Page 14 - 2018 Insurance Book
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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%


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                                                                                                                                                                                   Revised on April 15, 2015
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