Medical Insurance
Medical benefits are provided by AmeriBen using the national
Blue Cross/Blue Shield network.
AmeriBen offers broad, comprehensive coverage for you and your eligible dependents. As a Full-time or Part-time Level I team member, you have your choice between a PPO plan or three High Deductible Health Plans.
Services and Tools to Save You Money
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If you currently receive the wellness incentives for the 2024 plan year, you will automatically receive the discount for 2025, and no further action is required. If you did not participate in the wellness incentives in 2024, you will have a new opportunity to participate for 2025.
If you participate in any company-provided medical plan, you will have the opportunity to lower your base monthly premium by up to $100 per month by completing the requirements for one or both of the following discounts:
TOBACCO FREE
Non-tobacco users or those who have completed a tobacco cessation program within the last three months will receive a monthly $50 tobacco discount off their medical premium.
WELLNESS DISCOUNT
Those who have completed the wellness requirements (biometric screening and completion of the health survey in the wellness portal) with the wellness plan by December 20, 2024 can save $50 per month on medical premiums.
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If you are facing complex health challenges, you may be eligible for care at Mayo Clinic with travel and lodging covered and coordinated for you.
The Mayo Clinic Complex Care Program is an enhanced health care benefit available to eligible employees and dependents for complex medical conditions.
The Mayo Clinic Complex Care Program is for these medical conditions:
Autoimmune disorders
Cancer
Complex pediatric conditions
Gastrointestinal disorders
Hemophilia
Neurological disorders
Spine health
Transplant
Undiagnosed symptoms or conditions
WHAT MAKES CARE AT MAYO CLINIC DIFFERENT?
Effective treatment depends on getting the right diagnosis as soon as possible. Our specialists collaborate across disciplines to listen to your story, evaluate your condition from every angle, and develop a diagnosis and treatment plan that’s just for you.
DOES MAYO CLINIC TREAT MY CONDITION?
Mayo Clinic experts solve the world’s toughest medical problems — one patient at a time. No matter what serious, complex or rare health challenge you’re facing, you can be confident that Mayo Clinic has extensive experience in treating patients with your specific condition.
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Regenexx® - A medical specialty that uses non-surgical regenerative medicine to treat a broad range of orthopedic conditions such as damaged bone, cartilage, muscles, tendons, and ligaments. Available to participants who are enrolled in the ONB medical coverage.
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Old National’s prescription drug plan continues to offer team members the opportunity to reduce your out-of-pocket costs for specialty drugs. The plan includes a program through Paydhealth, called the Select Drugs and ProductsTM Program. Participation is required as a plan member seeking coverage for products included on the Select Drugs and Products List. On this list, are brand name medications for rheumatoid arthritis, cancer, multiple sclerosis, and other conditions typically treated by a specialist. All products included in the program require prior authorization. A case coordinator from the program will assist you with accessing and making these high-cost specialty drugs affordable. The Specialty Contact Center may be reached toll-free at 877-869-7772 from 8 a.m. to 8 p.m. CT, Monday through Friday.
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New for 2025 - MaxorPlus Pharmacy Discount Program - Get the best prices on your medications at participating pharmacies without additional cards or applications to manage.
The medical insurance plans have four tiers of prescription drug coverage: Tier 1, Tier 2, Tier 3 and Tier 4. You may obtain covered prescriptions by having them filled at a participating pharmacy or by mail order.
MaxorPlus’ participating pharmacy network includes more than 67,000 retail pharmacies, including regional and national chains, as well as independently owned pharmacies. To locate a pharmacy near you, log on to www.maxorplus.com and access the online pharmacy locator. You may also contact MaxorPlus Member Services at 1-800-687-0707 and speak with a member advocate to assist in finding a pharmacy near you.
Prescription Mail Order Form - A prescription mail order form may be obtained through the MaxorPlus member services website. Please follow the instructions on the form to submit it to the vendor.
Home Delivery Choice Program - You can have qualifying prescription drugs you take on a routine basis sent to your home through the Home Delivery Pharmacy. Or, you can get them from your local pharmacy. It's your choice. Up to two refills can be obtained from the pharmacy before your decision is made.
Specialty Pharmacy - If you have a long-term health condition that needs to be treated with complex drugs, the specialty pharmacy will work with you to get the best health results from the drug you take. To see a list of specialty drugs that need to be filled through the specialty pharmacy, log on at MaxorPlus.com and go to your personalized pharmacy page.
Preferred Generics - Most times when your doctor prescribes a medication that’s a brand-name drug and it has a generic option, your pharmacy will automatically fill the prescription using the generic drug. And you will pay less for the generic drug. The Preferred Generics program helps you save money when you “prefer a generic” over a brand name.
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As part of Old National’s commitment to health and wellness, team members covered under an Old National medical plan who are not users of tobacco products will be eligible to receive a monthly $50 tobacco discount as a part of their medical premium. Individuals using any form of tobacco products (e.g., cigarettes, electronic nicotine delivery systems, cigars, pipes, plus tobacco products applied to the gums such as dipping, chewing tobacco, or snuff, and/or inhaled tobacco products) four or more times per week will be considered tobacco users for purposes of the discount eligibility.
We encourage team members who use tobacco or other related products, such as e-cigarettes, to use this change as an opportunity to consider the impact the products have on their overall wellness. Tobacco use is the leading cause of preventable illness and death in the United States, costing the country over $175 billion in direct medical care and $156 billion in lost productivity.
Making a lifestyle change and becoming tobacco-free is not easy, and we want to support those willing to do so. Tobacco users who complete the required components of a tobacco cessation program and notify HR Services will have the tobacco discount added on a go forward basis.
For additional details see the list of tobacco cessation programs and resources available.
Plan Information
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Medical insurance premiums for qualified Old National team members are divided into two coverage tiers based on salary. Premium costs within each tier will vary based on the plan chosen and whether a team member elects individual or family coverage. With this tiered approach, premium costs are balanced across Old National's team member base. Team members in the lowest tier who elect a coverage that includes children will receive a greater employer contribution, comparatively speaking, than the higher income tiers. Couples where both spouses/partners work for Old National and both are enrolled in an ONB medical insurance with team member & spouse or family coverage, plan will use the premium for the tier in which the highest wage earner falls. See Plan Documents on this page for Monthly Rates.
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The medical insurance plans have two levels of coverage. You will enjoy “Network” coverage when you receive medical services from doctors and hospitals that participate in the Anthem BCBS Network. “Non-network” coverage is a lower level of coverage that you receive when you obtain care from doctors and hospitals that do not participate in the plan’s network.
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A PPO plan pays a portion of your eligible medical expenses after you meet the annual deductible each year. If your portion of the co-insurance expense (your “our-of-pocket” expense) for medical claims reaches a certain dollar amount during the plan year, then the plan will pay 100% of your eligible costs for the remainder of the plan year for expenses requiring a co-insurance payment. If you are enrolled in Team Member & Spouse, Team Member & Child(ren), or Family coverage, the deductible and out-of-pocket amounts can be satisfied by any combination of family members but an individual would never satisfy more than their own individual amount (embedded).
The medical co-pay amounts do not count toward the annual deductible amount. However, they do count toward the maximum out-of-pocket.
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A High Deductible Health Plan (HDHP) requires the enrollee to pay for most medical and all prescription drug expenses up to a certain dollar amount before the plan begins to cover them. It is intended to protect you should you experience a major (or catastrophic) health care event.
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You are free to choose any doctor or hospital. You or your doctor should call the pre-certification number listed on your plan ID card before any hospitalization.
Search the provider directory for your doctor, hospital or other health care provider. You should contact your provider to ensure that they will continue to participate in Blue Cross/Blue Shield Network during the plan year.
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You may contact AmeriBen's customer service at (844)209-0080 for questions regarding eligibility, claims, ID cards or for specific coverage information.
Membership Information - request an ID card, view claims, check eligibility, review deductibles and maximums.
New ID cards will be issued to new members and team members who change plans and/or coverage levels. The new ID cards will be mailed to associates prior to January 1.
Downloadable Forms & PDF's
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2025 Monthly Medical Rates Tiered - With Discounts (pdf) (68KB)
2025 Monthly Base Medical Rates - Tiered (pdf) (42KB)
2025 RATES - Dental, Vision, Life, CI, Accident, HI (pdf) (148KB)
2024 Medical Rates Monthly - with Discounts (pdf) (68KB)
2024 Base Medical Rates Monthly - Tiered (pdf) (59KB)
2024 Rates Dental, Vision and Supplemental Coverages (pdf) (148KB)
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2025 ONB HDHP 3500 SBC (pdf) (344KB)
2025 ONB HDHP 4000 SBC (pdf) (343KB)
2025 ONB PPO 1250 SBC (pdf) (351KB)
2025 ONB HDHP 2250 SBC (pdf) (364KB)
2025 Medical Plan Summary (pdf) (167KB)
2025 Benefits Guide (pdf) (2170KB)
2024 Benefits Guide (pdf) (3757KB)
2024 ONB SBC PPO 1000 (pdf) (354KB)
2024 ONB SBC HDHP 2000 (pdf) (349KB)
2024 ONB SBC HDHP 3200 (pdf) (349KB)
2024 ONB SBC HDHP 4000 (pdf) (348KB)
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2025 ONB Preventive Maintenance List (pdf) (178KB)
2024 Preventive Maintenance list (pdf) (197KB)
MyAmeriBen Mobile (pdf) (668 KB)
MyAmeriBen Login Instructions (pdf) (169 KB)
AmeriBen Case Management (pdf) (1108KB)
AmeriBen Dialysis Treatment (pdf) (375KB)
AmeriBen Maternal Health Program (pdf) (553KB)
PaydHealth (pdf) (237KB)
PaydHealth FAQ (pdf) (473KB)
Live Health Online - How to Register (pdf) (325KB)
Regenexx (pdf) (85KB)
Mayo Clinic Complex Care FAQ (pdf) (466KB)
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The Women's Health & Cancer Rights Act (WHCRA) (pdf) (88 KB)
Notice of Privacy Practices (pdf) (155 KB)
2022 SMM for Window Severance Pay Plan (pdf) (395 KB)
Chip Model Notice (pdf) (178 KB)
Initial Notification of COBRA Rights (pdf) (137 KB)
Health Insurance Marketplace Notice (pdf) (482 KB)
Medicare Part D Non-Creditable coverage notice (pdf) (312 KB)
See Your Current Coverage Online or on your mobile device!
If you are enrolled in this benefit, you may view your current coverage by accessing the ADP mobile app or MyONB portal. The portal may be accessed from the home page of the intranet or at MyADP.com. Once you log onto the portal, select Benefits from along the top of the screen, then Health & Welfare. Select View Benefits on the Current Benefits card to access your Benefits Summary.