2021 Flexplan Benefits

         
         Illinios/Outside of Wisconsin          

Annual Enrollment Benefits Presentation


Annual Enrollment - Flexplan Guide

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What's new! Watch your home mailbox for additional information coming soon.

Didn't receive your Annual Enrollment Packet in the mail?  Click here to access an electronic copy.
 

Please Note:

During this fall’s Annual Enrollment you must enroll for 2021 benefits. If you don’t actively enroll, all of your previous coverage will NOT roll over and your current coverage will be waived for 2021.
 

New Medical Claims Administrator for the HSHS Healthy Plan - Illinois and Colleagues living outside of Wisconsin
Effective January 1, 2021, Health Choices replaces Aetna as the administrator of the medical plan, providing customer service, medical plan management and claims processing for Illinois colleagues and those who reside outside of Wisconsin. Live360 will be the new provider network. While Live360 will be the primary network, additional network coverage will be available for colleagues residing outside of the Live360 network.

Your 2021 HSHS Healthy Plan Medical Options
For 2021, you will continue to have a choice of Basic and High options like today. However, the 2021 options will be Exclusive Provider Organization (EPO) options that only cover services received from Live360 network providers, in most cases. This means, if you receive care outside your network, you will most likely be responsible for the full cost of care.

Transitioning Your HSHS Healthy Plan Care 
With Live360 as the primary network for the HSHS Healthy Plan for Illinois colleagues and those who reside outside of Wisconsin in 2021, there are several important things to note:

Medical Care

  • If you are currently receiving ongoing specialty medical care that may extend into 2021 from an Aetna provider who does not participate in your new network, you may be eligible for transitional care benefits for specialty medical care, such as pregnancy care, received from that provider. The treatment must be actively underway prior to January 1, 2021. You will need to complete and submit a Transition of Care form to Health Choices for approval. The forms will be available on the HSHS Benefits Website and the HSHS Virtual Benefits Fair. You may also contact Health Choices customer service directly at 833-728-0538 to request the form. If you are approved for transitional care benefits, you will receive the network benefit level for a period of time for out-of-network approved care.
  • For specific services, such as a hospital stay and private duty nursing, scheduled to occur after January 1, 2021, you will need to obtain prior authorization from Health Choices. If services will be provided by a Live360 provider, the provider will handle pre-authorization for you. For services with other providers, you will be responsible for making sure prior authorization is obtained. Your benefits will be reduced for all covered services for which prior authorization was not obtained.

How to Determine If You Are in the Live360 Network Service Area
Generally, you need to receive care inside your designated network to have coverage for your medical care through the HSHS Healthy Plan for 2021. Your network is determined by your home county or zip code.

You live inside the Live360 network service area if the county or zip code of your primary home residence is shown in the chart below:

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Find a Provider
After you determine your Network Service Area, you can then find a doctor, specialist, hospital, or other providers that are covered by your HSHS Healthy Plan. Use the convenient Find a Provider tools below. You may need to enter your group number which is printed on the front of your ID card, or find it on the HSHS benefits website. The search results only show providers who are covered by your plan.

 Inside the Service Area                          Outside the Service Area
Find a Provider                           Find a Provider 
Live 360 Health Plan                                   Live 360 Health Plan

                                                                    Find a Provider 
                                                                     First Health Network

For more information regarding the updates to the HSHS Healthy Plan visit HSHS Healthy Plan - Health Choices or www.live360healthplan.com

Additional 2021 Benefit Program Updates

HSHS Virtual Benefit Fair
Learn about all of the HSHS benefits in one place by visiting the new HSHS Virtual Benefits Fair
Click here for more information.

Identity Theft Protection
HSHS is excited to offer colleagues the opportunity to purchase identity theft protection. AllState Identity Protection Pro Plus provides proactive monitoring – plus a $1 million identity theft insurance policy. You have an additional way to protect your personal data, including your identity, credit and finances. The program also includes social media monitoring of your social accounts for vulgarity, threats or violence, explicit content and cyberbullying. Learn more about Identity Theft Protection here.

Enhancements to the LiveWELL Program
LiveWELL, relaunched on September 16th. Be sure to continue to complete challenges and earn points to receive your wellness credit starting in 2021. Explore all LiveWELL offers here.

Health Care Flexible Spending Account (FSA) Contribution Limit
The annual contribution maximum for the Health Care FSA will increase from $2,700 to $2,750.
Click here to learn more about the Flexible Spending Account benefit.

New Online Process to Submit Evidence of Insurability: It’s Easier and More Convenient!
When you choose supplemental life insurance through Securian, you will be able to provide any required evidence of insurability (EOI) online. You no longer have to complete and return a paper form. The verification process will be simpler, too! Learn more about the supplemental life insurance benefit here.

Except for the changes to medical plan administrator and network and those described in this section, your benefits for dental, vision, life, accidental death and dismemberment (AD&D) and disability are not changing for 2021.