Local Health Employers
Vol. 22, Local J
August 16, 2005
Consider WPE Group Health Insurance Program Options for
Local government employers participating in the Wisconsin Public
Employers (WPE) Group Health Insurance Program available through
the Department of Employee Trust Funds (ETF) are invited to consider
electing from the following health program options available for
plan year 2006:
- A Standard Plan that is a preferred provider plan (PPP) administered
by Wisconsin Physician Service (WPS) Health Insurance, as an option
to the classic fee-for-service Standard Plan.
- A deductible option for both Uniform Benefits and the Standard
Plan or the Standard PPP, offering premium rates that average
10% below traditional rates.
This bulletin is intended to provide some basic information and
direct you to additional detailed information on selecting the available
You may elect to participate in one of the following options, effective
January 1, 2006, instead of the current benefit option in which
you currently participate:
- Standard PPP - The Standard PPP option, available at a lower
premium rate, allows participants to see any provider of their
choice, but with differences in reimbursement depending on whether
participants go to an in-network or an out-of-network provider.
- A deductible option for your employees and annuitants, in lieu
of the “traditional HMO” benefit plan and the Classic
- The Deductible Uniform Benefit option: This option has an up-front
deductible of $500 individual / $1000 family per calendar year
for medical services. (Note: The deductible does not apply to
pharmacy benefits.) Once the deductible has been met, the traditional
benefits are administered as described for each plan.
- The Deductible Standard Plan: This program continues to offer
participants the choice to see any provider with up-front deductible
and coinsurance amounts on all medical services. (The Classic
Standard Plan has deductible and coinsurance amounts on major
medical services only.)
- The Deductible Standard PPP: This PPP program operates as the
Standard PPP, but has a larger deductible to allow greater premium
Listed below are the options available to employers for plan year
- Traditional HMO Option paired with the Classic Standard Plan
- Traditional HMO Option paired with the Standard PPP
- Deductible HMO Option paired with the Deductible Standard Plan
- Deductible HMO Option paired with the Deductible Standard PPP
What Must I Do Now?
- If you wish to remain in your current benefit plan, do nothing.
- If you wish to offer a different benefit plan to employees and
annuitants, you must file a new
resolution (attached to this bulletin) to select your new
choice. The resolution must be received by ETF by October 1, 2005,
for coverage effective January 1, 2006.
For more information on the WPE Group Health Insurance Program
options, contact ETF’s Employer Communication Center at (608)
264-7900. Information regarding the WPE Group Health Insurance Program
and other benefit programs is also available on our Internet site
This chart summarizes these non-Medicare
benefit options available January 1, 2006.