Health (Illinois/Outside of Wisconsin)

How do I find an in-network provider (Health Choices/Live360)?
Go to www.live360healthplan.com and follow the instructions to locate a provider. 

For help determining which network service area you are in, see the 2021 Flexplan Benefits Guide or click here to view the list of zip codes.

If you have a dependent who lives outside of the network area, such as a child attending college, you and/or your out-of-area covered dependent must complete and submit the Care Package Form in order to have additional providers available to your out-fo-area covered dependent in the First Health Network. The Care Package Form must be completed and submitted before receiving any services.
When does health insurance coverage begin?
  • Your coverage will begin on the first day of a pay period following two full pay periods of employment.
  • The two full pay period waiting period applies if you are a newly hired colleague or have transferred from a PRN position to a benefits eligible position.
  • Coverage for your dependents begins on the same day as your coverage as long as you have enrolled them for health insurance.
If I do not enroll by my enrollment deadline, what coverage will I have?
If you are a new hire and you do not enroll by your enrollment deadline, you will have the following coverage by default:
  • Basic Life and AD&D insurance
  • Short-Term Disability Coverage
  • Long-Term Disability Coverage
What about emergency room care?

If your condition is a true emergency, you will have a $100 copayment for emergency services. This is in addition to your deductible and coinsurance for the medical plan option you select.

If you utilize the emergency room for a non-emergency condition, you will have a $300 copayment in addition to your deductible and coinsurance for the medical plan option you select.

For True Medical Emergencies:
For an emergency medical condition, the HSHS Healthy Plan provides the same benefit level regardless of the provider who provides your care.

  • Medical Emergency and Emergency Accident facility charges are covered at the HSHS benefit level, whether you go to an HSHS or another facility.
  • Likewise, Medical Emergency and Emergency Accident Specialist Physician charges are covered at the HSHS Specialist Physician benefit level, regardless of whether the Specialist is an HSHSSpecialist. 
  • Medical Emergency and Emergency Accident PCP Physician charges are covered at the HSHS Specialist Physician benefit level, if the PCP is an an Out-of-Network PCP.
True emergencies may include seizures, loss of consciousness, severe and/or persistent chest pain, severe bleeding and shortness of breath.
What if I need care from a non-network provider?

Out-of-network services will not be covered unless you first obtain a referral from your provider and prior authorization from Health Choices. Your provider will need to submit a referral request to Health Choices. If you have the Live360 network plus access to the wrap provider network, you need a referral if the provider required for your care is not in the Live360 plus wrap network or if the services require prior authorization per the summary plan description. In order for services to be covered, the referral needs to be reviewed and approved prior to services being received.

If you have questions about the referral process, contact Health Choices at 1-833-728-0538