MEMBER HEALTH BENEFIT PROGRAM (“THE PROGRAM”)
FOR CHICAGO ASSOCIATION OF REALTORS MEMBERS
HOW DID THE PROGRAM COME ABOUT?
During the past five years, C.A.R. leadership has been looking for a solution that offers its members who are not eligible to participate in an employer sponsored group health insurance plan options that go beyond what is available under the Affordable Care Act (ACA). Finding a solution has grown in interest/importance as the options available under ACA have experienced significant premium increases, higher and higher deductibles, and carriers have left the Illinois ACA exchange leaving only one carrier standing.
WHO IS STRATEGO PARTNERS?
STRATEGO is a Chicago area management consulting firm in business since 2002. STRATEGO works with clients to identify “outside of the box” cost saving strategies, including creative ways to reduce health insurance costs. STRATEGO has been engaged to identify and coordinate all of the resources required to develop, deliver, support and service the PROGRAM.
WHAT ARE THE PRIMARY BENEFITS OF THE PROGRAM COMPARED TO THE OPTIONS AVAILABLE ON THE ILLINOIS ACA EXCHANGE?
The PROGRAM will provide members not participating in an employer sponsored group health insurance plan access to one of the nation’s largest hospital and physician networks, including Northwestern, University of Chicago and Rush hospitals, which are no longer available under Chicago-area ACA plans.
The PROGRAM also provides members not participating in an employer sponsored group health insurance plan the ability to select cost-effective monthly premium levels, optimized deductible levels , and annual maximum out-of pocket levels that fit different family medical requirements and annual budgets.
WHO CAN APPLY TO THE PROGRAM?
All members not participating in an employer sponsored group health insurance plan are eligible to apply to the PROGRAM.
HOW DO I APPLY TO THE PROGRAM?
Each member who applies to the PROGRAM will be required to complete an online medical questionnaire. The medical questionnaire will take about twenty to thirty minutes to complete. We recommend that you have information about your doctors, prescriptions and any hospital procedures readily available. If you are unable to complete the entire questionnaire in one sitting you will be able to save it and return at a later time.
WHEN CAN I APPLY TO THE PROGRAM?
The first step in applying to the PROGRAM is completing the medical questionnaire. The on-line medical questionnaire will be available from October 2-16, 2017. The medical questionnaire must be completed and submitted no later than October 16, 2017.
WHEN WILL I KNOW IF I HAVE BEEN ACCEPTED INTO THE PROGRAM?
Completed medical questionnaires will be submitted and subject to an insurance underwriting process. The underwriting process will take approximately 2-3 weeks, and there may be follow up questions or additional medical information requested. Email and telephone assistance will be available throughout the medical questionnaire application process so that your questions can be answered in a timely fashion.
You will be informed of underwriting’s acceptance decision into the PROGRAM during late October/early November. The underwriting process acceptance decision is final.
HOW MUCH WILL MEMBERS LIKELY SAVE UNDER THE PROGRAM?
We expect most C.A.R. members will see a 10-20% reduction in their health insurance premiums. The actual savings will vary member by member, and all C.A.R. members who are accepted into the Program will have access to an expanded hospital and physician network, including Northwestern Memorial, University of Chicago and Rush.
For example, C.A.R. members who currently receives monthly health insurance premium subsidies under ACA will not receive any monthly premium subsidies under the Program (and may actually pay higher monthly premiums). They will receive access to the expanded hospital network if they are accepted into the Program. Higher income C.A.R. members who are not eligible for ACA subsidies will likely receive the 10-20% monthly premium savings and access to the expanded hospital network.
Additionally, the Program provides for varying deductible and annual out-of-pocket maximum amounts. C.A.R. members who move from a high deductible and high annual out-of-pocket maximum ACA plan to a lower deductible and lower annual out-of-pocket maximum plan under the Program will experience less monthly premium savings, but will see lower annual out-of-pocket costs and access to the expanded hospital network.
WHEN CAN I REVIEW THE HEALTH PLAN OPTIONS, MONTHLY PREMIUMS AND SELECT THE RIGHT PLAN FOR ME AND MY FAMILY?
We expect the final plan options and monthly costs effective for January 1, 2018 will be available to review during mid-late November 2017.
WHEN WILL THE PROGRAM BEGIN?
Coverage under the PROGRAM will begin January 1, 2018.
WHAT ARE MY OPTIONS IF I HAVE NOT BEEN ACCEPTED INTO THE PROGRAM FOR JANUARY 1, 2018?
For 2018, the first year of the PROGRAM, we are planning to accept a pilot group of approximately 250-500 C.A.R. members. We anticipate expanding the PROGRAM to more and more C.A.R. members during 2019 and beyond after we have developed initial medical claims experience with the C.A.R. member group.
C.A.R. members not accepted into the PROGRAM for January 1, 2018 will be able to continue the health insurance plan they currently participate in and they will have all of the individual plan options available to them available under the Illinois ACA exchange. Acceptance decisions into the PROGRAM will be made during the first week in November, providing plenty of time for members to evaluate their existing options and apply for coverage during ACA open enrollment during November and December 2017.
For those C.A.R. members who would like assistance evaluating their Illinois ACA exchange options, we are arranging for telephone and email assistance and will provide more details as soon as they are available.
WHERE CAN I OBTAIN MORE INFORMATION ABOUT THE PROGRAM?
Be sure to check the C.A.R. Weekly Connection and ChicagoREALTOR.com for more information about the PROGRAM and key dates.