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Employers

Employer Bulletin

Local Employers
Vol. 16, Local G
September 10, 1999

DUAL-CHOICE PERIOD FOR 2000 SET FOR OCTOBER 4-22, 1999

The Group Insurance Board has designated October 4-22, 1999 as the Dual-Choice Enrollment period for coverage effective January 1, 2000. It's Your Choice booklets for the year 2000 will be supplied in sufficient quantities to all employers participating in the Wisconsin Public Employers (Local) Group Health Insurance Program.

This Bulletin contains the following: plan information; application submission deadlines; booklet distribution information; and details associated with rescinding Dual-Choice applications. Individual letters identifying the lowest-cost plan in your service area and 2000 Health Plan Contacts (ET-1728) will be mailed out later this month. ETF will send the monthly reporting forms for 2000 during the second week of November 1999.

Employes with questions regarding network changes should contact their plans. The state map and the Plan Descriptions in It's Your Choice clarify how these changes may impact employes.

Plan Information

The year 2000 plan changes are as follows:

  1. Two Plans No Longer Available:
    • Managed Health Services (carrier suffix .58) no longer available in Kenosha, Milwaukee, Ozaukee, Racine, Washington and Waukesha Counties.
    • North Central Health Protection Plan Southern Region (carrier suffix .51) no longer available in Langlade, Lincoln, Marathon, Portage, Price, Taylor and Wood Counties. North Central Health Protection Plan Northern Region (carrier suffix .52) no longer available in Forest, Lincoln, Oneida and Vilas Counties.

    Current members of these plans must select another for 2000. Both plans will notify current members of the change.

  2. Other Plan Changes
    • The State Maintenance Plan (SMP) will be available in Pierce County.
    • Many plans have changed their service areas. Refer to the map on page A-3 and the Plan Descriptions in It's Your Choice. Verify with your plan that your provider will be available in 2000.

    The following table identifies plan changes specific to certain counties.

    County-By-County Health Plan Changes

    Plan Newly Available No Longer Available County
    Compcare Northwest

    X

      Out of State*
    Compcare Northwoods

    X

      Waupaca*
    Compcare Northwoods  

    X

    Shawano
    Compcare Southeast  

    X

    Jefferson
    Compcare Southeast

    X

      Manitowoc*
    Dean Health Plan

    X

      Kenosha*

    Racine*

    HMP-90 North Central

    X

      Out of State*
    HMP-90 North Central  

    X

    Forest
    Humana/Emphesys- Milwaukee

    X

      Fond du Lac*

    Manitowoc*

    Rock*

    Sheboygan*

    Walworth

    Humana/Emphesys - Wisconsin

    X

      Out of State*
    Humana/Emphesys - Wisconsin  

    X

    Rock
    LaCrosse Care Plus

    X

      Crawford
    MercyCare

    X

      Out of State*
    Network - Community

    X

      Calumet*
    Network - Community  

    X

    Walworth
    Network - Fox Valley

    X

      Portage*

    Sheboygan*

    Network - Fox Valley  

    X

    Columbia
    Prevea

    X

      Marinette
    Security

    X

      Dunn*
    Security  

    X

    Washburn
    United Health of Wisconsin  

    X

    Marinette

    Marquette

    Unity - Community  

    X

    Green Lake

    LaFayette

    Waushara

    Unity - UW Health  

    X

    Dodge

    Fond du Lac

    Plan Name Change

    United Health of Wisconsin (carrier suffix .94) has changed its name to Touchpoint Health Plan (carrier suffix .94). No action by the participant is necessary as a result of the name change.

General Information about Dual-Choice

Dual-Choice provides an opportunity for insured employes to change health insurance plans and/or change from single to family coverage without a waiting period for pre-existing conditions.

Important Note:

Even if employes want to continue participating in their current plan, they should still do the following:

  1. Verify that their current plans will be available in their areas for 2000.

  2. Review the 2000 premiums for any change in the employe share.

  3. Verify that selected physicians, clinics and/or hospitals will be available under their plans in 2000.

  4. Review changes in benefits by reading the "Notable Plan and Program Changes" section and the individual plan descriptions in It's Your Choice.

  5. Call the health plan directly with specific benefit or provider questions.

Completed applications to change plans must be turned in to employers no later than 4:30 p.m., Friday, October 22, 1999.

Employes may select any alternate plan regardless of their resident counties, but should be sure that the providers are within reasonable distance for medical care. It’s Your Choice identifies geographic areas covered by each plan.

The Dual-Choice period for active and retired employes, as well as former employes who have continued their insurance, takes place simultaneously.

ETF and/or the plans will mail It's Your Choice booklets, complete with special application forms, directly to retirees and former employes (health insurance continuants). If you have employes that want to change plans and who will retire effective January 1, 2000 or later, they must complete applications as active employes. Changes in annuitant coverage will be handled by ETF when employes apply for annuitant benefits. However, employers with employer paid annuitants should provide these subscribers with the 2000 It's Your Choice booklets.

NOTE: Forward all "carrier advance registration" copies of the Dual-Choice applications to the plans by Friday, November 5, 1999. Please make sure that the employe selected a primary care physician and that the employer portion of the application is completed.

Specific Instructions

Booklet Distribution

It's Your Choice booklets must be distributed in a timely manner to all insured employes. These include:

  1. Insured employes that have indicated they do not wish to make a change during Dual-Choice. Remind these employes that they remain responsible for understanding the information in the booklet and that it serves as their certificate of coverage if they are enrolled in an alternate plan.

  2. Insured employes on layoff or leave of absence. Employes who have let their health insurance lapse while on leave of absence or layoff should be advised that they are eligible to make a Dual-Choice election within 30 days of returning from the leave or layoff.

ETF does not distribute Health Insurance Applications (ET-2301) in It's Your Choice, due to the small percentage of employes actually electing to change health plans during Dual-Choice. To request these forms, or if you need Health Insurance Information Change forms (ET-2329), contact ETF Supply and Mail Services Section at (608) 266-3302. Indicate your Employer name and Identification Number (EIN), location, form name and number, and the quantity of forms desired. Please indicate that your request is Dual-Choice related.

Procedure for New Employes

New employes initially eligible for coverage on November 1 or December 1, 1999 must file two applications during their regular enrollment period if they wish to enroll in a different plan for 2000. The first application covers the period from the date of initial coverage through December 31, 1999. The second application changes their health insurance to the plan of their choice for 2000, and must have the "Dual-Choice" box checked.

Procedure for Employes Who Terminate in November or December After Making a Dual-Choice Election

For employes terminating in November or December after making a Dual-Choice election, the plan they elected during Dual-Choice is the plan to record in the "plan information section" of the Continuation-Conversion Notice (ET-2311).

If an employe's termination date is such that he or she will still be eligible for health insurance coverage after January 1, 2000, and the employe has also notified your office within 30 days of a move, a new health insurance application must be submitted and the appropriate Transfer, Deletion and Addition Reports attached to the corresponding Coverage Reports. In this instance, the plan information indicated on the Continuation-Conversion Notice (ET-2311) should reflect the new plan.

If an employe's move occurred after the termination date but prior to the date the coverage ends, report the applicable change as you would for any other active employe. However, if the effective date of the move is the same as or after the date the coverage ends, ETF will make the applicable plan contacts.

Procedures for Withdrawing Dual-Choice Elections

Employes may rescind Dual-Choice elections by notifying their employers in writing prior to December 31, 1999. The written request should be filed with the employe's records. When you receive a request to rescind, make two copies of your ply of the Dual-Choice application and write "Rescind" across each copy. Forward one copy to the current plan and the other copy to the plan indicated as "Plan Selected".

Please contact the Division of Employer Services at (608) 264-7900 with all questions associated with health insurance eligibility and reporting, including any concerns related to Dual-Choice or this specific Employer Bulletin.

 

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