Medical Coverage
Gallagher wants you and your loved ones to stay healthy and feel great. That’s why we provide medical coverage and programs to support you no matter your stage of life or individual health needs. There is something for everyone. We even offer great ways to save money and protect your financial health as well.
Eligibility & Enrollment
Regular, full-time employees who work 30 hours or more per week are eligible for Medical Benefits* on the first day of employment. You can enroll as a new hire, during the fall Annual Enrollment, or in conjunction with a relevant qualified life event.
Part-time employees may attain eligibility for medical/Rx plan benefits under the Affordable Care Act. You can learn more on the Compliance Page.
*Employees working in Hawaii have medical coverage available through HMSA. Details will be provided to you separately.
How it Works
Gallagher offers three PPO medical plan options that give you freedom of choice, flexibility and access to a large national provider network. Each plan option is bundled with a monetary account—a Health Savings Account (HSA) or a Health Care Account (HCA)—that is funded with company money to help you pay for the care you need. Medical plan coverage is administered by Blue Cross Blue Shield of Illinois (BCBSIL).
Comparing your BCBSIL plan options
| PPO + HSA 1 | PPO + HSA 2 | PPO + HCA | ||||
|---|---|---|---|---|---|---|
| Network | Out-of-Network | Network | Out-of-Network | Network | Out-of-Network | |
| Annual Deductible | ||||||
| Individual | $1,700 | $3,000 | $3,000 | $6,000 | $2,500 | $5,000 |
| Family | $3,400 | $6,000 | $6,000 | $12,000 | $5,000 | $10,000 |
| Gallagher Account Contribution | ||||||
| Individual | $450 | $450 | $450 | |||
| Family | $900 | $900 | $900 | |||
| CoInsurance (office visits, hospital care, urgent care, X-rays, lab tests, etc.) | You pay 20% after deductible | You pay 40% after deductible | You pay 20% after deductible | You pay 40% after deductible | You pay 20% after deductible | You pay 40% after deductible |
| Annual out-of-pocket maximum (includes deductible) | ||||||
| Individual | $4,500 | $11,900 | $6,000 | $11,900 | $5,500 | $12,000 |
| Family | $8,000 | $23,800 | $12,000 | $23,800 | $11,000 | $24,000 |
| You may be subject to balance billing by out-of-network providers even after the out-of-pocket maximum is met. | ||||||
| Preventive care | You pay 0% | You pay 40% after deductible | You pay 0% | You pay 40% after deductible | You pay 0% | You pay 40% after deductible |
| Inpatient hospital services (pre-authorization required) 3 | You pay 20% after deductible | You pay 40% after deductible | You pay 20% after deductible | You pay 40% after deductible | You pay 20% after deductible | You pay 40% after deductible |
| Emergency room (emergency care only) | You pay 20% after deductible | You pay $250 facility copay (waived if admitted), 20% after deductible | ||||
| Therapy services (outpatient physical, occupational and speech) • 30-visit maximum per year • Excess visits require authorization for medical necessity | You pay 20% after deductible | You pay 40% after deductible | You pay 20% after deductible | You pay 40% after deductible | You pay 20% after deductible | You pay 40% after deductible |
| Mental health and substance abuse treatment | You pay 20% after deductible | You pay 40% after deductible | You pay 20% after deductible | You pay 40% after deductible | You pay 20% after deductible | You pay 40% after deductible |
- The network deductible and out-of-pocket expenses offset the out-of-network deductible and out-of-pocket maximum and vice versa.
- Under the PPO + HCA plan, you don’t need to meet the deductible before prescription drug coverage applies. For the PPO + HSA plans, you pay out-of-pocket for prescription drugs until you meet your deductible. Pre-authorization is required at least one business day before an elective admission and within two business days of an emergency or maternity admission.
- HCA funds cannot be used to pay for flat dollar copays (e.g., for emergency room, if not admitted, and Telemedicine)
Doctor on Demand by Included Health
Gallagher plan members can also take advantage of Doctor on Demand to connect with board-certified doctors via live video right from their phone, tablet or computer. An easy and convenient solution when you don’t have time for an in-office appointment or need care after-hours, Doctor on Demand simplifies the process of caring for yourself and your family. You’ll pay lower fees, too, than you would at an urgent care or most brick-and-mortar doctor’s offices.
Prescription Drug Benefits
To learn more about the prescription drug benefits included in your BCBSIL medical coverage, visit the Prescription Drug Coverage page.
Health Savings Account & Health Care Account
To learn more about the monetary account and company contributions that are included in your BCBSIL medical coverage, click here to view the Health Savings Account & Health Care Account page.
Find a Provider
There are two ways you can find an in-network provider.
- Call Blue Cross Blue Shield at 800.203.3765
- Visit bcbsil.com/ajg, click “Doctors and Hospitals” and select your area of residence under the Provider Finder section
If you do not see your state/location, click on “Members living in all other locations.” (California residents, enter the prefix “GMB” when prompted.)
Provider details
Transition Timeline
View key milestones and dates so you can plan ahead with confidence.