It's Your Choice 2018
State of Wisconsin
Group Health Insurance Program
(State Employees, Retirees, Continuants and Graduate Assistants)
Important Changes for 2018
Health Plan Changes
There are several changes to the available health plans for 2018. Use the interactive map to find health plans and covered providers where you live or receive care.
Health Plans No Longer Available
If you are currently enrolled in any of the following health plans, you will need to choose a new plan for 2018:
Health Plan Name Changes (No Action Required)
NOTE: If you take no action during open enrollment, you’ll be enrolled in the renamed or merged plan listed above.
The Medicare Advantage Program administered by Humana will not be available in 2018. If you are currently enrolled in Medicare Advantage, you must choose a new plan during open enrollment. Medicare Plus is another plan option with nationwide provider access. See details here.
IYC Access Plan / Access High Deductible Health Plan (HDHP) Medicare Plus
State Maintenance Plan (SMP) / SMP HDHP
WEA Trust will be the new administrator of these plan designs. Here is a summary of in-network benefit changes. See detailed plan design comparisons and benefit comparisons If you are a current participant, you will also receive information in the mail from your health plan. Participants of these plans will automatically be transitioned to WEA Trust if another plan is not selected during IYC open enrollment.
IYC Access Plan In-Network Cost-Sharing Changes
All prices are listed as individual / family. See benefit comparison for more information.
IYC Access Plan Overview of Benefit Changes
SMP County Changes
Now administered by WEA Trust, will be only be available in Florence County and will have a new provider network. Click here for details. Participants who live in Florence County will be limited to SMP providers in and near Florence County.
SMP now offers some out-of-network benefits.
Primary Care Provider Required
No Domestic Partner Coverage
Certain Pharmacies No Longer In-Network
CVS (including Target pharmacies) and certain other out-of-state pharmacies are no longer in-network. Find in-network pharmacies at Navitus.com.
Certain Over the Counter Medications No Longer Covered
This includes medications such as steroid nasal sprays like Fluticasone, known as Flonase®, and medication to treat heartburn such as Omeprazole, known as Prilosec. If you have a prescription for these medications, you can use your Health Care Flexible Spending account to pay for them with your TASC Card or to be reimbursed.
New Mandatory Specialty Pharmacies (Level 4 Prescriptions)
Level 4 prescription drugs can be filled at Lumicera or the UW Specialty Pharmacy. Diplomat will no longer be the preferred specialty pharmacy. This change does not affect members enrolled in the Navitus MedicareRx Medicare Part D prescription drug plan. Navitus MedicareRx members see website for details.
New Mail Order Pharmacy
Serve You is replacing WellDyneRx as the mail order pharmacy. Current participants will receive detailed information in the mail from Navitus. Call Navitus at 1-866-333-2757 with questions.
Medication Therapy Management Available
You can learn how to manage your medications through a free Medication Therapy Management Program. Navitus will contact you if you are eligible.
New Discounted Drug List
Though these drugs are not covered by your pharmacy benefit, you’ll receive a discount on them if you have a prescription. The discount drug list will include drugs used for infertility, weight loss, cosmetic and other lifestyle needs as prescribed by your doctor.
Changes for Existing Participants only
Additional changes for current employees & retirees enrolling for the first time
Well Wisconsin Program
State and UW Employees: 2018 participation will also determine your eligibility for a 2019 premium reduction. The 2019 premium reduction will increase if both you and your eligible spouse participate in the 2018 Well Wisconsin Program. Watch for more information from StayWell in 2018.
This page was last modified on: 9/8/2017 12:16:57 PM