ICHIP High Deductible Health Plan _HDHP_

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							      Important Notice

There are coverage                                                                                              Illinois
differences between                                                                                             Comprehensive
ICHIP HDHP plans                                                                                                Health
and Non-HDHP                                                                                                    Insurance Plan
ICHIP Plans

   No payment for any covered services
     until plan deductible has been met in-
     cluding prescription drugs, pre-                                                               ICHIP
     admission testing, and second surgical
     opinions.                                                                                  High Deductible
   Maternity coverage is included in HI-
     PAA HDHP Plans and is available for                                                          Health Plan
     purchase as an additional rider on Tra-
     ditional HDHP plans.                                                                          (HDHP)
   No limit on the number of deductibles
     and coinsurance maximums per family                                                      If you are eligible for one of the
     as with other CHIP plans.
                                                                                              ICHIP plans, you now have the
   Plan deductible options are subject to                                                   option of choosing a plan that
     change, based on the federal require-
     ments for minimum and maximum                                                            qualifies for use with a Health
     deductibles for HDHP plans.
                                               ICHIP
                                                                                              Savings Account (HSA)

                                               Illinois Comprehensive Health Insurance Plan
                                               320 West Washington Street Suite 700
                                               Springfield, Illinois 62701-1150
                                                                                                 Read on for details!

                                               Phone Toll Free: 866-851-2751                        Call Toll Free 866-851-2751
                                               Fax: 217-558-4831                                      Or visit us on the web:
                                               TDD: 800-545-2455                                        www.chip.state.il.us
                                               www.chip.state.il.us
                                               Rev. 12/10
    ICHIP High Deductible Health Plan (HDHP)
                        The ICHIP
                                           HDHP Deductible Options                            Health Savings Account Basics
                        HDHP plans                                                                 An HSA is a tax-advantaged, individu-
                        comply with           $1,200 deductible plus $1,500 coinsurance            ally owned savings account that can be
                                                limit (for a total of $2,700);                       used to cover a wide range of qualified
                        the require-
                                                                                                     medical expenses.
                        ments of an           $2,000 deductible plus $2,500 coinsurance          An HSA can be used to pay your annual
                        HDHP as de-             limit (for a total of $4,500); and                   deductible and, if applicable, any cost-
                                                                                                     sharing for covered services.
                        fined in federal
                                              $5,200 deductible with $0 coinsurance.             HDHPs qualify for use with HSAs.
                        law.                                                                       HSAs have tax and legal ramifications.
                                           These plans each qualify as high deductible             Information about HSAs and HDHPs is
                                                                                                     available at www.treas.gov.
                                           health plans that can be used in conjunction
                                           with a federally approved Health Savings Ac-
The CHIP HDHP Plans are available to       count (HSA). All HDHP’s are PPO plans.             This brochure is for informational
persons who qualify for Traditional and    These plans typically cost less than the other     purposes only and is not intended
HIPAA coverage under the CHIP Act.         PPO options with lower deductibles because         as tax or legal advice. Consult a
                                           participants assume a greater share of the cost    tax and/or legal professional for
These plans qualify as High Deductible
                                           of their health care expenses initially. An im-    advice regarding HSAs.
Health Plans (HDHPs) that can be used      portant difference between the HDHP plans
in conjunction with a federally approved   and the other PPO plans is that in the HDHP
                                           plans all charges are subject to the deductible,
Health Savings Account (HSA).                                                                 For more information or to obtain an application call
                                           including prescription drugs, pre-admission        or visit the web site listed below.
                                           testing and second surgical opinions.
All covered services and supplies, in-
                                                                                                   Illinois Comprehensive Health Insurance Plan
cluding prescription drugs, are subject    Plan deductible options are subject to change,               320 West Washington Street Suite 700
                                           based on the federal requirements for mini-                      Springfield, Illinois 62701-1150
to a deductible which must be satisfied
                                           mum and maximum deductibles for HDHP
                                                                                                          Phone Toll Free: 866-851-2751
before the plan will pay any benefits.     plans.
                                                                                                               Fax: 217-558-4831
                                                                                                              TDD: 800-545-2455
                                                                                                              www.chip.state.il.us
                                                                                                                   Rev. 12/10

						
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