Schedule of Benefits

Blue Cross Blue Shield of Illinois is the Claims Administrator effective March 1, 2019. If you have questions about your benefits, please contact BVA Customer Service at 1 (855) 686-8517.  BVA representatives are available to help you find PPO providers and help you understand your benefits and your share of the costs based on the plan’s copays, deductibles, coinsurance, and out of pocket maximums.

Following are the Schedule of Benefits and Summary of Benefits and Coverage (SBCs) which have been updated for the 9/1/2023 Open Enrollment.

Schedule of Benefits

Plan A
Plan B
Plan C
Plan D (HDHP) as of 9/1/2023
Plan D (HDHP) as of 1/1/2024
Plan E1
Plan AB1
Plan M3
Plan M6
Plan M7
Plan M8
Plan H1
Plan H4
Plan H5

Summary of Benefits and Coverage (SBC)

Plan A
Plan B
Plan C
Plan D (HDHP) as of 9/1/2023
Plan D (HDHP) as of 1/1/2024
Plan E1
Plan AB1
Plan M3
Plan M6
Plan M7
Plan M8
Plan H1
Plan H4
Plan H5