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Employer Bulletin

All Employers
Vol. 17, No. 20
October 2, 2000

Application Processing Instructions Provided for Dual Choice 2001

Application Processing Instructions Provided For Dual-Choice 2001

The Department of Employee Trust Funds (ETF) has developed special health insurance processing instructions for use during the 2001 Dual-Choice Enrollment period, October 2-20, 2000. These instructions will help you streamline the processing of Dual-Choice Health Insurance Applications (ET-2301 for state and local government employees; ET-2302 for University of Wisconsin graduate assistants) and Health Insurance Information Change forms (ET-2329) during this busy time of the year.

Please process your Dual-Choice applications for the year 2001 as follows:

  1. Verify that the employee has completed the application in its entirety. If an HMO is selected, there must be a Physician Name, County and Provider Number on the application.
  2. IMPORTANT NOTE: Due to new system developments and processing changes, you must complete the Employer Section on all application forms. Bundles of applications (ET-2301, ET-2302 and ET-2329) with prepared cover sheets supplying employer information will no longer be accepted.
  3. Complete the Employer Portion of the application and provide the following information on each Dual-Choice 2001 Health Insurance Application:
    • Enrollment Type 40 = Dual-Choice; 43 = Change from Single to Family
    • Employee Type
    • Coverage Code
    • Carrier Suffix
    • Standard Plan Waiting Period if the Standard Plan is chosen
    • Participant County - This county code represents the county in which your employee resides.
    • Physician County - This county code represents the county in which your employee receives primary care.
    • Payroll Representative Signature
    • Telephone Number
    • Name of Employer
    • Employer Number
    • Group Number
    • Date Received by Employer
    • Monthly Employee Share
    • Monthly Employer Share
    • Date Employment Began - This box can be left blank, or insert the date on which employment began with your entity.
    • Event Date = January 1, 2001
    • Effective Date of Coverage = January 1, 2001



    CompcareBlue Southeast


    CompcareBlue Northwoods


    CompcareBlue Northwest


    CompcareBlue Northeast


    Dean Health Plan


    CompcareBlue - Aurora/Family






    GHC - Eau Claire


    GHC - South Central


    Gundersen Lutheran


    Atrium Health Plan




    Prevea Health Systems


    LaCrosseCare Plus


    Medical Associates HMO


    MercyCare Health Plan


    Valley Health Plan


    Network - Fox Valley




    Physicians Plus - South Central


    Unity - UW Health




    Standard Plan - State


    Standard Plan II - State


    State Maintenance Plan (SMP)


    Standard Plan: Dane - Local


    Standard Plan: Milwaukee - Local


    Standard Plan: Waukesha - Local


    Standard Plan: Wisconsin - Local


  4. Separate each type of application form (ET-2301, ET-2302, and ET-2329). Within each form type, separate enrollment type 40 from enrollment type 43. Within enrollment type 40 or 43, separately bundle applications by employee type.
  5. Send the Advanced Carrier ply of your Dual-Choice applications on a weekly basis directly to the plans using the plan addresses attached to this Bulletin. All Advance Carrier plies must be forwarded to the plans by November 10, 2000. This approach will assist ETF in ensuring that your employees receive their new subscriber cards prior to January 1, 2001.
  6. Send the ETF ply of your Dual-Choice applications on a weekly basis directly to ETF. All ETF plies must be forwarded to ETF by November 10, 2000.

We hope these health insurance application processing instructions will help you accomplish your tasks for Dual-Choice 2001 in a timely and efficient fashion. The 2001 Health Insurance Reporting forms, Monthly Coverage Reports and Summaries, and additional reporting instructions will be sent to you in late November.

Remind Employees to contact the plans directly with questions, and provide plans with current mailing addresses.

Employees who request verification or explanation of service area and/or provider availability related to Dual-Choice 2001 must contact the plans directly. In doing so, your employees will receive the most up-to-date information regarding providers or service areas.

PLEASE NOTE: In order to receive information pertinent to the Group Health Insurance Programs administered by ETF, your employees must identify themselves as a State of Wisconsin Plan employee (State and University of Wisconsin employees), or a Wisconsin Public Employer Plan employee (local government or school district employees).

Please remind your employees who participate in the Group Health Insurance plan they are responsible for providing their current mailing addresses to their respective plans. The plans will take employee address information over the telephone and report any changes to ETF. Plans often tell us they are unable to contact current subscribers due to incorrect addresses on file. Once mailing addresses are updated, employees will receive provider information in a timely fashion. This includes information related to student status, which will enable dependents to continue their current health insurance.

If you have questions related to Dual-Choice or questions about health insurance eligibility and reporting, please contact the Employer Communication Center at (608) 264-7900.

Local Government Employees and UW Graduate Assistants

The 2001 It's Your Choice booklets for local government employees and UW graduate assistants contain a Health Insurance Application for continuants and annuitants in Section G. These applications (ET-2334 in the local government booklet and ET-2332 in the UW graduate assistant booklet) are to be used only by inactive employees and annuitants that pay their health insurance premiums directly to the plan. These applications are not to be used by your active employees.

Active employees must complete the Group Health Insurance Application (ET-2301 for local government employees; ET-2302 for UW graduate assistants) and submit the applications to you. If an active employee incorrectly completes the application in Section G and submits it to you, record the date you received the incorrect application (for deadline filing purposes). Then, have the employee immediately complete the proper application and submit it to you for completion of the employer section and distribution to ETF and the plans.

If one of your employees submits an incorrect application directly to ETF in error, ETF will record the date received and return the incorrect application to you so the appropriate application can be completed to ensure the requested Dual-Choice change is made.

Please direct any questions to the Employer Communication Center at (608) 264-7900.


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