Loyola University Chicago

Human Resources

Health Insurance

‌‌Loyola University Chicago offers a choice of health, dental, and vision plans as part of a high-quality benefits package that helps you stay well and protect yourself and your family.
  • New employees have 31 days from the date of hire to enroll in the medical plan, along with other benefits options.
  • Current employees can make changes to their benefit elections during the annual Open Enrollment Period each fall or 31 days from the date of a qualifying life event (e.g., birth of a child, loss of coverage, etc.).
QUESTIONS ABOUT AETNA? See "2020 Aetna Medical Insurance" below for more information or visit the Open Enrollment Communications Library for detailed information.
 
Helpful links:
 
‌Questions about your benefits? Talk to ALEX!
 

Loyola University Chicago transitioned to Aetna medical insurance as of January 1, 2020. 

Beginning January 1, 2020, Loyola’s medical plan provider changed from Blue Cross Blue Shield to Aetna. Loyola has worked to minimize disruption for members, and employees are encouraged to review information provided regarding this change. This change does not affect your pharmacy benefits with CVS Caremark.
 
Aetna Contact Information
Aetna Concierge Line (Monday to Friday, 8:00 a.m. to 6:00 p.m.): 855.586.6958
Access the Aetna portal online and find a provider: www.Aetna.com/Loyola
The plan control number for all medical plan options is 143775
 
Insurance Cards
Faculty and staff members who enrolled in Loyola health insurance for 2020 should have received new insurance cards in the mail the week of December 16, 2020 In addition, you may download the Aetna Health app to your smartphone and are able to use the app to view your benefits, track progress toward your deductible, and access the digital version of your member ID card. To request additional copies of your Aetna insurance card to be mailed to your home address, contact the Aetna Concierge Line at 855.586.6958 between 8:00 a.m. and 6:00 p.m., Monday through Friday.
 
Summary of Benefits & Coverage 
View the Summary of Benefits & Coverage for the Loyola Medical Plans below to learn how your medical coverage will work under Aetna:
If you have questions regarding Aetna coverage, you may contact the Aetna Concierge Line at 855-586-6958 between 8:00 a.m. and 6:00 p.m., Monday through Friday.
 

Find an In-Network Provider

To verify your current medical providers are covered by Aetna’s extensive network, you may visit Aetna’s DocFind tool to search for a network provider at www.Aetna.com/Loyola. Simply enter your ZIP code, select the number of miles you wish to search, and click "Search." Then you will be able to choose from a variety of categories of health care providers and facilities. It should be noted that "Aetna Choice® POS II (Open Access)" is the plan name for all three Loyola medical plans.

 

What If My Provider is Considered Out-of-Network with Aetna?

If you had Loyola health insurance in 2019 with Blue Cross Blue Shield (BCBS), and have determined that your BCBS provider is not in Aetna's network, please see the Transition of Care (TOC) information below. Transition of Care may be available for those in an active course of treatment. View the Aetna TOC FAQs and see below for more information.

 

Aetna Transition of Care Form

If your in-network provider with Blue Cross Blue Shield is not a current member of Aetna's network, Loyola has approved Transition of Care from January 2020 through June 2020. This means that you can continue to see your existing provider with in-network rates (usually, covered at 80%, after deductible). Please complete the Aetna Transition of Care Form as soon as possible to initiate the process for a smooth transition.

Note: The plan control number is 143775.

 

How Can I Learn More about Aetna?

Please visit www.Aetna.com/Loyola for more information. Additionally, you may wish to review the Aetna New Member Account Registration Flyer to get accommodated with Aetna health insurance and set up your account once you receive your ID card(s) in the mail. The Aetna Discount Program Flyer is also a great resource to learn more about the health and wellness resources that are available to members.

Note: Loyola's health insurance coverage under Blue Cross Blue Shield ended on December 31, 2019. The following information is for reference only.

Loyola Medical Plan Options 
‌Loyola University Chicago provides medical coverage for employees through the Loyola PPO 1 Plan (formerly the Loyola University Advantage Plan), the PPO 2 Plan, and the PPO 3 HSA Plan. The plans do not require you to sign up with a particular hospital or physician when you enroll. Each time you need care, you can visit any doctor or hospital you choose, but you receive a higher level of benefits if you choose a home hospital or BCBSIL network provider.  For complete information on the Loyola medical plan options, please see the Benefits Booklet, located in the Resources section (upper right).
  • How can I get a new ID card? If you’ve misplaced or lost yours, you can print a temporary card or request a new one in Blue Access for MembersSM (BAM)or call BCBSIL customer service at 866.266.3674.
    • PPO 1 Plan Group ID #: 200864
    • PPO 2 Plan Group ID #: 208490
    • PPO 3 HSA Plan Group ID #: 226497
  • To find out if a particular hospital or physician is a part of the PPO network, contact Blue Cross Blue Shield Member Services at 866.266.3674 or http://bcbsil.com/providers.
    • You can search from this website by selecting "Plan Networks" and selecting Participating Provider Option [PPO]. You can search by state, ZIP code or address. If looking for a doctor at the Loyola Medical Center (Home Hospital), please search by the main hospital address or by ZIP code.
MDLIVE - Telemedicine
Board Certified doctors can visit with you either by phone or secure video to help treat any non-emergency medical conditions.
  • MDLIVE doctors can diagnose your symptoms, prescribe medication, and send prescriptions to your pharmacy of choice.
  • The virtual visit will only cost you $44. Plus, it allows you to connect with a doctor in the comfort of your home or office without needing a pre-scheduled appointment.
  • Contact MDLIVE at MDLIVE.com/LUC, download the MDLIVE App from the App Store, Google Play or Windows Store, or call 800.770.4622.
 
BCBS Contact Information
BCBSIL Customer Service: 866.266.3674
Access BCBSIL online:  Blue Access for Members(SM) (BAM)
PPO 1 Group ID #: 200864
PPO 2 Group ID #: 208490
PPO3 HSA Group ID #: 226497
Aetna Medical Insurance Cards
Faculty and staff newly enrolled in the Loyola medical plan will receive both their medical and prescription drug benefit insurance cards in the mail 2-3 weeks after enrollment.
  • If you need a new or additional card(s) at any time, contact Aetna directly at 855.586.6958 or online at Aetna's member website.
  • You can access a digital copy of your insurance card anytime if you create an Aetna account online or download the Aetna Health App to your smartphone.
  • The group number is 143775.
Contraceptive Medical Services with Aetna
**NEW AS OF JANUARY 1, 2020** In order to obtain contraceptive medical services (including contraceptive counseling services/office visits, medical procedures for contraceptive services such as contraceptive device implantation and removal, voluntary sterilization (both inpatient and outpatient), contraceptive devices such as IUDs, implants, diaphragms, and cervical caps), you will need to request and obtain a Contraceptive Services Payment Program ID card from Aetna.
  • Contact the member services number on your current Aetna medical ID card (855.586.6958) and request that a Contraceptive Payment Program ID card be sent to you.
  • You may also access the Aetna member portal to print an image of this ID card.

CVS Caremark Prescription Drug Insurance Cards

  • If you need a new or additional card(s) at any time, contact CVS Caremark directly at 888.202.1654 or online at www.Caremark.com.
  • You can access a digital copy of your insurance card anytime if you create an CVS Caremark account online or download the CVS Caremark App to your smartphone.
  • If you do not have your card, you can use the following information to obtain a prescription: Reference RX BIN#: 004336 and GROUP#: RX0804.
Contraceptive Prescriptions with CVS Caremark
In order to obtain contraceptive prescriptions, you will need to obtain and utilize a separate ID card from CVS Caremark. Reference RX BIN#: 004336 and the Group#: RX3923.
  • Contact 888.924.8738 to enroll in the Contraceptives Coverage and receive your separate ID card.
  • For a list of covered contraceptives, please refer to the Preventive Care Contraceptive Drug List.
 
Below are common preventive care services that Loyola medical plans cover at 100% when you receive these services from a participating provider.
  • When you see your doctor for a preventive care visit, be sure to specify that your visit is for preventive care or wellness, as covered under the plan.
  • If your doctor discusses other preventive care or wellness services not listed below, be sure to ask if the service is covered at no additional cost.
Breastfeeding support, supplies and counseling Pap Smear*
Health Counseling for Sexually Transmitted Infections and HIV
Colonoscopy*  Physical Exam* Health Education/Counseling Services
Obesity Screening and Counseling Prostate Test* Screening and Counseling for Domestic Violence
*Routine exams are covered as preventive care services, however, diagnostic exams will apply toward your annual deductible.
Your plan covers emergency medical care for the initial treatment of a sudden and unexpected medical condition which has such severe life-threatening symptoms that the absence of immediate emergency medical attention could result in serious or permanent medical consequences. It also covers emergency accident care and related diagnostic services when initiated within 72 hours of the accidental injury.
  • For the PP0 1 & 2 plans, all emergency health services (including at a home hospital) are subject to a $150 per-visit copay.
  • * If enrolled in the PP0 3 HSA plan, emergency health services are covered at 80% after deductible.
CVS Caremark manages your prescription benefits just like your health insurance company manages your medical benefits. Outpatient prescriptions (mail order and specialty) must be filled through CVS Caremark. Retail pharmacy prescriptions can be filled at CVS, Walgreens, Target, Walmart, and many more participating pharmacies. You will receive a separate prescription drug ID card from CVS Caremark. For complete information on Prescription Drug Coverage, please see the Benefits Booklet, located in the Resources section (upper right).
 
Register online with CVS Caremark at www.caremark.com to:
  • Locate pharmacies (60,000+)
  • Check plan coverage
  • Print a temporary card or request new/additional card(s)
  • Set up access for family members
  • Set up shipping/billing/payment information
  • Check medication costs
  • A complete list of what drugs are excluded
How can I get a new or additional ID card? You can request a card to be mailed to your home online at www.caremark.com, or call customer service at 888.202.1654. You may also download the CVS Caremark mobile app to access a digital copy.  If you do not have your card, you can use the following information to obtain a prescription: Reference RX BIN#: 004336 & GROUP#: RX0804
 
Call CVS Caremark customer service:  888.202.1654
*SPECIAL NOTE ABOUT PRESCRIPTIONS FOR CONTRACEPTIVES:  In order to obtain these prescriptions, you will need to obtain and utilize a separate RX bin # and ID #, along with a SEPARATE ID card from CVS Caremark. The RX BIN # is: 004336 and the Group # is: RX3923. Contact 888.924.8738 to enroll in the Contraceptives Coverage and receive your separate ID card.

**SPECIAL NOTE ABOUT PPO 3 HSA:  If you enroll in PPO 3 HSA, the medical and prescription drug has a combined deductible. Certain preventive generic drugs may be covered before meeting the deductible. Review the Preventive Therapy Drug List for more information.

Review Prescription (Rx) Plan FAQs

Loyola University Chicago is a Catholic institution, and has a birth control coverage exemption as a religious employer; therefore, prescriptions for contraceptives are excluded on the Loyola medical plan. However, there is a program available whereby you can obtain certain contraceptive prescriptions (through CVS Caremark) and contraceptive medical services (through Aetna) at no cost to you, as part of the Affordable Care Act. See below program information for both CVS Caremark and Aetna.

1.  ENROLL IN A SEPARATE PROGRAM THROUGH CVS CAREMARK FOR THE CONTRACEPTIVE PRESCRIPTION BENEFIT:
  • In order to obtain contraceptive prescriptions through CVS Caremark, you will need to obtain and utilize a separate RX bin # and ID #, along with a SEPARATE ID card from CVS. The RX bin # is: 004336 and the Group # is: RX3923.
  • Contact 888.924.8738 to enroll in the Contraceptives Coverage and receive your separate ID card.
  • For a list of covered contraceptives, please refer to the Women's Health Preventive Services Contraceptives Drug List.
2. *NEW AS OF JANUARY 1, 2020* YOU ALSO NEED A SEPARATE ID CARD THROUGH AETNA FOR THE CONTRACEPTIVE MEDICAL SERVICES BENEFIT (these services include contraceptive counseling services/office visits, medical procedures for contraceptive services such as contraceptive device implantation and removal, voluntary sterilization (both inpatient and outpatient), contraceptive devices such as IUDs, implants, diaphragms, and cervical caps):
  • In order to obtain the contraceptive medical services listed directly above, you will need to request and obtain a Contraceptive Services Payment Program ID card from Aetna.
  • Contact the member services number on your current Aetna medical ID card (855.586.6958) and request that a Contraceptive Payment Program ID card be sent to you. You may also access the Aetna member portal to print an image of this ID card.
Medical plan participants are eligible to utilize a number of health and wellness discounts offered through Aetna, including:
  • Healthy vision (savings on eyewear and exams),
  • Hearing exams, hearing aids, and batteries,
  • Natural therapy, massage and nutrition services, and
  • Fitness (health coaching, gym memberships, and home exercise equipment).
View the Aetna Discount Program Flyer for more details.
When You Need Health Care Outside the U.S.
Always carry your Aetna identification card. You should also download the Aetna Health app to your smartphone for easy digital access to your ID card at any time. Check with Aetna before leaving the U.S. because your health care benefits may be different outside the U.S.
 
If you need emergency medical care, go to the nearest hospital. If you need help, call 855.888.9046 or 959.230.8220. Ask for the Aetna Special Case Precertification Unit when you call.
  • Aetna will check if a hospital can treat you, or help you transfer to the closest facility that can provide care.
  • You must need emergency care that cannot wait until you return to the U.S., and you will have to pay for services at the time of care. Aetna will need an itemized bill and receipt for all services provided.
Call Aetna for pre-certification or prior authorization, if necessary. Refer to the phone number on the back of your ID card.
  1. Annual Deductible – The amount you have to pay each year before the plan starts paying a portion of expenses. Most covered expenses count toward the annual deductible. Prescription drugs do not count toward PPO 1 or PPO 2 medical deductibles. Prescription drugs do count toward the deductible in PPO 3 only.

  2. Annual Out-of-Pocket Maximum – Total amount you pay out of pocket each calendar year before the plan pays 100 percent of covered expenses for the rest of the calendar year. Expenses paid to satisfy the annual deductible count toward the annual out-of-pocket maximum. Most covered expenses count toward the out-of-pocket maximum, except prescription drugs if you are covered under PPO 1 or PPO 2 (which have a separate out-of pocket maximum).

  3. Coinsurance – A percentage of a claim you pay after you meet the annual deductible.

  4. Copayment (copay) – A fixed dollar amount you pay for emergency room visits and hospital admissions.

  5. Home Hospital – Loyola University Health System or Gottlieb Hospital.

  6. PPO (Preferred Provider Organization) – A network of doctors, hospitals and other health care givers. All of Loyola's medical plans use the Aetna network.
Learn how to make benefit elections in Employee Self-Service: Enrollment Guide - Employee Self-Service

If you have additional questions regarding ALEX, or benefits provided at Loyola, please feel free to contact the Benefits team.

Edited: 11/10/16, 12/20/16, 12/21/16, 02/24/17, 12/8/17, 12/11/17, 1/5/18, 3/21/19, 12/18/19, 1/3/20