Argonne National Laboratory

Human Resource Services

Healthcare Insurance

We offer competitive, affordable plans to help you manage your health care.

New hires and employees newly eligible for benefits can elect health care coverage within their first 30 days of employment, or within 30 days of an employment status change. An eligible employee means an employee of UChicago Argonne, LLC who is regularly scheduled to work a minimum of 20 hours per week and who is: a regular employee; a temporary employee with a term appointment of six months or more; a former employee who is receiving Long Term Disability benefits and who had medical coverage prior to becoming disabled; an eligible retiree as defined in the Summary Plan Descriptions. 

Employees can cover the following legal dependents under Argonne health care plans: spouse (regardless of sexual orientation), legal civil union partner, child(ren) under the age of 26 or under the age of 30 (military dependents), stepchild(ren), adopted child(ren), child(ren) for whom legal guardianship was obtained, disabled child(ren) over the age of 26. 

Employees covering legal dependents will need to submit supportint documentation such as marriage, birth, or adoption certificates; court order; and/or other supporting documents at the time of enrollment. Employee premium contributions are required, and the contributions are made on a pretax basis via automatic payroll deduction.

Medical Insurance Plans

All benefit eligible employees have the choice of three medical plans.  Aetna is the insurance carrier for all medical plans. All medical plans are effective the first day of hire if a medical plan is elected by the employee within 30 days of employment. There are no pre-existing condition clauses under Argonne’s medical plans.

Aetna Enhanced PPO

The Aetna Enhanced PPO plan is part of the Aetna Choice POS II (Open Access) network.

  • This plan has a deductible of $200/individual or $400/family. Primary care office visits in-network will be subject to a $15 copay and specialist office care visits will be subject to a $30 copay.  For all other services, if the provider is in-network, and after the deductible has been met, the plan will pay 85% of the eligible charge and the member will pay 15%. If the provider is out-of-network, after the deductible, the plan will pay 70% of the eligible charge and the member will pay 30%. Preventive services using an in-network provider are covered at 100% of the eligible charge.

  • There is an out-of-pocket limit each calendar year for in-network expenses of $3,000/individual, and $6,000/ family. Once the limit is reached, in-network expenses are then paid at 100% of the contracted rate for the remainder of the calendar year. The out-of-pocket limit for out-of-network expenses is $6,000/individual, and $12,000/family. The deductible and copays apply to the out-of-pocket limit.

Aetna Standard PPO

The Aetna Standard PPO plan is part of the Aetna Choice POS II (Open Access) network.

  • This plan has a deductible of $300/individual or $600/family. Primary care office visits in-network will be subject to a $25 copay and specialist office care visits will be subject to a $40 copay.  For all other services, if the provider is in-network, and after the deductible has been met, the plan will pay 75% of the eligible charge and the member will pay 25%. If the provider is out-of-network, after the deductible, the plan will pay 60% of the eligible charge and the member will pay 40%. Preventive services using an in-network provider are covered at 100% of the eligible charge.

  • There is an out-of-pocket limit each calendar year for in-network expenses of $5,000/individual, and $10,000/ family. Once the limit is reached, in-network expenses are then paid at 100% of the contracted rate for the remainder of the calendar year. The out-of-pocket limit for out-of-network expenses is $10,000/individual, and $20,000/family. The deductible and copays apply to the out-of-pocket limit.

Aetna Select

The Aetna Select plan is part of the Aetna Select network.

  • To enroll in this plan, a primary care physician must be chosen, and the primary care physician will coordinate all care.  Referrals are necessary for services with providers other than the primary care physician.  The provider ID of the primary care physician must be identified during enrollment in the plan. If services are not authorized by the primary care physician, they are not covered.  In addition, there are no out-of-network benefits under this plan.

  • This plan has no annual deductible. There is an out-of-pocket limit each calendar year for in-network expenses of $1,800/individual and $3,600/family.  Most services are subject to a copay.

Prescription Drug Plan

All medical plan participants will receive pharmacy benefits through the Argonne Prescription Drug plan administered by Express Scripts, Inc.

  • Depending on the type of prescription (generic, formulary brand, non-formulary brand) members will be charged a copay at the time of purchase, with the exception of specialty drugs, which requires a 20%-member coinsurance.

  • The annual out-of-pocket maximum for all prescription drugs, including retail, mail order, and specialty under the Enhanced PPO and Select plan is $2,300/individual and $4,600/family.  The annual out-of-pocket maximum for all prescription drugs, including retail, mail order, and specialty under the Standard PPO plan is $2,800/individual and $5,600/family.  When a generic drug is available, participants must use generic or pay the cost difference along with the brand copay whether using retail or mail order.

Dental

All benefit eligible employees will have the option to enroll in the PPO Dental plan. Delta Dental of Illinois is the insurance carrier for the dental plan. The dental plan is effective the first day of hire if it is elected by the employee within 30 days of employment.

  • The Delta Dental PPO program allows you to go to any in- or out-of-network general or specialty dentist at the time of treatment. Argonne National Laboratory dental enrollees have access to two networks, Delta Dental PPO and Delta Dental Premier managed fee-for-service.  Your out-of-pocket costs will vary depending on whether your dentist participates in Delta Dental PPO, Premier, or neither (i.e., ​“out-of-network”). You will maximize your benefits by receiving care from a Delta Dental PPO network dentist.

  • This plan has an annual deductible of $100/individual or $300/family. Preventive and diagnostic services are covered by the plan at 100% of the reduced fee or maximum plan allowance, and basic and major services are covered at 75% of the reduced fee or maximum plan allowance.

  • There is a maximum benefit limit of $3,000 per calendar year and a separate $3,000 lifetime orthodontia benefit (no age limit).

EyeMed Vision Plan

All benefit eligible employees will have the option to enroll in the voluntary vision plan. EyeMed is the insurance carrier for the vision plan. The vision plan is effective the first day of hire if it is elected by the employee within 30 days of employment.

  • The EyeMed vision plan is voluntary, and employees pay the entire premium. The premium is a pre-tax payroll deduction. 

  • The network for Argonne members is the Insight network. To find in-network providers, visit the Eyemed website or call EyeMed Member Services.

  • The plan covers services from both in-network and out-of-network providers and includes, but is not limited to, discounts and allowances on exams, frames, standard lenses, contact lenses and laser vision correction. Additional discounts of up to 40% apply for services rendered by an in-network provider.

Flexible Spending Accounts (FSA)

Argonne offers two FSA programs, one for the payment of health care expenses and the other for dependent day care expense. Each calendar year, you decide whether you want to participate in one or both accounts. Once you have made that decision, you then estimate the amount of eligible expenses you are likely to have during the year and decide how much of your earnings you want to set aside to help pay for them. Because FSA contributions are untaxed at deposit and untaxed at withdrawal, you decrease your taxable income while increasing your spendable cash.

Health Care FSA

  • The Health Care FSA allows you to contribute up to the annual maximum to be used for eligible health care expenses that are incurred in the calendar year in which you are enrolled, and for which are not paid for by insurance. Balances between $10 and 20% of the allowed annual contribution amount, will be carried over to the next plan year.  If no new account is established in the next year, any remaining balance will carry over for a maximum of two years.

  • Re-enrollment in a Health Care FSA is required from year to year. Additional information regarding eligible expenses can be found on the HealthEquity|WageWorks website at www​.wage​works​.com.

Dependent Care FSA

  • The Dependent Care FSA allows you to contribute up to $5,000 pre-tax dollars in the calendar year in which you are enrolled to cover the cost of child or elder daycare.  Contributions made to your dependent care FSA that are not used to cover expenses in the calendar year in which you are enrolled, have a grace period and can be used for expenses incurred through March 15 of the following calendar year.

  • Re-enrollment in a Dependent Care FSA is required from year to year.  Additional information regarding the Dependent Care FSA can be found on the HealthEquity|WageWorks website at www​.wage​works​.com.