It's Your Choice 2016
State of Wisconsin
Group Health Insurance Program
(State Employees, Retirees, Continuants and Graduate Assistants)
What is changing in 2016
Whether you are satisfied with your current health plan, looking to make changes to your current coverage or are a new employee, you should know what is changing for 2016. Read this section and see if there are changes that affect you. At minimum you should confirm your current health plan service area and provider network is available for 2016.
The Uniform Dental Benefit will be offered by Delta Dental instead of through health plans. You will automatically be enrolled in your current health plan with Uniform Dental Benefits if you do not make any changes, or opt out, for 2016. To opt out for the plan year beginning January 1, 2016, you must file an application/change form to opt out during open enrollment.
Medical & Prescription Drugs
Check out the complete Comparison of Medical Benefits Chart.
Habilitation services are now covered. These services help you learn or improve skills and functioning for daily living. Advance care planning and/or a palliative care consultation should be offered to participants facing a serious illness and survival of less than 12 months so they are fully informed of care options. Advance care planning is a new covered benefit for any participant who is diagnosed with a terminal illness.
Plan Design Names Changing
The health plan design names are changing.
Increased HSA Employer Contribution
For 2016, employers will increase their health savings account contribution to $750 per individual/$1,500 per family for those enrolled in the high deductible health plans. HSA employer contributions will be spread out on your paychecks throughout the year.
Group Health Insurance Opt Out Option
You may be eligible receive $2,000 from your employer if you opt out of state group health insurance coverage. Contact your employer to see if you are eligible.
Health Plan Changes to Note
New effective date for new hires: Coverage will now be effective on the first of the month on or following your hire date, or on the date that you are eligible for an employer contribution. Previously, the effective date was the first of the month following your employer’s receipt of your completed application.
New effective date for employees eligible for an increase in employer contribution: Coverage will now be effective on the first of the month following the date in which you become eligible for an increase in employer contribution. Previously, the effective date was the first of the month following your employer’s receipt of your completed application.
Coverage end date in case of employee death: In the event you should pass away, your coverage will cease at the end of the month of your death and continuation for your surviving dependents will begin the first of the month following. Previously, the effective date was dependent on whether premiums had been deducted.
Move to a new county: If you move to a new county you can now switch to any health plan. Previously, you were limited to the health plans offered in the new county.
Dependents only covered once: Dependents can only be covered once within the program (including state or local). If determined that a dependent is double-covered, the members will have 30 days to determine who will cover the dependent and then one must file an application dropping the coverage. Previously, there was no double-coverage restriction.
Removal of six month waiting period for life insurance and income continuation insurance (ICI): There will no longer be a six month waiting period for ICI and life insurance to become effective. This is effective January 1, 2016 for all employees with a hire date of July 1, 2015 or after.
Participation of Adult Children in Well Wisconsin: Effective January 1, 2016, adult children will no longer be eligible for the Well Wisconsin Incentive program. The incentive will continue to be available for active employees and retirees participating in the State of Wisconsin Group Health Insurance Program and their enrolled spouse/domestic partner. This is the result of the Equal Employment Opportunity Commission’s (EEOC) recent ruling on the applicability of Genetic Information Nondiscrimination Act (GINA) to employee wellness programs and the proposed rule amending GINA to allow spouse participation.
This page was last modified on: 1/25/2016 10:44:23 AM