2019 Benefits Key Changes

  • Advocate Centered EPO and HMO - Access to the Aurora Physician Network

    Advocate Centered EPO members must use Advocate physicians, specialists and facilities to receive the highest level of benefits, as well as the 10% discount applied for Advocate hospitals and facilities. If using Aurora Health Care physicians – the same lower level of benefits would be paid as if using providers in the Humana or Health Alliance networks. No facility discount would apply. Team members should check with their EPO plan administrator, Humana (Advocate) or Health Alliance (BroMenn), first before using Aurora Health Care providers.

    Advocate Centered HMO members must use Advocate physicians, specialists and facilities for benefits to be paid. Aurora Health Care physicians and facilities are treated the same as any non-Advocate provider or facility. Team members should receive a PCP referral and check with the HMO plan administrator, Humana, first before using Aurora Health Care providers to validate the provider is in-network.

  • Advocate Centered EPO: Continues to Be Lowest Cost Per Pay Period

    • Advocate pays about 75% of the cost for medical coverage; team members share in the cost.
    • The Advocate Centered EPO and Advocate Centered HMO offer great care, a large network and lower costs per pay period.
    • The Advocate Centered EPO will continue to be the lowest cost.
    • The PPO plan is the highest cost per pay period since we can’t control costs outside of Advocate.
    • Access 2019 Team Member Contributions.
  • Advocate Centered EPO BroMenn: New EPO Plan Administrator

    • Effective January 1, 2019, the Advocate-BroMenn EPO will be administered by Health Alliance™ to provide team members with increased access to care providers in Central Illinois.
    • Enhanced access to care in Central Illinois, with inclusion of Carle Physician Speciality Group for specialist visits in tier I of the network.
    • Health Alliance will process BroMenn EPO claims.
    • Team members will call Health Alliance with claims-related questions.
    • BroMenn and Eureka team members currently enrolled in the EPO Plan will automatically transition to Health Alliance on Jan. 1, 2019.

  • Advocate Centered EPO & PPO: DRA Change / Healthe Rewards Credit Increase

    Deductible Reimbursement Account (DRA) Change

    • A DRA funded by Advocate is automatically set up for you if you choose the Advocate EPO or PPO Plan.
    • Advocate puts “first-dollar” funds in your DRA that you can use for eligible expenses applied to your deductible.
    • In 2019, these first-dollar fund are $400 for team member and $400 for a covered spouse/partner.    
    • You can earn additional DRA funds by completing Healthe You activities.


    Healthe Rewards Credit Increase  

    • In 2019, team members can earn up to $800 and a covered spouse/partner can earn up to $800, too, by completing Healthe You activities.
    • You will now earn a portion of the total incentive dollars after taking the Health Risk Questionnaire and completing an Initial Measures Screening.
    • These earned credits are added to your Deductible Reimbursement Account (DRA).  
  • Prescription Drug Plan: Change in plan administrator, new copay and coinsurance model

    • Express Scripts will be the new plan administrator.
    • Preferred and non-preferred brand name prescription drugs will change to new coinsurance model.
    • BroMenn EPO and PPO plan participants can fill a 90-day supply of maintenance medications at the BroMenn Atrium Pharmacy. In addition to the convenience, receiving a 90-day supply costs less than a 30-day supply.

    Transitioning to Express Scripts Checklist

    • New ID cards will be mailed to your home by December 31, 2018.
    • Order mail order refills if you will need medications by January 2019.
    • Accredo to fill Specialty Prescriptions effective January 1, 2019.
    • Register to use express-scripts.com for a fast, safe and secure way to order refills, manage your account, get medications, pricing and more. 

    Learn more: Copay vs Coinsurance

  • Dental Rate Changes

    • Advocate shares in cost for dental coverage.
    • Increases reflect higher plan utilization.
    • Average increase of 6% per pay period for those enrolled in either MetLife PDP or MetLife PDP with Ortho Plan.    
  • Vision Changes

    • Advocate shares in cost for vision coverage.
    • Enhanced benefits in 2019.
    • Increases per pay period:  
      • Single: $3.57 to $3.77
      • Single + Spouse/Partner: $6.75 to $7.14
      • Single + Child(ren): $9.22 to $7.51
      • Family: $9.92 to $11.03
  • Life Insurance: change in plan administrator, enhanced benefits

    • Prudential Life is the new plan administrator.
    • Basic Life Insurance coverage for exempt team members is changing from 1.5 to 1X base salary.
    • Optional Life insurance coverage limits are increasing.
  • Flexible Spending Accounts (FSAs)

    • Must elect Health Care and/or Dependent FSAs* during Annual Benefits Enrollment:
      • Health Care FSA: from $200 up to $2,650 a year;
      • Dependent Care FSA: from $200 up to $5,000 a year per family.

    *Note: IRS limits are subject to change and will not be available until mid to late October.