Medical Plan

Choose from three medical plans (includes prescription drugs) or waive coverage.

Learn More

ALEX

BCBSIL

Prime Therapeutics

Prime Balanced Drug List (formulary)

No-Cost Preventive Drugs List

Your Choice Overview

One of the biggest differences among the three plans is how you pay for services. With the Blue Choice and Blue PPO plans, you pay more out of your paycheck and less when you need care. If you don’t go to the doctor often, or prefer to pay later, the Blue PPO + HSA takes less out of your paycheck, but you pay the full cost of services until you meet the deductible. Consider this as you compare the plans.

NOTE: New medical ID cards will be issued for fiscal year 2026 (starting July 1, 2025). Please watch your mail for your new ID card and begin using it July 1, 2025.

Blue Choice	Blue PPO	Blue PPO + HSA
PPO plan with two tiers of in-network benefits	PPO plan with a broader provider network than Blue Choice	Consumer-driven health plan (CDHP) uses the same provider network as Blue PPO HSA helps you pay for your eligible medical expenses, including deductible, tax free
No deductible when you choose Tier 1 providers Moderate deductible when you choose Tier 2 providers	Moderate deductible	Higher deductible, but lowest contributions from your pay
In-network preventive care 100% covered
No benefits out of Tier 1 and Tier 2 networks	Reduced benefits out-of-network	Reduced benefits out-of-network
Lowest overall out-of-pocket cost when you need care and choose Tier 1 providers	Moderate overall out-of-pocket cost when you need care	Highest overall out-of-pocket cost when you need care, but HSA helps cover it

Your Choice Overview

Select the tab for each plan to review the details.

NOTE: New medical ID cards will be issued for fiscal year 2026 (starting July 1, 2025). Please watch your mail for your new ID card and begin using it July 1, 2025.

PPO plan with two tiers of in-network benefits

No deductible when you choose Tier 1 providers

Moderate deductible when you choose Tier 2 providers

In-network preventive care 100% covered

No benefits out of Tier 1 and Tier 2 networks

Lowest overall out-of-pocket cost when you need care and choose Tier 1 providers

PPO Plan with a broader provider network than Blue Choice

Moderate deductible

In-network preventive care 100% covered

Reduced benefits out-of-network

Moderate overall out-of-pocket cost when you need care

Consumer-driven health plan (CDHP) uses the same provider network as Blue PPO

HSA helps you pay for your eligible medical expenses, including deductible, tax free

Higher deductible, but lowest contributions from your pay

In-network preventive care 100% covered

Reduced benefits out-of-network

Highest overall out-of-pocket cost when you need care, but HSA helps cover it

Medical and Prescription Drug Plans at a Glance

Medical Comparison

The plans differ in the providers available to you and how much you pay for your plan, services, and medications.

			In-Network Medical Coverage Details
	Per Pay Period Cost	AIC HSA Contribution	Preventive Care	Annual Deductible	Coinsurance	Office Visit	Urgent Care/ Emergency Room	Medical and Presciption Drug Out-of-Pocket Maximum (includes deductible)
Blue Choice¹ Chicago Area Only	Employee Only: Effective 7/1/2025: $87.07 Effective 9/1/2025: $105.73 Employee + 1 Dependent: Effective 7/1/2025: $212.83 Effective 9/1/2025: $258.45 Employee + Family: Effective 7/1/2025: $360.70 Effective 9/1/2025: $438.01	NA	Tier 1: Blue Choice OPT PPO Network
			100% covered	NA	NA	$25 copay for primary doctor $40 copay for specialist	$75 copay for urgent care $250 copay for emergency room	$2,500 per person $5,000 per family
			Tier 2: Participating Provider Organization (PPO) Network
			100% covered	$1,000 per person $2,000 per family	You pay 20% after deductible	You pay 20% after deductible	$75 copay for urgent care $250 copay for emergency room	$3,000 per person $6,000 per family
			In-Network Medical Coverage Details
	Per Pay Period Cost	AIC HSA Contribution	Preventive Care	Annual Deductible	Coinsurance	Office Visit	Urgent Care/ Emergency Room	Medical and Presciption Drug Out-of-Pocket Maximum (includes deductible)
Blue PPO	Employee Only: Effective 7/1/2025: $83.33 Effective 9/1/2025: $101.19 Employee + 1 Dependent: Effective 7/1/2025: $203.68 Effective 9/1/2025: $247.33 Employee + Family: Effective 7/1/2025: $345.17 Effective 9/1/2025: $419.16	NA	100% covered	$600 per person $1,200 per family	You pay 15% after deductible	$25 copay for primary doctor $40 copay for specialist	You pay 15% after deductible	$3,000 per person $6,000 per family
Blue PPO + HSA	Employee Only: Effective 7/1/2025: $51.36 Effective 9/1/2025: $62.37 Employee + 1 Dependent: Effective 7/1/2025: $136.92 Effective 9/1/2025: $166.27 Employee + Family: Effective 7/1/2025: $239.99 Effective 9/1/2025: $291.43	$500 for Employee Only coverage $1,000 for Employee + 1 or Family coverage	100% covered	$2,000 per person $3,500 per family	You pay 15% after deductible	You pay 15% after deductible	You pay 15% after deductible	$3,500 per person $7,000 per family²

This plan only covers services within its network of providers. If you choose to go out of network, you will pay the full cost of care. Deductibles and out-of-pocket maximums cross-apply between the tiers, meaning anything that counts toward your Tier 1 deductible or out-of-pocket maximum also counts toward your Tier 2 deductible and out-of-pocket maximum.
With family coverage, any individual family member will meet their out-of-pocket maximum when they have paid the individual out-of-pocket maximum of $3,000. The remaining family members will continue to pay until either they reach their individual maximum of $3,000, or the family out-of-pocket maximum of $6,000 is met.

Prescription Drug Comparison

	Up to 30-Day Supply Prescriptions (Retail)				90-Day Supply Prescriptions (Mail-Order or Walgreens Retail)			Preventive Drugs Coverages
	Generic	Brand Formulary	Brand Non-formulary	Specialty	Generic	Brand Formulary	Brand Non-formulary	ACA Standard Prescription Drugs ³	Enhanced Preventive Drugs ⁴
Blue Choice¹ Chicago Area Only	$10 copay	$40 copay	$70 copay	$100 copay	$20 copay	$80 copay	$140 copay	100% covered	NA



Blue PPO	$10 copay	$40 copay	$70 copay	$100 copay	$20 copay	$80 copay	$140 copay	100% covered	NA
Blue PPO + HSA	You pay 15% after deductible	You pay 15% after deductible	You pay 15% after deductible	You pay 15% after deductible	You pay 15% after deductible	You pay 15% after deductible	You pay 15% after deductible	100% covered	You pay 15% with no deductible; coinsurance counts toward out-of-pocket maximum

This plan only covers services within its network of providers. If you choose to go out of network, you will pay the full cost of care. Deductibles and out-of-pocket maximums cross-apply between the tiers, meaning anything that counts toward your Tier 1 deductible or out-of-pocket maximum also counts toward your Tier 2 deductible and out-of-pocket maximum.
With family coverage, any individual family member will meet their out-of-pocket maximum when they have paid the individual out-of-pocket maximum of $3,500. The remaining family members will continue to pay until either they reach their individual maximum of $3,500, or the family out-of-pocket maximum of $7,000 is met.
Includes aspirin, fluoride, folic acid, smoking cessation, contraceptives, drugs for prevention and treatment of cancer. Limitations based on age and health conditions apply.
Includes certain drugs for asthma, bone disease, diabetes, heart disease, high blood pressure, and to lower cholesterol.

Medical and Prescription Drug Plans at a Glance

Medical Comparison

The plans differ in the providers available to you and how much you pay for your plan, services, and medications.

Per Pay Period Cost	Employee Only: Effective 7/1/2025: $87.07 Effective 9/1/2025: $105.73 Employee + 1 Dependent: Effective 7/1/2025: $212.83 Effective 9/1/2025: $258.45 Employee + Family: Effective 7/1/2025: $360.70 Effective 9/1/2025: $438.01
AIC HSA Contribution	NA
In-Network Medical Coverage Details	Tier 1: Blue Choice OPT PPO Network	Tier 2: Participating Provider Organization (PPO) Network
Preventive Care	100% covered	100% covered
Annual Deductible	NA	$1,000 per person $2,000 per family
Coinsurance	NA	You pay 20% after deductible
Office Visit	$25 copay for primary doctor $40 copay for specialist	You pay 20% after deductible
Urgent Care/Emergency Room	$75 copay for urgent care $250 copay for emergency room	$75 copay for urgent care $250 copay for emergency room
Medical and Prescription Drug Out-of-Pocket Maximum (includes deductible)	$2,500 per person $5,000 per family	$3,000 per person $6,000 per family
Up to 30-Day Supply Prescriptions (Retail)
Generic	$10 copay
Brand Formulary	$40 copay
Brand Non-formulary	$70 copay
Specialty	$100 copay
90-Day Supply Prescriptions (Mail-Order or Walgreens Retail)
Generic	$20 copay
Brand Formulary	$80 copay
Brand Non-formulary	$140 copay
Preventive Drugs Coverages
ACA Standard Prescription Drugs³	100% covered
Enhanced Preventive Drugs⁴	NA

Per Pay Period Cost	Employee Only: Effective 7/1/2025: $83.33 Effective 9/1/2025: $101.19 Employee + 1 Dependent: Effective 7/1/2025: $203.68 Effective 9/1/2025: $247.33 Employee + Family: Effective 7/1/2025: $345.17 Effective 9/1/2025: $419.16
AIC HSA Contribution	NA
In-Network Medical Coverage Details
Preventive Care	100% covered
Annual Deductible	$600 per person $1,200 per family
Coinsurance	You pay 15% after deductible
Office Visit	$25 copay for primary doctor $40 copay for specialist
Urgent Care/Emergency Room	You pay 15% after deductible
Medical and Prescription Drug Out-of-Pocket Maximum (includes deductible)	$3,000 per person $6,000 per family
Up to 30-Day Supply Prescriptions (Retail)
Generic	$10 copay
Brand Formulary	$40 copay
Brand Non-formulary	$70 copay
Specialty	$100 copay
90-Day Supply Prescriptions (Mail-Order or Walgreens Retail)
Generic	$20 copay
Brand Formulary	$80 copay
Brand Non-formulary	$140 copay
Preventive Drugs Coverages
ACA Standard Prescription Drugs³	100% covered
Enhanced Preventive Drugs⁴	NA

Per Pay Period Cost	Employee Only: Effective 7/1/2025: $51.36 Effective 9/1/2025: $62.37 Employee + 1 Dependent: Effective 7/1/2025: $136.92 Effective 9/1/2025: $166.27 Employee + Family: Effective 7/1/2025: $239.99 Effective 9/1/2025: $291.43
AIC HSA Contribution	$500 for Employee Only coverage $1,000 for Employee + 1 of Family coverage
In-Network Medical Coverage Details
Preventive Care	100% covered
Annual Deductible	$2,000 per person $3,500 per family
Coinsurance	You pay 15% after deductible
Office Visit	You pay 15% after deductible
Urgent Care/Emergency Room	You pay 15% after deductible
Medical and Prescription Drug Out-of-Pocket Maximum (includes deductible)	$3,500 per person $7,000 per family²
Up to 30-Day Supply Prescriptions (Retail)
Generic	You pay 15% after deductible
Brand Formulary	You pay 15% after deductible
Brand Non-formulary	You pay 15% after deductible
Specialty	You pay 15% after deductible
90-Day Supply Prescriptions (Mail-Order or Walgreens Retail)
Generic	You pay 15% after deductible
Brand Formulary	You pay 15% after deductible
Brand Non-formulary	You pay 15% after deductible
Preventive Drugs Coverages
ACA Standard Prescription Drugs³	100% covered
Enhanced Preventive Drugs⁴	You pay 15% with no deductible; coinsurance counts toward out-of-pocket maximum

This plan only covers services within its network of providers. If you choose to go out of network, you will pay the full cost of care. Deductibles and out-of-pocket maximums cross-apply between the tiers, meaning anything that counts toward your Tier 1 deductible or out-of-pocket maximum also counts toward your Tier 2 deductible and out-of-pocket maximum.
With family coverage, any individual family member will meet their out-of-pocket maximum when they have paid the individual out-of-pocket maximum of $3,500. The remaining family members will continue to pay until either they reach their individual maximum of $3,500, or the family out-of-pocket maximum of $7,000 is met.
Includes aspirin, fluoride, folic acid, smoking cessation, contraceptives, drugs for prevention and treatment of cancer. Limitations based on age and health conditions apply.
Includes certain drugs for asthma, bone disease, diabetes, heart disease, high blood pressure, and to lower cholesterol.

Learn More

ALEX

BCBSIL

Prime Therapeutics

Prime Balanced Drug List (formulary)

No-Cost Preventive Drugs List