Supplemental Fully-insured HMO RFP

On Thursday, November 15, the award resulting from the supplemental fully-insured HMO RFP was posted.  The changes involved will be effective February 1, 2013.  This award results in supplemental fully-insured HMO coverage through Health Alliance HMO and Coventry HMO being awarded in all but 6 northeastern Illinois counties (Cook, Du Page, Kane, Kendall, Lake and Mc Henry).  HMO Illinois, BlueAdvantage HMO, Coventry OAP, Healthlink OAP, and the Quality Care Health Plan (QCHP) were not affected by this procurement.

Because this procurement was for fully-insured HMO coverage only, Health Alliance Illinois was not included in this procurement process.  Health Alliance Illinois is currently offered under an emergency contract which, as a result of the completion of this procurement, will be terminated effective February 1, 2013.  Therefore, all members currently covered under Health Alliance Illinois will need to change their health carrier by January 31, 2013, in order to prevent being defaulted to the QCHP on February 1, 2013.  The loss of Health Alliance Illinois is considered a qualifying change in status which will allow the affected members to switch carriers.  Affected members will be allowed to elect a new carrier up to 60 days after February 1, 2013; however, changes will be effective the date of the request if made after February 1, 2013.  Letters will be sent to members during the month of December advising them of these changes and encouraging them to make their election prior to the February 1, 2013, termination date.

Member and dependent rates for full-time or part-time members will not change as a result of this procurement.  Members will not be required to satisfy the prescription deductible if it has already been satisfied for this plan year.