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.
FOR RETIREES WITHOUT MEDICARE
Check out the complete Comparison of Medical Benefits Chart.
FOR ALL STATE RETIREES
Prescription Drug Costs
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 unless you file an application to opt out.
If you are enrolled in It’s Your Choice Medicare Plus, you will have Uniform Dental Benefits available to you beginning in 2016. If you do not want Uniform Dental Benefits beginning on January 1, you must file an application to opt out durring open enrollment.
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.
Note: It’s Your Choice Medicare Plus pays only for services that Medicare covers. Medicare covers some habilitation services and is potentially adding coverage for advance care planning. Please contact WPS at 1-800-634-6448 if you have specific questions about these benefits.
Plan Design Names Changing
The health plan design names are changing.
Health Plan Changes to Note
Coverage end date in case of 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.
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