The federal Affordable Care Act ("ACA") requires that nearly all individuals (who are above the threshold for filing income tax) must obtain health insurance for themselves and any of their dependent family members. The following plans will satisfy this individual responsibility requirement:

• State of Illinois health insurance plans offered through the Department of Central Management Services ("CMS") based on University employment, which include:
  • Aetna HMO
  • Blue Advantage HMO
  • Health Alliance HMO
  • HMO Illinois
  • Aetna OAP
  • HealthLink OAP
  • Quality Care Health Plan (QCHP/Aetna)
• University's ACA Plan, a minimum essential coverage plan
• Student Health Insurance plan offered based on student enrollment, which include:
  • Urbana: UnitedHealthcare
  • Chicago: Campus Care
  • Springfield: Academic Health Plans

The following types of health insurance coverage will also satisfy the individual responsibility requirement as long as the insurance qualifies as "minimum essential coverage" under ACA (contact the plan directly to find out if it qualifies):

• Health insurance provided by a parent/guardian, spouse, or other family member who claims you as a dependent
• Another employer-provided health insurance plan, if your primary employment is somewhere other than the University
• Private health insurance coverage purchased independent of employment

The fee for not having health insurance (sometimes called the "Shared Responsibility Payment" or "mandate”) ended in 2018. This means you no longer pay a tax penalty for not having health coverage.

If you have questions about your employment status, please contact your university HR office.

If you have questions about your health insurance coverage offered through CMS, please contact University Payroll & Benefits.

FAQs

Where can I read the Notice?

You can find the Insurance Marketplace Notice online.

Why am I, as a new University employee, receiving this notice?

ACA requires the University, as your employer, to provide you with information relating to the Health Insurance Marketplace ("Marketplace"). The notice provides basic information about the Marketplace and how it may relate to coverage that is offered to eligible employees.

Why does ACA encourage individuals to purchase health coverage?

The rationale for requiring nearly all individuals to purchase coverage is that having a larger pool of individuals (both healthy and sick people) will reduce the overall cost of providing health care in this country. Other ACA requirements, such as prohibiting denial of coverage based on pre-existing conditions and removing annual and lifetime limits on coverage, provide increased protections to those who might otherwise not be able to obtain coverage. ACA attempts to create incentives for healthy individuals to obtain coverage and to guard against the adverse financial consequences of unexpected health care costs resulting from significant illness or injury.

What if I already have insurance?

If you participate in a State of Illinois health plan offered through CMS, through University student insurance, or you have coverage that meets the minimum essential coverage requirements through another employer, a spouse, parent, or other family member, then you do not need to take any action as long as you and your dependents maintain health insurance coverage.

What if I already have health insurance, but I would rather purchase coverage through the Marketplace?

You may be able to change to Marketplace coverage if you desire to do so. However, if you are eligible for coverage offered through CMS and choose to purchase a health plan through the Marketplace instead, then you will lose vision and dental coverage provided through CMS, and you will also lose any employer contribution for CMS coverage. In addition, while both the employer contribution and your employee contribution to CMS coverage are typically excluded from income for Federal and State income tax purposes, your payments for coverage through the Marketplace will be made on an after-tax basis.

If you are eligible for the University’s ACA plan and choose to purchase through the Marketplace instead, then you will lose the employer-paid premium for employee only coverage.

What if I don’t have coverage?

If you are not eligible for CMS coverage  or the ACA Plan based on your University employment or student status, and you do not otherwise have coverage through a spouse or other family member, then you should carefully review the Insurance Marketplace Notice and understand your option to purchase health insurance through the Marketplace at HealthCare.gov.

If you were eligible for health insurance coverage through CMS or the ACA Plan but declined or opted-out of that coverage and do not have any other health coverage through a spouse or family member, then you can elect coverage through the respective open enrollment period for each program to satisfy your individual responsibility requirement under ACA:

• CMS during the May Benefit Choice period (or when experiencing a qualifying event)
• ACA Plan during the Fall open enrollment period

See also – Student FAQ: What if I don’t have insurance?

I work at the University, how do I know if I'm eligible for coverage?

The State of Illinois Group Insurance Act establishes eligibility for CMS health plans; the University established eligibility for ACA Plan based on ACA requirements. If you are unsure whether you are eligible for health insurance coverage based on your University employment, please contact your supervisor or your unit’s hiring manager with questions. If you have questions about your employment status, please contact your campus/central HR office at the number noted above.

I waived CMS insurance as a part-time employee and now I want to reinstate coverage. When can I elect it - do I have to wait until I experience a qualifying event or until the next annual Benefit Choice period?

If you are a part-time employee (working 50% to 99% of a normal work period) who declined health insurance through CMS previously, you can elect coverage through CMS during the Benefit Choice period, typically held in May, or earlier if you experience a qualifying event. 

Can my dependents be covered through the Marketplace if I am not getting insurance through the Marketplace?

Based on the currently available information, health insurance plans will be available through the Marketplace for you to cover your dependent family members. Please contact the Marketplace at HealthCare.gov for coverage in any state or go directly to GetCoveredIllinois.gov for coverage in the State of Illinois for more information.