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Wisconsin Department of Employee Trust Funds header image It's Your Choice 2018 State of Wisconsin Group Health Insurance Program
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2018 It's Your Choice - State of Wisconsin Group Health Insurance for Employees and Retirees

Wisconsin Department Of Employee Trust FundsIt's Your Choice 2018


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

How To Choose Your Benefits

You may enroll or change your benefits during the annual It’s your Choice open enrollment period, when you start a new job, or when you experience a life event. The Take Action checklist, e-Learning module and printable worksheet will walk you through choosing your benefits during one of these events.

View 2018 Important Changes
eLearning
View Choose Your Benefits
eLearning
Print Checklist Includes room for notes!

Compare the plan design available to you:

View Plan Design eLearning (Active Employees not on Medicare) View Comparison Chart (Active Employees and Retirees Without Medicare) View Comparison Chart (Retirees With Medicare)

Key Factors to Consider:

  • Monthly Payment (Premium)
  • Premiums can change every year. Review your premium for next year.

    Generally, the less you pay per visit, the more you pay per month for your premium. If you choose a high deductible plan, which has a lower premium, consider putting the premium savings in a Health Savings Account (HSA) pre-tax to pay for health care services.

    If you choose a High Deductible Health Plan (HDHP), you must enroll in a Health Savings Account (HSA) every year, even if you don’t make any contributions yourself. See the HSA page for eligibility information and possible tax advantages.

  • Cost-Per-Visit (Deductibles & Copays)
  • How often do you visit your doctor? Do you need surgery next year? Review the breakdown of your costs by plan design (Active Employees and Retirees Without Medicare) (Retirees with Medicare).

    With a High Deductible Health Plan, the medical deductible must be met before copays and coinsurance begin.

    Example: Before meeting his $1,500 deductible, Joe must pay the full cost of the office visit, including any services or labs. After his deductible, he will only be responsible for 10% of his medical costs.

    With a non-high deductible plan, office copays begin before the deductible is met.

    Example: Maria chose a health plan with a $250 deductible. Before meeting her deductible, she will pay a $15 copay for an office visit plus the costs of any labs or services. After her deductible, she will continue paying the office visit copay but only be responsible for 10% of labs and services costs.

  • Out-Of-Network Availability
  • Do you or your dependent(s) need access to a doctor outside of the health plan’s service area or out of state? Review the Access Plan options.

  • No matter which plan design or health plan you choose, the benefits are the same (Uniform Benefits).

Retirees eligible for Medicare must:

  1. Enroll in Medicare Parts A and B.
    • Medicare Part D enrollment is automatic through the State Group Health Insurance Program.
  2. Notify ETF immediately or your Medicare coordinated coverage may be delayed.

Medicare will be the primary payer of your covered medical services and prescription drugs.

Our interactive map shows available health plans by county. Results include major health care systems and provider directories. Keep travel time in mind if you select a plan that’s not offered nearby.

A few questions to keep in mind:

  • Is your health plan available next year? Health plans may merge or change their service areas. Review important changes.
  • Have your premiums changed?
  • Is your doctor, clinic and hospital still covered? Verify with the provider directory find provider iconfound on the interactive map.
  • All health plans offer the same benefits package, but are there additional services, requirements or programs that are important to me? Check out Available Health Plans.
  • How satisfied are current health plan participants? Compare health plan report cards.    

Supplemental benefits such as dental, vision, long-term care and employee reimbursement accounts are a great way to add coverage and put more money in your pocket through pre-tax savings.

Things to consider:

  • Do you want basic dental coverage (Uniform Dental Benefit)?
    • Only available if you enroll in health insurance. Your dental coverage will mirror your health coverage (ie: individual/family).
    • Included as part of your premium if you choose your health plan with dental.
  • Will you need additional dental coverage for a crown, root canal, bridge, dentures or orthodontics?
  • Do you need any additional benefits such as vision, long-term care or AD&D? See all options on the Supplemental Benefits page.
  • Active state employees: Enroll in an employee reimbursement account to set aside money pre-tax to pay for health care, dependent care and parking/transit expenses.

Employee Reimbursement Accounts

You must re-enroll every year to continue participation. Elections do not carry forward from year to year.

Made your decisions? Visit the Enrollment page for instructions on how to enroll.

Questions? Active employees: Contact your employer benefits specialist. Retirees: Contact ETF.

red envelope image Sign up for What's New and IYC E-Alerts: Health & Wellness along with any other topics of interest.

OPT-OUT INCENTIVE: ANNUAL ACTION NEEDED

If you are declining health insurance and electing to receive the $2,000 opt-out incentive payment in 2018, you must complete a paper Health Insurance Application/Change (ET-2301) form and submit to your payroll or benefits office during open enrollment, or check with your employer to see if you can opt out electronically. You may be required to provide proof of other minimum health care coverage for yourself and your dependents.

Note: This is an annual requirement. See eligibility requirements.

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: 10/5/2017 7:07:16 AM