Page 14 - 2018 Insurance Book

ILFI Trust

ILFI Trust 2018

Illinois League of Financial Institutions Trust (ILFI)
Plan Options Rates - Effective 1/1/2018
BCBSIL Option 1 BCBSIL Option 2 BCBSIL Option 3 BCBSIL Option 4 BCBSIL Option 5 BCBSIL Option 6 BCBSIL Option 7
Plan Name Platinum Gold Silver Silver Silver Silver Bronze
Product BCBS BCBS BCBS BCBS BCBS BCBS BCBS
Option PA3147 PA3150 PA3151 PA3152 PA3154 PA3156 PA3160
Plan Offering
HRA or HSA No No No No No HSA HSA
Benefits* Network Single/Family Network Single/Family Network Single/Family Network Single/Family Network Single/Family Network Single/Family Network Single/Family
Office Copay (PCP/SPC) PCP $20, SPC $40 PCP $20, SPC $40 PCP $30, SPC $50 PCP $30, SPC $50 PCP $20, SPC $40 PCP N/A, SPC N/A PCP N/A, SPC N/A
Hospital Copays NA NA NA NA NA NA NA
UC/ER/Major Diag Copay ER $150 ER $150 ER $150 ER 150 ER $150 ER N/A ER N/A
Other
Deductible $250/$750 $500/$1500 $1000/$3000 $1500/$4500 $3500/$10200 $2500/$5000 (Non-Emb) $6000/$12700 (Emb)
Coinsurance 80% 80% 80% 80% 80% 100% 100%
Out-of-Pocket $1250/$3750 $2500/$7500 $4000/$10200 $4500/$10200 $5500/$10200 $2500/$5000 $6000/$12700
Pharmacy $15/30/50; 2x for M.O. $10/40/60; 2x M.O. $10/40/60; 2x M.O. $8/35/75/150; 2x M.O. $10/40/60; 2x M.O. subject to deduct/coinsurance subject to deduct/coinsurance
Pharmacy Out-of-Pocket $1000/$3000 $1000/$3000 $1000/$3000 $1000/$3000 $1000/$3000
Out of Network Single/Family Out of Network Single/Family Out of Network Single/Family Out of Network Single/Family Out of Network Single/Family Out of Network Single/Family Out of Network Single/Family
Deductible $500/$1500 $1000/$3000 $2000/$6000 $3000/$9000 $7000/$21000 $5000/$10000 (Non-Emb) $12000/$25400 (Emb)
Coinsurance 60% 60% 60% 60% 60% 80% 100%
Out of Pocket $2500/$7500 $5000/$15000 $8000/$20400 $9000/$20400 $11000/$20400 $5000/$10000 $12000/$25400
Enrollment
Rates Rates Rates Rates Rates Rates Rates
Active Rates Proposed Proposed Proposed Proposed Proposed Proposed Proposed
Employee $804.07 $773.51 $734.66 $724.36 $686.99 $714.01 $588.27
Employee + Spouse $1,615.47 $1,552.50 $1,472.46 $1,451.26 $1,374.22 $1,429.93 $1,170.81
Employee + Child(ren) $1,335.18 $1,285.29 $1,200.15 $1,182.73 $1,136.82 $1,182.61 $969.56
Employee + Family $2,294.13 $2,204.06 $2,059.21 $2,028.91 $1,949.01 $2,028.70 $1,658.03
Rates Rates Rates Rates Rates Rates Rates
Medicare Rates Proposed Proposed Proposed Proposed Proposed Proposed Proposed
Employee $656.52 $631.86 $592.20 $583.90 $562.03 $583.84 $482.34
Employee + Spouse $1,305.67 $1,238.06 $1,111.81 $1,095.72 $1,053.68 $1,156.57 $948.37

HEALTH PLAN RATE CHANGE HISTORY FOR THE ILFI TRUST
Average Increase 7.3%

HEALTH PLAN RATE CHANGE HISTORY FOR THE ILFI TRUST
Year Rate Change Year Rate Change Year Rate Change
Note: This summary 2007 10.5% 2011 1.5% 2015 12.5%
provices only the 2008 25.0% 2012 -3.6% Average Increase 7 .3%
2016 5.8%
highlights of the various 2009 4.2% Year Rate Change Year Rate Change
2013 6.9%
2017 8.4%
2018 -5.8%
programs. Specific details 2010 7.5% 2007 . . . . . . . . . . . 10 .5% 2014 14.9% 2011 . . . . . . . . . . . . 1 .5%
on each program are 2008 . . . . . . . . . . . 25 .0% 2012 . . . . . . . . . . . . -3 .6%
Note: This summaery provides only the highlights of the various programs. Specific details on each program are contained in the master policy issued to the group.
contained in the master 2009 . . . . . . . . . . . . 4 .2% 2013 . . . . . . . . . . . . 6 .9%
policy issued to the group 2010 . . . . . . . . . . . . 7 .5% 2014 . . . . . . . . . . . 14 .9%

12

Revised on April 15, 2015