Frequently Asked Questions (FAQ)

• How can I make corrections or updates to my personal information such as employee name, date of birth, address?
  
• How can I correct an error in my dependent's information (misspelling, incorrect date of birth, etc)?
  
• Do I have to change my health care plan right now?
  
• How do I find out who my Primary Care Physician or Dentist is?
  
• Can my dependents have a different Primary Care Physician/Dentist, or does the family have to have the same doctor?
  
• How do I change my primary care physician?
  
• How long can my dependent children be covered under my insurance plan?
  
• How much do I have to pay for my health insurance benefits?
  
• What do I need to do if I need to see a specialist?
  
• What do I do if I receive medical or Dental bills?
  
• What if I don't need health insurance because I have coverage elsewhere?
  
• What if I am on leave - how do I pay for my contributions?

I need to make changes my personal information such as employee name, date of birth, address. How can this be corrected?

You must contact your Timekeeper or Human Resources within your department. The Department of Risk Management does not have the authority to change personnel-related information. Once the information is updated in the payroll system, it will be sent automatically to the insurance providers as part of the ongoing eligibility maintenance.

My dependent information is incorrect (misspelling, incorrect date of birth, etc). How can this be corrected?

Please provide a copy of the dependent's birth certificate to correct this information along with a copy of the Personal Information Statement. This can be sent to the Employee Benefits Office as shown on the statement (118 North Clark Street, Room 1072, Chicago, IL 60602).

Do I have to change my health care plan right now?

No. The annual open enrollment period is an opportunity for you to re-evaluate your health care needs and the plan that covers you. It is the one time during the year that you may switch from one plan to another. But, if you are happy with your current plan, you do not need to do anything to remain in the plan.

How do I find out who my Primary Care Physician is?

The Primary Care Physician (Unicare) and Medical Group (for HMO Illinois members) is listed on your insurance card. If you cannot locate your insurance card, you can call the customer/member service number listed in the open enrollment materials you have received.

Can my dependents have a different Primary Care Physician, or does the family have to have the same doctor?

Each family member is allowed to designate their own primary care physician or dentist for HMO plans. In addition, all females can also choose a separate WPHCP-Women's Principal Health Care Provider within your medical group (HMO members) in addition to a PCP. Please call the Customer Service Representatives for details on this.

How do I change my primary care physician?

In order to change your Primary Care Physician (PCP), you need to contact your health plan directly. If you are changing doctors within the same group, call the medical group directly. You need to contact the insurance plan/medical site prior to the 15th of the month in order to have the change processed for the following month. For example, if you call your provider prior to October 15, the change will be effective November 1. If you call October 28, the change will not be effective until December 1.

How long can my dependent children be covered under my insurance plan?

That depends on your date of hire with Cook County.

If you were hired before March 1, 1988, your unmarried children are covered up to age 25.
If you were hired on or after March 1, 1988, your unmarried children are covered to age 19. If they are full-time students (certified by a letter from the school's registrar), their coverage is extended to age 22.

How much do I have to pay for my health insurance benefits?

If you are enrolled in a PPO-Preferred Provider Organization, a pre-tax contribution of 1.5% of your annual base pay is deducted via payroll deduction.
If you are enrolled in an HMO-Health Maintenance Organization:
Non-union employees who earn less than $65,000 a year, as well as union employees (per the current collective bargaining agreement), contribute .5% of annual bas pay (pre-tax) – up to $8 per pay period toward medical coverage.
Non-union employees who earn more than $65,000 a year contribute .7% of annual base pay (pre-tax) for single coverage, or 1.4% of annual base pay (pre-tax) for family coverage.
The First Commonwealth Dental Plans and the Cole Vision Plan are offered at no additional cost (i.e., payroll deduction).

What do I need to do if I need to see a specialist?

OB/GYN SERVICES
If you are a female and are in PPO plan, you may see your approved WPHCP (Women's Principal Health Care Provider) without a referral. If you are a member of the HMO IL plan, you must register your OB/Gyn choice with HMO IL.
If you are a member of the Unicare HMO Plan, you must obtain a referral from your primary care physician to see an OB/Gyn. For both HMO plans, the Primary Care Physician must have referral relationship within the same contracted medical group.
Please contact your health care company for more details.

HMO SPECIALISTS
Under an HMO program, you need to contact your PCP-primary care physician-to obtain a referral to a specialist within their network. If you choose to see a specialist without a written referral, no benefits will be paid and you will be responsible for all charges.

PPO SPECIALISTS
Under a PPO program, you may choose to see a specialist within the Blue Cross PPO network, or someone outside of the network. You do not need a referral to see a specialist. Your cost will be $20.00 at the time of the appointment(s). If you choose to see a specialist within the Blue Cross PPO network, your approved claims will be paid at 70% - 90% of the usual and customary charges. You will be responsible for the other 10% - 30% of the charges. There is no deductible if the services are in network. If you choose to go out of network, your approved claims will be paid at 60% of the usual and customary charges. You will be responsible for the other 40% of the charges and a $200.00 annual deductible for single coverage and a $400 annual deductible for family coverage

What do I do if I receive medical or dental bills?

If you are in an HMO, you need to call the customer/member service number listed on your identification card. In most cases, the insurance company may have not received an itemized bill from your provider or may not have all the necessary documentation, i.e., copy of referral, necessary to process the claim. If you are in a PPO plan, you need to contact the insurance company to see if the bill has been processed. If the bill is not showing in their system, contact your medical provider to have the claim re-processed or obtain a medical claim form from the Blue Cross web site to expedite the claim.

What if I don't need health insurance because I have coverage elsewhere?

An eligible employee can waive their health coverage if they can show proof that they are covered under another health insurance program. Those people who are part of a collective bargaining group may continue to receive a monetary benefit for waiving their medical plan. Please see your union representative to find out if this applies to you.

If you are covered under the health plan of another Cook County employee, you will be asked to furnish your spouse's social security number. If you are covered under another insurance program, you will be asked to furnish a copy of your insurance card with the other provider.

In addition, you can waive your dental and/or vision coverage.

What if I am on leave - how do I pay for my contributions?

If you are on an approved medical leave of absence, your benefits will continue and you will be billed on a monthly basis at your address on record by the County Revenue Department for the per pay period contribution(s) that are due. Your benefits will, however, be terminated if your Revenue balance remains unpaid for two (2) months.

If you are on a personal leave, the full premium of the health, dental and vision plans are due to your department beginning the first of the month following your leave date. The County is not responsible for your health plan when you are on a personal leave. If payment is not received, the plan will be terminated until your return to work. Please contact your department regarding these payments.