It's Your Choice 2016
State of Wisconsin
Group Health Insurance Program
(State Employees, Retirees, Continuants and Graduate Assistants)
HDHP Health Insurance Option With HSA
There are two different high deductible health plan (HDHP) options available to you:
It's Your Choice High Deductible Health Plan
The It's Your Choice High Deductible Health Plan (IYC HDHP)—formerly the High Deductible Health Plan—provides the same uniform benefits package and health plan providers as the It's Your Choice Health Plan. The difference is that this plan option has a higher deductible and out-of-pocket limits. In exchange for the increased cost sharing, this design is paired with a required Health Savings Account into which your employer deposits money, if you are eligible. This plan offers a lower monthly premium cost.
It's Your Choice Access High Deductible Health Plan
The It's Your Choice Access High Deductible Health Plan (IYC Access HDHP)—formerly the High Deductible Standard Plan—provides freedom of choice for doctors and hospitals across the country, along with a higher deductible and out-of-pocket limits. In exchange for the increased cost sharing, this design is paired with a required Health Savings Account into which your employer deposits money, if you are eligible. Your monthly premium contribution amount is less than the It's Your Choice Access Health Plan.
IYC HDHP Program Facts
The IYC HDHPs will be offered through each of the health plans that are a part of the State of Wisconsin Group Health Insurance Program. Each health plan’s HDHP option will provide a uniform set of benefits.
An HDHP is a health plan that, under federal law, has a minimum annual deductible and a maximum annual out-of-pocket limit.
An HDHP generally begins paying for health care costs once the annual deductible has been met (except for preventive services mandated by federal law).
Preventive services mandated by federal law are covered at 100%, regardless of the deductible.
The plan is designed to offer a lower monthly premium in exchange for more shared health care costs by the member.
Program Annual Deductibles
When Deductible is Met
When the deductible is met, office visit copayments or coinsurance apply. The deductible does apply to pharmacy benefits. After the deductible is met, pharmacy copayments and coinsurance apply up to the out-of-pocket limit. In a family plan, the entire $3,000 deductible must be met before coverage begins.
IYC HDHP Benefits
Check out the comparison of benefits for details on HDHP benefits for both plan designs.
The full Certificates of Coverage can be found above, under the Benefits tab.
A health savings account (HSA) is a savings or investment account set up to pay for health care expenses or to save for future health care expenses. HSAs are owned by the individual employee and balances roll over annually. In addition, the funds in an HSA are portable, meaning that the employee keeps them if they leave the health plan or state service.
HSA Quick Facts
This is the amount your employer will deposit to your HSA in 2016, if you are eligible.
HSA Contribution Limits
This is the total amount that the IRS allows to be contributed to an individual HSA during 2015. If a married individual’s spouse also has an HSA, the two can only contribute up to the total contribution limit between the two HSAs.
* Contributions from all sources, such as employee and employer, count towards meeting the annual contribution limits.
Employer HSA Contribution Eligibility
Only active employees who are participating in the HDHP and HSA will be eligible for an employer HSA contribution. When an employee leaves state service (including retirees), they will become responsible for paying all fees associated with the HSA. The monthly maintenance fee is $3 per month and is automatically deducted from the account. HSAs with a zero balance for 90 days will be automatically closed.
Employer HSA Contribution Timing
State employer HSA contributions in 2016 for employees who are paid biweekly will be provided in 24 payments. For employees who work for agencies covered by STAR, these payments will occur on the first two checks payable within the month. Employees paid monthly will receive one payment per month. Employees changing coverage due to a qualifying event, or those obtaining state coverage after January 1, will receive the full annual employer contribution amount spread out in equal amounts over the remaining eligible paychecks in the calendar year. Employees who leave state service will not receive any payments that would have occurred on future paychecks.
Use of HSA Funds
You can use the funds* in your HSA to pay for qualified medical, dental and prescription drug expenses for yourself and your eligible tax dependents. You can find a list of qualified expenses and the definition of eligible tax dependents at etf.wi.gov.
*HSA funds will only be available as they are contributed.
Important Information for RETIREES
Retirees are required to have an active State HSA if they are enrolled in an HDHP. Retirees are responsible for the $3 per month account maintenance fee. Retirees must keep adequate funds in the account to cover the $3 monthly fee. HSAs with a zero balance for 90 days will be closed automatically. If the account is not active, you will no longer be eligible for the HDHP.
The State of Wisconsin sponsored HSA will be administered by Total Administrative Services Corporation (TASC). You can visit the TASC website at tasconline.com to learn more about HSAs, and to enroll. To enroll online, you will need a registration code. Please contact your employer for that registration code. A TASC representative will be available at many of the fall benefit fairs.
How to Enroll
The HSA Program requires re-enrollment for 2016.
The Open Enrollment period for the 2016 Plan year is October 5th to October 30th, 2015. You are encouraged to enroll online, but can enroll via telephone or paper application.
By October 30th, you will need to complete the following actions:
For detailed plan information and an online enrollment guide, please click the Tools and Support tab after logging in.
Enrollment Help & Questions: If youb have difficulties logging on, enrolling online or have questions, you can contact a TASC Customer Representative at 608-241-1900 or toll-free at 844-786-3947
New Mobile Application
In order for you to be able to access your 2015 benefits, you will use the current 2015 mobile application.
TASC Debit Card for 2016
HDHP and HSA Eligibility
Who is eligible?
State employees, except those who are eligible for the graduate assistant/short term academic staff benefits package and are not in the Wisconsin Retirement System.
Limited Term Employees (LTEs) who are eligible for the State of Wisconsin Group Health Insurance Program.
Retirees younger than age 65.
Who is Ineligible?
See the employee contribution rates and the premium rate charts, under Health Plan Options above, to compare HDHP and HSA rates with traditional rates.
Limited Purpose Flexible Spending Account
Individuals who enroll in the HDHP and HSA are not allowed to have a regular health care flexible spending account (FSA), otherwise known as an employee reimbursement account (ERA), according to IRS rules. This is because FSAs are considered to be disqualifying “other” insurance coverage by the IRS. Therefore, ETF will offer a Limited Purpose Flexible Spending Account (LPFSA). An LPFSA can be used for vision, dental and post-deductible expenses only. The annual contribution limit for an LPFSA is $2,500, the same as a regular health care FSA. The LPFSA is new for 2015 and will also be administered by TASC.
This page was last modified on: 12/18/2015 9:30:23 AM