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Make your move to Coventry Health Care

At Coventry, we know how important it is that your health benefits meet your needs and the needs of your family. We’ve served the state of Illinois since 1984, helping employees and their families make the most of their health benefits. When you choose Coventry, in addition to excellent customer service, you also have access to preventive health programs. Make your move to Coventry during Benefit Choice period (ends May 31, 2015). Below you will find the available benefit plans for the current Benefit Choice period.

Click here to learn more about the services offered by Coventry Healthcare!

Nothing is more important than your health.

That's why we take your health care personally. Since 1984, we have helped State of Illinois employees manage their most important asset - their health.  At Coventry Health Care, we know the importance of health benefits that meet your needs and the needs of your family.  Click here for health and wellness resources.

If you have specific benefit questions or need help finding a provider, please call Customer Service during normal business hours at 800-431-1211 or visit the State of Illinois benefit page.

Great Coverage for Out-of-Area Dependents

The Passport Program provides members who have enrolled dependents outside of the Coventry service area with coverage at the highest level of benefits.  Services must be obtained from providers that are in the Coventry National Network. 

To find a Coventry National Network provider, use our online provider search at www.chcillinois.com.  Click on Find a Doctor, then click on Coventry National Network - Out of Area to find a provider near you.  Click here for more service area information. 

BENEFIT CHOICE - OAP BENEFIT INFORMATION FOR FY16 - EFFECTIVE 7/1/15

State of Illinois

Local Government Health Plan
Teachers Retirement Insurance Program College Insurance Program

Prior Authorization List 2015

Services requiring prior authorization

How To Enroll

Click here to find out how to enroll in the State of Illinois OAP.

Transition of Care

Once enrolled in a Coventry Health Care health insurance plan, please complete a Transition of Care Form to help ensure a smooth transition for you or any covered dependents that are receiving or may be receiving medical services involving the following:

  • Upcoming surgery or hospitalization
  • Recent transplant (within past 12 months), or an evaluation
  • Receiving dialysis
  • Pregnancy (second or third trimester) and under the care of an out-of-network provider
  • Under a current plan of care (post-operative surgical care, cancer care, etc.)
  • Using durable medical equipment (oxygen, c-pap machine, etc.)
  • Under the care of a mental health provider
  • Diagnosed with one of the following five health conditions, and would like to receive information on our disease management programs: asthma, diabetes, chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF) and coronary artery disease (CAD).

OAP Pharmacy Benefits

Express Scripts administers the pharmacy benefits provided by the State of Illinois.  For questions about OAP pharmacy benefits, call Express Scripts at 800-735-4404 or visit www.express-scripts.com.

OAP Service Area

The Coventry Health Care OAP is available in all 120 counties throughout Illinois.  Please see below for a map of our service area.

Service Area Map

OAP Provider Network

Coventry Health Care continues our discussions with prominent Illinois providers and hospitals to expand OAP members' options for quality care at an affordable price.

Our provider lookup tool is a convenient and easy way for you to find the right in-network doctor or physician to suit your health care needs.  Click here for instructions on using our provider lookup tool.  Click here to locate a provider.  The provider directory does not include behavioral health providers.  To locate a behavioral health provider, call 800-423-8070.

BENEFIT CHOICE - HMO BENEFIT INFORMATION FOR FY 16 - EFFECTIVE 7/1/15

State of Illinois

Local Government Health PlanTeachers Retirement Insurance ProgramCollege Insurance Program

Prior Authorization List 2015

Services requiring prior authorization

How To Enroll

Click here to find out how to enroll in the State of Illinois HMO plan.

Transition of Care

Once enrolled in a Coventry Health Care health insurance plan, please complete a Transition of Care Form to help ensure a smooth transition for you or any covered dependents that are receiving or may be receiving medical services involving the following:

  • Upcoming surgery or hospitalization
  • Recent transplant (within past 12 months), or an evaluation
  • Receiving dialysis
  • Pregnancy (second or third trimester) and under the care of an out-of-network provider
  • Under a current plan of care (post-operative surgical care, cancer care, etc.)
  • Using durable medical equipment (oxygen, c-pap machine, etc.)
  • Under the care of a mental health provider
  • Diagnosed with one of the following five health conditions, and would like to receive information on our disease management programs: asthma, diabetes, chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF) and coronary artery disease (CAD).

*Please note that if you are a current State of Illinois member enrolled with Coventry Health Care you do not have to fill out a Transition of Care form, as your authorizations are currently on file.

HMO Pharmacy Benefits

Express Scripts administers the pharmacy benefits provided by Coventry Health Care.  For questions about the HMO pharmacy benefits, please call Coventry Health Care at 800-431-1211, or visit the pharmacy section of the website by clicking here

2015 Prescription Formulary

HMO Service Area

The Coventry Health Care HMO is available in 115 counties throughout Illinois. Please see below for a map with our service area.


Service Area Map

HMO Provider Network

Our provider lookup tool is a convenient and easy way for you to find the right in-network doctor or physician to suit your needs.  Click here for instructions on using our provider lookup tool.  Click here to locate a provider.  The provider directory does not include behavioral health providers.  To locate a behavioral health provider, call 800-423-8070. 

Notice Regarding HMO and OAP Claims Payment Delays

The State of Illinois is facing a difficult and unprecedented funding situation which has significantly impacted the State Employees' Group Insurance Program through the delay of claim payments. A brief explanation of the cause of the delay of claim payment for the benefit plans are listed below.

Open Access Plan (OAP)

The State of Illinois' Coventry of Illinois (Coventry) OAP is a self-insured plan with funding provided through legislative appropriations, State revenue and a small amount of employee premiums. Funding availability is based on State revenue, which fluctuates from month to month. At this time funds remain insufficient to pay claims on a normal schedule, and we cannot estimate when a regular payment schedule will resume. Claim payments will be released according to the claim process date and available funding. Coventry, the claims administrator, continues to process claims in a timely manner, but release of claims must be held until revenue is available. Late payment interest is paid to healthcare providers on health claims that take longer than 30 days from the receipt of a complete claim submission to pay. If you decide to make arrangements with your out-of-network provider to pay the outstanding balance or establish a payment plan, your provider should reimburse you after they receive payment from Coventry. It is your responsibility to make reimbursement arrangements with your provider. 

HMO

The State of Illinois' Coventry of Illinois (Coventry) HMO is a fully.-insured plan Premium payments are funded through legislative appropriations, State revenue and a small amount of employee premiums. Premium payments are based on State revenue, which fluctuates from month to month. At this time funds remain insufficient to pay premiums on a normal schedule, and we cannot estimate when a regular payment schedule will resume. Claim payments will be released according to the date of service and paid premiums. Late payment interest is paid to healthcare providers on health claims that take longer than 30 days from the receipt of a complete claim submission to pay.

If you have specific benefit questions, or need assistance, please call Customer Service during normal business hours at 800-431-1211 or visit the State of Illinois benefit page.





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Didn't find what you needed? Don't hesitate to call our Customer Service department during regular business hours at 800-431-1211

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