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Wisconsin Department of Employee Trust Funds header image It's Your Choice 2017 State of Wisconsin Group Health Insurance Program
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2017 It's Your Choice - State of Wisconsin Group Health Insurance for Employees and Retirees

Wisconsin Department Of Employee Trust FundsIt's Your Choice 2017


State of Wisconsin
Group Health Insurance Program
(State Employees, Retirees, Continuants and Graduate Assistants)

HDHP Health Insurance Option With HSA

Important Health Savings Account News & Notes

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.

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) 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 plan offers a lower monthly premium cost and pairs with a Health Savings Account (HSA).If you decide to enroll in the HDHP, you must open and contribute to the HSA. Many members contribute the money they save on their health insurance premiums to their HSA. If you are eligible, your employer may contribute up to $750 individual/$1,500 family.

IYC HDHP Annual Medical Deductible

Coverage Level

2017 Deductible Amount

2016 Deductible Amount

Individual Plan

$1,500

$1,500

Family Plan

$3,000

$3,000

For benefit information, see the Comparison of Medical Benefits chart.
For pharmacy benefit information, see Pharmacy Benefits Plan Comparison chart.

IT’S YOUR CHOICE ACCESS HIGH DEDUCTIBLE HEALTH PLAN

It’s Your Choice Access High Deductible (IYC HDHP) 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 plan offers a lower monthly premium cost and pairs with a Health Savings Account (HSA). If you decide to enroll in the HDHP, you must open and contribute to the HSA. Many members contribute the money they save on their health insurance premiums to their HSA. If you are eligible, your employer may contribute up to $750 individual/$1,500 family.

IYC Access HDHP Annual Medical Deductible



Coverage Level

2017 Deductible   In-Network

2017 Deductible
Out-of-Network

2016 Deductible  In-Network

2016 Deductible Out-of-Network

Individual Plan

$1,700

$2,000

$1,700

$2,000

Family Plan

$3,400

$4,000

$3,400

$2,000

For benefit information, see the Comparison of Medical Benefits chart.
For pharmacy benefit information, see Pharmacy Benefits Plan Comparison chart.

 

IYC HDHP Program Facts

High Deductible Health Plan with HSA: 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, are eligible to participate.

Limited Term Employees (LTEs) who are eligible for the State of Wisconsin Group Health Insurance Program are eligible to participate.

Retirees younger than age 65 are eligible to participate.

To enroll in an HDHP with HSA, you must be enrolled in the one of the High-Deductible Health Plans (HDHP) and the Health Savings Account. In addition:

  • You cannot have any other health coverage that pays for out-of-pocket health care expenses before you meet your plan deductible, including Medicare A and B.
  • You cannot be covered by TRICARE.
  • You cannot have accessed your Veterans Administration (VA) benefits in the past 90 days (to contribute to an HSA). Exceptions may apply. See the HSA Participant Guide (coming soon) for more details.
  • You cannot be claimed as a dependent on another person’s tax return (unless it’s your spouse).
  • You (and your spouse) cannot have a Health Care FSA in the same year.
  • Important note: You must notify ETF of any other medical coverage when enrolling in, and at any point while enrolled in, the HDHP and HSA.

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. For pharmacy benefit information, see Pharmacy Benefits Plan Comparison chart.

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. If you are enrolled in a family plan, the entire family deductible must be met before coverage begins.

You Must Open and Contribute to the HSA

A Health Savings Account (HSA) is an individually-owned savings account that you must enroll in if you are enrolled in one of the High Deductible Health Plans. This benefit is established exclusively for the purpose of paying qualified medical expenses. For more information, see Health Savings Accounts Program.

Disclaimer:
Every effort has been made to ensure that this information is accurate, but may be subject to change. Please note revision dates located at the bottom of each page. In the event of conflicting information, federal law, state statute, state health contracts and/or policies and provisions established by the State of Wisconsin Group Insurance Board shall be followed.

This page was last modified on: 11/1/2016 2:08:28 PM