Your Medical Benefits

The University of Chicago offers a choice of four medical plans. One is a preferred provider plan, and three are HMOs.

The Maroon Plan is a preferred provider option (PPO). You choose the doctors and Hospitals you want to see for your medical care. The amount paid by the plan depends on the services you receive and the amount charged by the provider. When you choose providers in the network, you pay less. Unlike an HMO, you are covered, even if you get care outside the network. You can select from three levels of coverage: employee, double or family.

The University also offers three HMO-style medical plans: HMO Illinois, Humana Premier and the University of Chicago Health Plan (UCHP). HMOs only provide in-network coverage. You select a Primary Care Physician who coordinates all of your medical care. If you go to a doctor or Hospital outside of your HMO without prior approval, you will not receive any benefits from the plan, except in an emergency. You can select from three levels of coverage: employee, double or family.

The chart below highlights the major differences in the way medical care is provided between the Maroon Plan and the HMOs.

	Maroon Plan A Preferred Provider Option	HMOs
Summary	Gives you the maximum choice of doctors and Hospitals. Focuses on treating illness and injury. Has a higher premium than an HMO and you pay a higher share of the cost of care because you have a much wider choice of caregivers. Provides discounts and pays more if you use providers who are part of the network.	Limits your choice of doctors and Hospitals to only those who have contracted with the HMO to charge specific rates. Reduces illness through wellness care such as physical exams. Reduces unnecessary treatment by coordinating your care through your Primary Care Physician.
Intent	To provide true insurance for the cost of medically necessary treatment for illness and injury, while maintaining your freedom to choose providers.	To reduce medical care costs by keeping you healthy and to manage the costs that are incurred by monitoring your care and limiting your choice of providers.

Please review this summary and refer to your HMO documents for their terms of coverage for important details on plan limits and features.

If you have questions about your benefits, call the Benefits Office at 773-702-9634 or send an e-mail to benefits@uchicago.edu.

The capitalized terms in the Summary Plan Description have special meaning, which impacts your receipt of benefits under the plan. Please refer to the Glossary for the definition of those capitalized terms.

While this Summary Plan Description summarizes the major provisions of this plan, it does not provide you with every plan detail. The plan documents, which govern this plan, provide full details. If there are any discrepancies between this Summary Plan Description and the legal plan documents, the legal plan documents control.