Our Loyola Advantage PPO plan is administered by Blue Cross Blue Shield Illinois.
Enrollment in our health plan is optional therefore you may waive coverage through Loyola if you have coverage elsewhere. If you wish to enroll the PPO plan features a network of hospitals and physicians that have agreed to accept a scheduled, discounted rate for their services. Participants may choose to visit any health care provider included in the PPO network without a referral; charges will be paid at 90, 80 or 50 percent of the scheduled amount after satisfying the annual deductible depending on the provider they choose. Participants who choose Loyola University Medical Center as their primary place of care will recieve a higher discount up to 90 percent. Wellness visits are covered at 100 percent. Other procedures undertaken during the office visit may be subject to the deductible and co-insurance. When using providers who are not in the network, charges are paid at 50 percent after the annual out-of-network deductible is satisfied. Out-of-network charges are paid in accordance with our policy. For details on our BCBS PPO policy and rates Please click here for the 2016 Benefit Booklet.
Spousal Insurance Surcharge programs have gained popularity in recent years as a method to ensure that when spouses/partners of employees have access to their employer’s group insurance, they are encouraged to use their own employer’s health plan.
Beginning January 2016, employees must pay an additional cost to cover a spouse/LDA who has the option to elect health care coverage through their employer. The cost can be found in our Benefits Booklet. A link to the booklet is listed below.
You will be charged a surcharge if you fall under the following categories. If you qualify for the surcharge NO action is needed.
- If your spouse is working at an employer who offers group health insurance, but has declined that coverage and wants to remain on the University health plan.
- If your spouse is eligible and/or enrolled in Medicare, but is still actively working at their own employer, who offers group health insurance.
- If your spouse is offered coverage for any time period throughout the year with their employer, and you choose to continue their coverage under the Loyola University Chicago health plan.
- If you and your spouse/LDA are BOTH employed at Loyola University Chicago and are both covered on the University health plan under either you or your spouse coverage.
- If your spouse/LDA is a retiree from another employer, but is not actively working.
- If your spouse/LDA is self-employed, regardless of whether or not they offer insurance to their employees.
- If your spouse/LDA is a part-time employee and has NO access to health coverage.
- If your spouse/LDA is unemployed.
If you feel that you are eligible for the surcharge waiver you MUST take action by completing the spousal surcharge waiver form.
Enrolling/Change in Coverage:
Employees have 31 days from the date of a qualifying life event or 31 days from their eligibility date to enroll or make changes to their health, dental, and reimbursement accounts.
Beginning in 2016, plan members will have access to MDLIVE. The MDLIVE benefit gives employees access to physicians and allows employees to request prescriptions during or after normal business hours, including nights, weekends, and holidays. Employees can also use MDLIVE for non-emergency medical issues and when they need medical care while traveling.
|Health Insurance Vendor Contact|
|Medical||BCBS PPO||www.bcbsil.com Group Number 200864
Provider Finder-PPO Preferred Provider Organization
For more information on Health Care Reform, please click here.
Contraceptive are not provided by Loyola however these services are available directly from Blue Cross Blue Shield of Illinois. Access the benefit by providing your insurance card as you normally do to an in-network pharmacy. BCBS will in turn arrange payment directly to the pharmacy for approved prescriptions.To review the the Loyola Religious Exemption Statement and BCBS Coverage communication regarding birth control please click below:
Blue Cross Blue Shield Member Resources
- Blue Card Worldwide—When Traveling Outside of the US
- Davis Vision Discount Information (PDF)
- BCBS Disabled Dependent Certification Form (PDF)
- PPO Rx Cost Estimator website
- Prescription Drug Claim Form
- PrimeMail New Prescription Drug Mail Order Forms
- PrimeMail Refill Prescription Drug Mail Order Form
- Preventative Care (PDF)
- Transitional Care Form (PDF)
- HIPAA Notice of Privacy Practices (NoPP) and Privacy Forms