Date of Issue 6/05

Subject: Health Care Coverage

IIT offers a group plan for hospitalization and medical-surgical insurance administered by Blue Cross Blue Shield for the employee and his/her family¹.

Both a traditional indemnity plan that includes a preferred provider program (PPO) and a Network PPO plan are available to all eligible employees.

All eligible employees have coverage on the first day of the month coinciding with, or following the date of hire. An application must be submitted to Human Resources and the employee must be actively at work when coverage begins. Otherwise, coverage will begin on the first day the employee returns to work after s/he is eligible.

If the employee does not enroll within 31 days of becoming eligible, proof of good health must be provided.

The university pays most of the cost of medical coverage with the employee paying the balance of the cost by payroll deduction on a pre-tax basis. However, the portion of the payroll deduction attributable to a same-sex domestic partner and his/her children may be taxed.

Employees may request coverage or changes to existing coverage during an annual open enrollment period during May of each year for coverage/changes effective June 1. In addition, changes may be made during the plan year if the employee has a change in family status for one of the following reasons:

marriage
divorce
death of a dependent
birth or adoption of a child
a change in health care coverage due to spouse's or same-sex
domestic partner's employment
a qualifying event as defined under the domestic partnership policy

Continuation of coverage is available upon termination or an approved leave of absence. If the leave qualifies under the Family and Medical Leave Act (FMLA), policy C. 6.00, the employee pays only the portion normally deducted from her/his paycheck. All other leaves of absence require the employee to pay the full monthly premium based on the payment schedule established with Human Resources.

Coverage terminates based on the last day of employment as follows:

If the last day worked occurs between the first and the fifteenth day of the month, coverage will terminate on the last day of that month.

If the last day worked occurs between the sixteenth and last day of the month, coverage will terminate on the last day of the following month, providing the employee has paid his/her portion of the cost.

Upon termination, a former employee will receive a written offer to elect COBRA coverage and will pay the full monthly premium plus an additional 2% administrative fee. Contact Human Resources for the schedule of premiums.

The following forms are available in Human Resources:

Medical and Vision Claim Form
Enrollment/Change Form

Employees should use the following telephone numbers to contact Blue Cross Blue Shield:

1-800-548-1686 to request a duplicate identification card, to inquire about the status of a claim, to verify benefit coverage

1-800-635-1928 to report a scheduled hospital admission or emergency hospital stay.

1-800-810-2583 to find a PPO provider in your service area or when traveling.

1-800-423-1973 for pharmacy inquiries.

Website: www.bcbsil.com to request a duplicate identification card, inquire about the status of a claim, verify benefit co verage, locate a preferred provider, and purchase mail order prescription drugs

Contact Human Resources for:

Summary Plan Description
Plan Document

¹"Family" includes an eligible same-sex domestic partner and his/her children. See Policy B. 10.00
²Employees covered by a collective bargining agreement should consult their respective contract for information on health insurance benefits and cost.

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