The following is important information for employees enrolled in State of Illinois health insurance coverage who made a health plan change for the new plan year, beginning July 1.
If you did not make a health plan change, or you are NOT a current health plan participant, then you may disregard this email.
I changed to a new health plan beginning July 1, what do I need to know?
- If you or your dependent was hospitalized as an inpatient prior to July 1, 2025, and the inpatient stay continues beyond July 1, 2025, then your prior (fiscal year 2025) health plan will continue to be responsible for the claims until you are discharged. This includes Health Alliance plan participants.
- If you or your dependent is in an ongoing course of treatment or in the third trimester of pregnancy, you will need to reach out to your new health plan to inform them. You will have 90 days to work with your new health plan and receive a pre-authorization if the provider is in-network or transition to an in-network provider.
- If you or your dependent has a current prescription, you will have 30 days from the date of your first refill on or after July 1, 2025 to work with your health plan (HMO plans) or with CVS Caremark® (OAP, QCHP or CDHP plans) to obtain a pre-authorization or change medications if necessary. View Prescription Coverage for additional information.
Questions?
Please contact your Health Plan for assistance with plan transition questions.
