Introduction

Annual enrollment is your opportunity to learn about the 2021 Health Care Program, review your current coverage and choose the best options for you and your family. During open enrollment, you can change plans, add or remove yourself or any dependents from the medical and/or dental effective 1/1/2021.


Benefits Overview

Benefits being offered by Ron Tirapelli Ford to all Full-time employees:


All benefits are provided through BlueCross BlueShield of Illinois

  • Medical: HMO & PPO plans
  • Dental: HMO & PPO plans
  • Vision: Voluntary plan - 100% employee paid
  • Life: Group life $10,000 benefit is covered by Ron Tirapelli Ford.
  • Voluntary life: 100% employee paid - additional benefit amounts are available to employees, spouse and/or dependent child(ren).
Benefits Guide

Benefits Guide

Medical HMO

Blue Advantage HMO

The only benefit change to the HMO for plan year 2021 is a $0 copay for Preferred Generic medications.


The cost per paycheck for the HMO is as follows:

Employee - $42.00

Employee + Spouse - $179.52

Employee + Child(ren) - $156.45

Family - $293.98

HMO Plan Overview

HMO Plan Overview

2021 HMO SBC

Summary of Benefits and Coverage

2021 HMO SBC

Summary of Benefits and Covera ...

HMO Reference Guide

How to use your HMO

HMO Reference Guide

How to use your HMO

Medical PPO

Blue Choice Options

The only benefit change to the PPO for plan year 2021 is a $0 copay for Preferred Generic medications.


The cost per paycheck for the PPO is as follows:

Employee - $54.00

Employee + Spouse - $207.70

Employee + Child(ren) - $181.87

Family - $335.52

Blue Choice Options Plan Overview

Blue Choice Options Plan Overview

2021 Blue Options PPO SBC

Summary of Benefits and Coverage

2021 Blue Options PPO SBC

Summary of Benefits and Covera ...

Dental

No changes to the dental benefits for 2021.


Here is the weekly per paycheck cost for both plans:

PPO

Employee - $7.36

Employee + Spouse - $15.99

Employee + Child(ren) - $21.11

Family - $32.29


HMO

Employee - $3.81

Employee + Spouse - $7.33

Employee + Child(ren) - $7.95

Family - $12.01


To change your HMO Dental Provider, call 800-323-7201. Changes made by the 20th of the current month will be effective the 1st of the following month.

Dental HMO Plan Summary

Dental HMO Plan Summary

Dental PPO Plan Summary

Dental PPO Plan Summary

Vision

Voluntary vision is now being offered effective 1/1/21. Please see the Vision Benefit Summary for all benefits provided.


Here is the weekly per paycheck cost:

Employee - $1.75

Employee + Spouse - $3.33

Employee + Child(ren) - $3.51

Family - $5.16

Vision Benefit Summary

Vision Benefit Summary

Life Insurance

Employees can elect additional voluntary life insurance for themselves, spouse and/or dependent children.


Voluntary Benefit Amounts:

  • Employee: $10,000 - $500,000
  • Guarantee issue amount (no health questions asked) up to $100,000 for new hires only.
  • Spouse: $5,000 - $250,000 in increments of $5,000, not to exceed 50% of employee benefit amount.
  • Guarantee issue amount up to $25,000
  • Child(ren):
  • Birth to 14 days: $0
  • Age 15 days to 6 months: $100
  • Age 6 months to 26 years: $5,000 - $10,000 in increments of $5,000
Basic Life Summary

Basic Life Summary

Voluntary Life Summary

Voluntary Life Summary

Voluntary Life Rates

Voluntary Life Rates

How To Enroll

Action Required

Please complete either the medical/dental app or life/vision app for any changes you would like to make.

BCBS Medical & Dental App

BCBS Medical & Dental App

Life, Voluntary Life and Vision app

Life, Voluntary Life and Vision app

Carrier Contacts

BCBSIL Contact Information:


BCBSIL HMO:

  • Customer service: 800-892-2803


BCBSIL PPO:

  • Customer service: 800-541-2767
  • Provider locator: 800-810-2583
  • 24/7 Nurseline: 800-299-0274
  • MDLIVE: 888-676-4204