Decision Guidance Tool (DGT)
Answer 5 quick questions for general plan selection guidance.
- This guide does not use any personally identifying information.
- Your results are not saved.
- Please review the detailed medical plan Summary of Benefits and Coverage (SBC) to determine the best plan for your needs.
- You are responsible for the plan you select.
This decision guidance is educational and does not use personal medical history or claims data. The results are directional in nature and not to be used as specific, definitive recommendations.
Help Choosing a Medical Plan
All displayed values are estimates, please consult official benefit documentation for exact amounts.
Which Medical Plan is Right?
Evaluate Your Needs. Consider your prior health care usage and select plans and options that fit your lifestyle and needs.
- Do you take regular prescription medications?
- Are you anticipating surgery or non-preventive dental care?
- Did you experience a qualifying life event this year?
- Review your current plans to ensure you have the coverage you need.
Review this benefits website to learn about your plan options.
A little bit of planning will help you select the best plans, coverage levels, and financial programs for your unique situation.
Medical Plan Comparison
Plan Option Summary
Benesch offers the option of a Traditional PPO or High Deductible Health Plan (HDHP) administered through Blue Cross Blue Shield of Illinois.
Please note that the network is nationwide, even though the plan is administered by BCBS of Illinois. For more detailed coverage information, please refer to the BCBSIL plan documents.documents.
| Plan Options | Traditional PPO* | High Deductible Health Plan (HDHP) |
||||||
|---|---|---|---|---|---|---|---|---|
| Calendar Year Deductible | In-Network | Non-Network | In-Network | Non-Network | ||||
| Embedded – no one individual must meet more than the individual limit | Embedded – no one individual must meet more than the individual limit | |||||||
| Individual | $1,500 | $3,000 | $3,500 | $3,500 | ||||
| Family | $3,000 | $6,000 | $7,000 | $7,000 | ||||
| Out-of-Pocket Max | Includes your Deductible | Includes your Deductible | ||||||
| Individual | $5,000 | $10,000 | $5,000 | $5,000 | ||||
| Family | $10,000 | $20,000 | $10,000 | $10,000 | ||||
| Coinsurance – You Pay |
In-Network 20% |
Non-Network 40% |
In-Network 20% |
Non-Network 40% |
||||
| Wellness/ Preventive Care Visit | $0 | 40% after deductible | $0 | 40% after deductible | ||||
| Physician Care Visit | $25 copay* | 40% after deductible | 20% after deductible | 40% after deductible | ||||
| Specialist Office Visit | $50 copay* | 40% after deductible | 20% after deductible | 40% after deductible | ||||
| Urgent Care | 20% after deductible | 40% after deductible | 20% after deductible | 40% after deductible | ||||
| Hospital Services | In-Network | Non-Network | In-Network | Non-Network | ||||
| Inpatient | 20% after deductible | 40% after deductible | 20% after deductible | 40% after deductible | ||||
| Outpatient | 20% after deductible | 40% after deductible | 20% after deductible | 40% after deductible | ||||
|
Complex Imaging (MRI, CAT, PET, etc.) |
20% after deductible | 40% after deductible | 20% after deductible | 40% after deductible | ||||
| Emergency Room | $400 Copay* (waived if admitted) plus 20% after deductible |
10% after deductible | ||||||
| Rehabilitation Services | In-Network | Non-Network | In-Network | Non-Network | ||||
| Physical, Speech & Occupational Therapy | 20% after deductible | 40% after deductible | 20% after deductible | 40% after deductible | ||||
*For the PPO, copays do not count towards the deductible, but do count towards the out-of-pocket maximum.
Employee Contributions
| Bi-Weekly Medical Contributions | HDHP Plan | PPO Plan |
|---|---|---|
| Employee | $92.08 | $179.64 |
| Employee & Spouse | $186.57 | $337.45 |
| Employee & Child(ren) | $159.12 | $300.78 |
| Family | $263.95 | $485.93 |
Finding A Physician
Visit www.bcbsil.com and click “Find a Doctor or Hospital.”
You may search either by physician name or network; the network for each of the plans offered is:
- Participating Provider Organization (PPO)
Blue Access for Members (BAM)
- All participants have access to BAM. You may create your own account at www.bcbsil.com
- Members can check the status of claims, view benefit information, access wellness information, compare hospitals, request replacement ID cards, and more.
- Employees can even access their accounts through their mobile or smart phone
Blue365®
Blue365 is a discount program for members. With this program, you can save money on health care products and services that are most often not covered by your benefit plan. There are no claims to file and no referrals or pre-authorizations.
See all the Blue365 deals and learn more at www.blue365deals.com/BCBSIL.
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2026 PPO SBC
2026 HDHP SBC
2026 HDHP - HSA Booklet
2026 Traditional PPO Booklet
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