Danville School District No. 118 Health and Vision Insurance Information

Important Documents (Click links to open):

Plan Summary

Enrollment Form

District employees can register an account online to see claims, create provider directory, preauthorization status and much more by following these simple steps:

-Go to
-click on “Log in”
-Click on “Register Now” and follow the on-screen instructions for setting up your account. You will need your member ID handy.
-Download the app for your smart phone from your phone's App Store (bcbsil).

Group Health Plan Information
If you need information for Blue Cross Blue Shield, utilize their website at or contact Blue Cross Blue Sheild at 1-800-828-3116 for assistance with any questions you have regarding covered services or the payment of claims. 

Notice of Group Health Coverage Continuation Rights
The Consolidation Omnibus Budget Reconciliation Act (COBRA), known as Public Law 99-272, requires that the District notify you of coverage available under this federal law. Please read the following information carefully so that you can make an informed choice about the benefits available to you.

You may elect up to 18 months of continued health coverage for yourself and your dependent if your coverage would otherwise end due to:
1. Your voluntary or involuntary termination of employment (unless for gross misconduct); or
2. A reduction in your work hours to fewer that the minimum needed to remain eligible for the plan.

You may elect up to 36 months of continued health coverage for yourself if you are an employee’s dependent whose coverage would otherwise end due to:
1. The employee’s death
2. The employee’s divorce or legal separation from his or her spouse
3. The employee’s eligibility for Medicare
4. Dependent child’s attainment of limiting age

You may elect up to 36 months of continued health coverage for yourself if you are an employee’s child whose coverage would otherwise end because you no longer qualify as the employee’s dependent as defined under the plan.

If you or your dependents qualify under one of the conditions listed above, you must complete the election form within 60 days of eligibility. You will be required to pay the full cost of the coverage plus 2% of the premium as a handling expense.

Extended coverage may be stopped if the following conditions apply:
1. You obtain coverage under another group plan or Medicare
2. You do not pay the required premium
3. Coverage for a dependent may be stopped if the spouse remarried and has other group coverage, becomes entitled to Medicare or does not pay the required premium.

Vision Service Plan Documents (Click on link to open):

Plan Summary 2018
VSP Remove Dependent Form
Vision Service Plan Enrollment Form
Out of Network Reimbursement Form

Delta Dental Plan Documents (Click on link to open):

Dental Plan Enrollment Form
Low Plan
High Plan

Provider Contact Information

Medical Coverage
Blue Cross Blue Shield

Benefit Planning Consultants (BPC)

 Prescription Coverage
PO Box 968022
Schaumburg, IL 60196-8022
Vision Service Plan (VSP)
PO Box 997105
Sacramento, CA 95899-7105
Group # 12-001821-001-001
Eye Care Providers

Chittick Family Eye Care
1104 N. Vermilion
Danville, IL 61832

Gailey Eye Clinic
478 E. Liberty Lane
Danville, IL 61832
Walmart Vision
4101 N. Vermilion
Danville, IL  61834

No claim form or card is necessary. Just contact the providers above and let them know you are a District 118 employee with the VSP plan.

Danville School District No. 118 Health Insurance Rates Health Insurance and Vision Plan Rates

Employee Expense Per MONTH for Health Insurance (26 pays per year, lesser pays are higher premiums) Effective January 1, 2018

  Health Plan Vision Service Plan
Monthly Premiums    
Employee Coverage $71.00 Board Paid
Optional Dependent Coverage    
   One Dependent
   Two Dependents
   Three or More Dependents
Deductions PER PAY when
both husband and wife are
District No. 118 employees
and elect family coverage
$0 $3.38

All Union Custodial and Food Service employees, please refer to your contract for your rates and co-pays.

POSC Plan In-Network Out-of-Network
Summary of Plan Benefit    
Co-pay Primary Care Physician
Co-pay Specialist
Annual Deductible    
Maximum Out of Pocket    
Note: Absolutely all co-pays apply to the maximum out of
pocket including pharmacy co-pays.

Co-pay Emergency Room $200 $200
Routine prenatal care
Maternity inpatient
Newborn Care
Preventative and Wellness Services
Immunizations, adult and child annual physical
Exams, mammograms, PAP smears, prostate
screening and more.
Age/frequency schedules apply 
 $0 50%
Prescription Drugs    
30-day Supply    
Generic - Tier 1
Brand - Tier 2
Non-preferred Brand - Tier 3
Specialty Pharmacy/Medical    
Preferred - Tier 4
Non-preferred - Tier 5
Non-formulary - Tier 6

All union Custodial and Food Service employees, please refer to your contract for rates, co-pays, plan description, etc.

Women's Health and Cancer Rights Act
December 1998

Dear Participant or Beneficiary,

On October 21, 1998, Congress passed a bill called the Women’s Health Care and Cancer Rights Act, also known as “Janet’s Law”. This law imposes new requirements on group health plans to provide benefits for reconstructive surgery following a mastectomy when mastectomy is a covered benefits under the plan.

As you know, for a number of years, the Danville Community Consolidated School District 118 Group Health Plan has provided coverage for mastectomies. As part of this coverage, the Plan also covered the procedures necessary to effect reconstruction of the breast on which the mastectomy was performed. As well as the cost of prostheses (implants, special bras, etc.) and physical complications of all stages of mastectomy; including lymph edemas, as recommended by the attending physician of any patient receiving Plan benefits in connection with the mastectomy in consultations with the patient. However, the Plan did not cover any surgery and reconstruction of the other breast to achieve a symmetrical appearance.

Effective for the Plan year beginning February 1, 1999 for any participants or beneficiary of the Plan who currently is receiving Plan benefits for a mastectomy, the Plan will provide coverage for any necessary surgery and reconstruction of the breast on which a mastectomy was not performed in order to produce a symmetrical appearance.

This new coverage will be subject to the same deductibles and co-payments that apply to mastectomies under the Plan’s current terms (see the Danville Community Consolidated School District 118 Group Health Plan Summary Plan Description for details of the Plan’s deductible and co-payment requirements for mastectomies).



Website by SchoolMessenger Presence. © 2021 Intrado Corporation. All rights reserved.