Yes. The employee and covered spouse can change their Primary Care Clinic/Physician once a year by contacting ACTIN Care Groups directly.

No. Covered dependent children can see any of the contracted Primary Care Clinic/Physicians.

Yes, you need to obtain a referral from your Primary Care Clinic/Physician or ACTIN to see a Specialist. The fee for not preauthorizing a specialist visit is $75 in addition to applicable Coinsurance per visits. Even though you pay the fee expenses, they do not count toward the out-of-pocket limit. You can obtain a referral authorization from your doctor or by calling ACTIN at 888-830-1664.

To avoid unexpected costs, notify us when a member is a STUDENT living OUT OF AREA.

IN-NETWORK Urgent Care providers are in the First Health Complementary Network when traveling outside the following counties: Boone, Cook, Dekalb, DuPage, Kane, Kankakee, Lee, McHenry, Stephenson, Will, and Winnebago (The First Health Network logo and contact information will be on the ID Card for you to access.) You can search https://www.firsthealthcomplementary.com to find a First Health urgent care center outside the Chicago/Rockford areas.

You are covered at any Emergency Department if the condition is an emergency and could not have been cared for by your doctor, Teledoc, or Urgent Care. Emergency Room Care includes a facility copay plus coinsurance. The copay is waived if you are admitted.

Your covered dependent residing more than 25 miles from the Employer’s zip code six months of the year or more can access Providers under the First Health Complementary Network (The First Health Network logo and contact information will be on the ID Card for you to access). The URL for provider look-up is https://www.firsthealthcomplementary.com. If the covered dependent does NOT access a First Health PPO provider, you will be responsible for the full charges.