Employer Bulletin

State Agencies
Vol. 18, State E
October 10, 2001

EPIC Correction and ERA Administrative Fee Suspended for 2002

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 program costs.

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.