Now is a good time to review your employe health insurance needs and compare them to the Wisconsin Public Employers (WPE) information in this Bulletin. The WPE Group Health Insurance Program has been available to local governments since 1987 through the Department of Employe Trust Funds (ETF). Currently, 195 local employers participate. There are approximately 8,000 active and retired local employes and their dependents enrolled in the program.
When an employer joins the program, all Wisconsin Retirement System (WRS) eligible employes must be offered coverage. This eligibility includes WRS retirees covered under your current group health insurance program. The WPE health program has no underwriting and there are no waiting periods for pre-existing medical conditions for eligible employes and retirees who were covered under the employer's prior group health plan.
This Bulletin contains the monthly premium rates for 2000 and a map showing which plans have primary providers, a hospital, pharmacy, chiropractor, and dentist (if applicable) physically located in specific counties. Other plans may have limited provider availability in the county, but do not appear on the map. Each employe has his or her choice of plans offered once a year in October. Employes may elect to change to a different participating plan without restriction, or to change from single to family coverage, effective the following January 1.
The WPE Group Health Insurance program offers three types of plans: Standard Plan (fee for service indemnity), Health Maintenance Organization (HMO) Plans and Preferred Provider Plans (PPP). The Standard Plan is a self-insured health plan, which pools the combined claims experience of all participating local governments. This pool can provide local governments with significant protection from adverse claims experience, reduce costs, and increase negotiating power. Blue Cross & Blue Shield United of Wisconsin provides administrative services for the Standard Plan and State Maintenance Plan (SMP).
The HMO plans include 20 participating health organizations with locations statewide. HMOs provide comprehensive benefits at a lower cost than the Standard Plan in exchange for some health care provider limitations. Except for dental coverage, which may be offered at the discretion of the plan, all employes enrolled in HMOs have the same levels of coverage excluding Group Health Cooperative - South Central. Uniform Benefits were designed to ease employe plan selection and assist ETF's efforts to negotiate quality care at the lowest possible cost. With Uniform Benefits, an HMO can be chosen based on cost, quality of services and access to specific physicians or other health care providers.
HMP-90, a preferred provider plan, also offers the Uniform Benefits package. This plan's benefits remain the same regardless of which provider the employe chooses, but may require certain out-of-pocket expenses when using providers that are not in the PPP network.
For more information on the WPE Health Insurance Program, contact Rick Parpart, ETF, Division of Employer Services, P.O. Box 7931, Madison, WI 53707-7931. Call (608) 267-2198 or FAX (608) 266-5801.
Other Benefit Programs
In addition to the WPE Group Health Insurance Program, ETF administers the Group Life Insurance Program, the WPE Income Continuation Insurance Program and the Wisconsin Deferred Compensation Program. Local government employers who participate in the WRS may join any of these programs.
If you would like more information on any of these benefit programs, complete the form on page three and return it to the Department of Employe Trust Funds, P.O. Box 7931, Madison, WI 53707-7931.