summary document indicating the benefit levels of the Quality Care Health Plan (QCHP).
Information regarding continuation of coverage.
Whenever questions arise, plan participants have various resources they can use. On the Contact Information page, members may view the phone number for the Group Insurance Division, a listing of agency/university group insurance representatives as well as links for all of the state insurance plan administrator websites.
Coverage elected during the annual Benefit Choice Period remains in effect throughout the entire plan year, unless the Member experiences a Qualifying Change in Status or a special enrollment event which would allow them to change their coverage elections.
Coverage is available for eligible dependents, including spouses, children and unrelated same-sex domestic partners.
Members not currently enrolled in the health, dental, vision and prescription coverage offered by the State due to waiving or opting-out may enroll in the Program during the annual Benefit Choice Period or upon experiencing a qualifying change in status.
Employees who either go on or return from a leave of absence have certain rights and responsibilities regarding their insurance coverage. Employees should read the documents regarding leaves of absence in order to be aware of those rights and responsibilities and to prevent unwanted termination of coverage.
Members on a leave of absence may pay for their group insurance premiums electronically by using E-Pay. E-Pay is a system developed by CMS Group Insurance and the Illinois Treasurer's Office to provide a quick and convenient way for members of the State Employees Group Insurance Program to pay group insurance premiums online.
Information regarding Medicare and how it affects your group insurance coverage.
Notices
The State is required to provide certain federal notices regarding their privacy and insurance coverage.
The State allows for employee, annuitants and survivors who meet certain criteria to opt-out or waive coverage.
The State offers three programs which save employees valuable tax dollars.
In addition to the insurance coverage and pretax programs the State offers, employees are offered additional benefits when
adopting a child, when needing support and information during
difficult times, when participating in an approved
smoking cessation or
weight loss program.
Plan Administrators
Members may view contact information, including phone numbers and addresses, for all plan administrators via these links.
Members can view health, dental and life coverage rates, as well as Quality Care Health Plan deductibles and family caps. Members interested in adding a non-IRS domestic partner, civil union partner, child of a civil union partner or an adult veteran child can view the premiums and imputed income associated with those types of dependent coverage. Full-time employees can calculate the applicable contributions for coverage.
Part-time employees are responsible for a portion of the State’s contribution for their health, dental and dependent coverage. Part-time employees should contact the
group insurance representative at their agency for rate information.
The State offers many valuable wellness programs to help keep our members healthy and help our members get healthier. The goal is for all State members to lead better, more satisfying lives. This
Wellness Chart lists many of the wellness benefits currently available to members through their health plans, most free of charge.