ACA Reporting 1095-B and 1095-C

Employees enrolled in a PDRMA Health medical plan in 2023 that wish to obtain their 2023 Form 1095-B and COBRA or IMRF continuation participants that wish to obtain their 2023 Form 1095-C should contact their agency Health Benefits Coordinator or submit a request to lreid@pdrma.org of PDRMA Health at 2033 Burlington Ave. Lisle, IL 60532 or 630.435.8998.

ACA Transparency in Coverage

The Transparency in Coverage Rule requires health insurers and group health plans such as PDRMA Health, including those that are self-funded, to provide access to cost-sharing data. PDRMA Health and our BCBSIL partner are committed to providing our health plan participants with the cost information they need to make informed decisions about their healthcare.

We maintain our Transparency in Coverage compliance by providing our in-network negotiated payment rates and out-of-network allowed amounts for covered items and services to the public in machine-readable file format. BCBSIL hosts and updates these files monthly and can be accessed by clicking here.

HIPAA Notice of Privacy Practices

To learn how PDRMA Health protects the privacy of health and medical information under the Health Insurance Portability and Accountability Act (“HIPAA”), click here.

No Surprises Act

When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing. Click here to learn more about balance billing and how PDRMA Health complies with this act.