Operators’ Health Center Plan

Attention active hourly members of the MOE Health Plan Marketplace

Effective April 1, 2018 the Midwest Operating Engineers Welfare Fund Board of Trustees are pleased to announce the addition of a new health plan option, the Operators’ Health Center (OHC) Plan to the MOE Health Plan Marketplace. This new plan option allows members to take advantage of the AAAHC rated Operators’ Health Center along with CVS MinuteClinics™ and the Advocate Health Care system to receive the highest quality of care in the Chicagoland area.

How does the OHC Plan work?

When you enroll in the OHC Plan, you and/or your family will receive primary and urgent care at the AAAHC rated Operators’ Health Center, located on the Countryside Campus directly across from the District 1 Union Office, or from one of the 6,000 affiliated doctors and specialists currently within the Advocate Health Care network. In addition, you may seek treatment for urgent care needs at your local CVS MinuteClinic or at any of the Advocate Clinics located in certain Walgreens throughout the Chicagoland area. Please note: You do not need to specify a primary care physician as long as they are a provider of the OHC, CVS MinuteClinic or in the Advocate Health Care system. When you need services not provided by the Operators’ Health Center, CVS MinuteClinics or the Walgreens’ Advocate Clinics, you will be referred to one of the many high-quality providers within the Advocate Health Care system.

What are the OHC Plan benefits?

The benefits are the same benefits offered by Plan A which provides the Welfare Fund’s most comprehensive coverage. Under the OHC Plan, all the medical, dental, death, disability, pharmacy and Family Supplemental Benefits are the exact same as what is provided to members who enroll in Plan A. In addition to providing the same benefits as Plan A, the OHC plan has no deductibles or co-insurance when you use in-network providers. This means when you use in-network providers you receive all medical services covered under the OCH Plan FOR FREE. However, you will incur significant out of pocket costs when you choose to use a provider outside of the Operators’ Health Center, CVS MinuteClinics or the Advocate Health Care system except in cases of life threatening emergencies.

Effective April 1, 2018, what is the monthly credit cost deduction for the OHC Plan compared to Plan A?

By limiting the network to the Operators’ Health Center, the CVS MinuteClinics and the Advocate Health Care system, the Welfare Fund negotiated significant discounts for covered services. These discounts are passed on to the membership in the form of a lower monthly credit cost deduction. In fact, the OHC Plan costs 15% less than the cost of Plan A:

COVERAGE TIER                OHC PLAN                          PLAN A
Member                                      1,033                               1,215
Member +1                                 1,198                               1,409
Family                                         1,363                               1,604

Why use the Advocate Health Care system?

Several factors were considered when we chose to partner with the Advocate Health Care system:

  • The Advocate Health Care system has 12 hospitals, over 6,000 affiliated doctors and specialists and nearly 50 medical and surgical specialties throughout the surrounding Chicagoland area
  • Advocate Health Care is recognized for its high quality of care
  • Advocate Health Care is known for medical excellence for:
    o cancer care
    o cardiac surgery
    o coronary bypass surgery
    o general surgery
    o joint replacement
    o orthopedic/spinal surgery or fusion
    o women’s health
  • Many Local 150 members are already using the AAAHC Operators’ Health Center or the Advocate Health Care system today

Why should you consider enrolling in the OHC Plan?

There are many factors to consider:

  • Do you already use the Operators’ Health Center for your primary care needs? If so the OHC Plan will work well to meet you and/or your family’s health care needs.
  • If you reside in Illinois and you are already using the Advocate Health Care system (i.e. 12 hospitals, 6,000 affiliated doctors and specialists, or 50 medical and surgical specialties), the OHC Plan may be right for you. Please review the zip code area map and hospitals that are available.
  • The OHC Plan provides the best medical benefits offered by the Midwest Operating Engineers Welfare Fund FOR FREE when you use in-network providers.
  • The OHC Plan provides you with great benefits for a significantly lower monthly credit cost deductions than Plan A.

What resources are available?

Advocate Network

The medical director of the Operators’ Health Center, Dr. Brian Casaclang, has nearly 20 years of combined experience for both Presence Health and most recently the Advocate Medical Group. He understands the Advocate Health Care system and more importantly has formed professional relationships with Advocate providers should you require a referral for any medical service that is not currently provided by the OHC. To find an Advocate in-network provider or facility click here.

Case Management

MCM Solutions, the Fund’s Case Manager, will still need to provide certification for medical necessity for certain services including but not limited to:

  • all inpatient hospital admissions
  • outpatient surgeries
  • home health care
  • durable medical equipment
  • occupational/physical/speech therapy
  • emergency hospital admission

For a full list of services that need certification, please contact the Fund Office. MCM will notify you if the provider or facility is not in the Advocate network.

PLEASE REMEMBER: You will incur significant out of pocket costs when you choose to use a provider outside of the Operators’ Health Center, CVS MinuteClinics or the Advocate Network except in cases of life threatening emergencies. If you use an out-of-network facility and you receive a bill from that facility, we have contracted with a third party that will negotiate the best price for medical services you received. The Patient Advocacy Center (PAC) will guide you through the process and a Patient Advocate will handle all the communication on your behalf with the out-ofnetwork facility.

Contact PAC:

Telephone: (888) 837-2237

Facsimile: (949) 891-0420

Email: pac@hstechnology.com

So, to sum it up, consider the OHC Plan when making your enrollment decision for the 2018/2019 Plan Year. The OHC Plan provides the best medical benefits available FOR
FREE when you use in-network providers and for a significantly lower monthly credit cost deduction than Plan A.

Let’s Gear Up and Build Better Health!

 

Upcoming Events

Fund Office Hours

Monday – Friday
8:00 a.m. – 5:00 p.m.

Saturday
8:00 a.m. – 12:00 p.m.

Closed Sundays


Eligibility/Member Services Hours

Mon., Tues., Wed., and Fri.
8:00 a.m. – 5:00 p.m.

Thurs.
9:00 a.m. – 5:00 p.m.

Saturday
8:00 a.m. – 12:00 p.m.

Closed Sundays


Operators' Health Center Hours

Monday – Wednesday
9:00 a.m. – 5:00 p.m.
(Last Appointment 4:00 PM)

Thursday
10:00 a.m. – 7:00 p.m.
(Last Appointment 6:00 PM)

Friday
9:00 a.m. – 5:00 p.m.
(Last Appointment 4:00 PM)

Saturday
8:00 a.m. – 12:00 p.m.
(Last Appointment 11:00 AM)

Closed Sundays

6150 Joliet Rd Suite OHC
Countryside, IL 60525
Tel: 708.485.2273 (CARE)