Illinois Small Business Health Insurance Guide

Illinois Market Overview

The Illinois small business health insurance market is a competitive and complex insurance market. For a small business, there are many health insurance options to choose from – multiple carriers, tiered doctor networks, government exchange vs private market plans, etc. The large number of options in the Illinois market can make looking for the right health insurance plan intimidating, but can also provide substantial savings opportunities by narrowing in on the most appropriate plan for specific needs.

Illinois Health Insurance Carriers at a Glance

Looking for specific coverage & rate information? See every carrier & plan online at SimplyInsured.com.

Insurance Carrier Overview:

Aetna is a national carrier offering medical, dental, and vision coverage. Aetna offers two main types of networks; (1) statewide PPO and HMO networks and (2) two regional networks called Savings Plus and Aetna Whole Health. Companies can mix and match up to 5 different plans to offer employees.

Aetna’s full PPO and HMO networks are very broad and includes a large number of hospitals and doctors, but also tend to be among the more expensive options in the market. (View Aetna plans & rates)

Network Overview

Open Choice PPO: Aetna’s largest network in Illinois, with access to expansive network of doctors and hospitals. Offers nationwide coverage through Aetna’s national network.
Savings Plus of Chicago PPO: Narrow PPO network comprised of medical providers with lower negotiated costs to Aetna. Plans are ~9% less expensive than the full network, and primarily includes medical providers in the greater Chicago area. Savings Plus plans can only be selected by companies located in the greater Chicago metro area.
HMO: Statewide HMO network with fairly large network of doctors and hospitals, and substantially less expensive compared to full PPO network.
Savings Plus of Chicago HMO: Similar to the Savings Plus PPO, the Savings Plus HMO network is about 20% smaller. Plans are also less expensive at ~22% less expensive than the full network. Savings Plus plans can only be selected by companies located in the greater Chicago metro area.
Aetna Whole Health HMO: Smallest HMO network available, and limited to companies located in the greater Chicago metro area. The plans are 28% less expensive than the full network.

Insurance Carrier Overview:

Blue Cross and Blue Shield of Illinois is part of the Health Care Service Corporation, and is a regional network of Blue Cross Blue Shield plans, offering medical and dental coverage. BCBS IL offers several networks, including lower cost narrow networks specific to the Chicago metro. Companies can choose to offer up to 6 plans, 3 PPO plans and 3 HMO plans. PPO plans provide national coverage through the Blue Cross Blue Shield BlueCard network. BCBS IL rates are among the most competitive in most areas of Illinois. (View BlueCross BlueShield Illinois plans & rates)

Network Overview

PPO Network: Full PPO network with access to the largest network in Illinois, and nationwide coverage through the BlueCard network. One of the best doctor networks available to small businesses.
Blue Options: The Blue Options network is a tiered PPO network available to companies located in greater Chicago metro. Blue Options separates in-network doctors into a preferred and non-preferred tier, with lower copays and deductibles for the preferred tiered. Blue Options plans are ~20% less expensive than the full network.
Blue Precision HMO: Full HMO with about 30% of the network size of the full PPO network. Blue Precision HMO plans are typically 23% less expensive than the full PPO network, but typically isn’t a better value compared to the narrow network PPO plans.
Blue Choice Preferred PPO: The Blue Choice Preferred PPO network is a narrow network available to companies in the greater Chicago area, and is 24% less expensive than the full network. The plan has a strong network in the Chicago metro, but has a smaller network for the rest of the state.
BlueCare Direct HMO: A narrow network HMO plan that utilizes the Advocate Health Care’s system of doctors and hospitals. The plan is available to companies in the Chicago metro, and is significantly less expensive than the full network plans.

Insurance Carrier Overview:

Humana offers a variety of medical, dental, and vision coverage. Humana offers two networks in Illinois, a full PPO and a point-of-service network. Humana’s full PPO plans have an expansive network of doctors and hospitals.

Humana is also very small business friendly, and covers many classes of small businesses that other insurance carriers do not, such owner-only companies and husband/wife-only companies. (View Humana plans & rates)

Network Overview

ChoiceCare PPO: Full PPO network with access to a very large Illinois doctor network and nationwide coverage on Humana’s national network.
NPOS – Open Access: Similar to the ChoiceCare PPO network in breadth, however the NPOS plan separates physicians into preferred vs non-preferred tiers. Going to physicians in the preferred tier will result in lower bills than a physician on the non-preferred tier. Plans on this network are ~6% less expensive than the full network.

Insurance Carrier Overview:

United Healthcare is the largest carrier in the country, and offers medical, dental, and vision coverage in Illinois. United Healthcare PPO plans provide access to the nationwide United Healthcare network. United Healthcare offers two tiers of PPO networks and a HMO network, and allows any number of plans to be offered. (View United Healthcare plans & rates)

Network Overview

Choice Plus PPO: Full PPO network with access to one of the largest network of doctors and hospitals in Illinois and nationwide coverage through United Healthcare’s national network.
Core PPO: Narrow network PPO with 85% of the doctors in the full network. Core PPOs have access to coverage nationally as well. Core PPO plans are ~16% less expensive than the full PPO version.
Navigate HMO: Fairly large HMO network with 50% of the doctors and 70% of the hospitals of the PPO network. One of the largest HMO networks in Illinois, and plans are ~23% less expensive than the full PPO.