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Page numbers referenced within this brochure apply only to the printed brochure

Health Alliance HMO

www.healthalliance.org
Customer Service 1-800-851-3379

2023



IMPORTANT:
  • Rates
  • Changes for 2023
  • Summary of Benefits
A Health Maintenance Organization Standard Option Plan

This plan’s health coverage qualifies as minimum essential coverage and meets the minimum value standard for the benefits it provides. See Page 9 for details. This plan is accredited. See Page 13.

Serving: Central, East Central, North Central, Southern and Western Illinois; Western Indiana; and Central and Eastern Iowa

Enrollment in this Plan is limited. You must live or work in our geographic service area to enroll. See Page 15 for requirements.

Enrollment codes for these plans:
   K84 Standard Option- Self Only
   K86 Standard Option-Self Plus One
   K85 Standard Option- Self and Family
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