Vol. 18, State E
October 10, 2001
EPIC Correction and ERA Administrative Fee Suspended for
Correction Regarding Eligibility for EPIC Dental, Excess
Medical and AD&D Coverage
The informational material recently printed by the EPIC Life Insurance
Company for the upcoming special enrollment opportunity included
an incorrect statement regarding eligibility for enrollment.
Enrollment in a Standard Plan or a Group Insurance Board HMO is
not required to be eligible for EPIC insurance.
The statement on the third page of the four-page brochure (E11575-0107)
says in bold "Note: You must be covered under a State
Base or Standard Plan to be eligible for this coverage."
There will be no change from existing practice. An employee does
not have to be enrolled in a Board plan, but does
have to be eligible for enrollment in a Board plan. However, you
should advise employees electing EPIC coverage who are not covered
by a Board plan, that their EPIC benefit level will be determined
as if enrolled in the Standard Plan.
The "State Base or Standard Plan" refers to the plans
offered by the Group Insurance Board, and includes all versions
of the self-insured plans offered to State employees as well as
the health maintenance organizations that have elected to participate
in the program.
If you have any questions regarding this, contact Steve Grob at
the Department of Employee Trust Funds, (608) 266-3099.
Employee Reimbursement Accounts (ERA) Program Administrative
Fee Will Be Suspended in 2002
The Employee Reimbursement Accounts (ERA) Program administrative
fee will be suspended for the 2002 plan year.
The administrative expenses incurred by the ERA program are funded
through three sources: account forfeitures, interest income, and
fees contributed by each state agency. Wis. Stat. §40.875(1)(a)
authorizes the Department of Employee Trust Funds (ETF) to determine
the fee amount that is equal to each state agency's share of the
Since the ERA program began in 1990, state agencies have contributed
a monthly fee for each health insurance contract that has an employer-paid
share reported to ETF. Despite a decrease in the administration
fee in 2001, the reserve balance in the ERA account has grown to
an amount that exceeds the targeted amount. To reduce the balance,
ETF will suspend the fee effective with the health summary report
due December 20, 2001 for January 2002 coverage. The balance will
be reviewed next year and a determination regarding the administration
fee for 2003 will be made at that time.
For more information about the administrative fee structure, contact
Marcia Blumer at (608) 266-2640. If you have questions about reporting
and transmitting the fee with the State Health Insurance Summary
(ET-1608) form, contact Ron Diehl, Division of Employer Services
at (608) 266-2737.