WRS News Online

No Increase for State Employee Health Insurance for Second Year

For the second consecutive year, the state's Group Health Insurance Program premiums will not increase in 2019, as recently approved by the Group Insurance Board. Local employee premiums will be more varied and set by each employer. While some health plans were able to reduce their rates, the overall increase is 1.7%.

In addition, the Department of Administration's Division of Personnel Management has confirmed contribution amounts will remain unchanged for 2019. This includes what state employees and employers pay for health insurance and Uniform Dental benefits as well as the employer contribution for the Health Savings Account.

The flat rates are a result of reduced pharmacy costs, successful contract negotiations with health plans to keep health care costs down and use of some of the program's reserve fund.

You may enroll or change your benefits during the annual It's Your Choice open enrollment period, October 1-26. Watch for the It's Your Choice 2019 Decision Guide, describing plan and benefit changes for 2019 and important take-action steps, from your employer in a few weeks.

Plan and Benefit Changes
Here are highlights of the most significant changes for 2019:

  • HealthPartners has added a new health plan option, Robin with HealthPartners, with coverage in northeast Wisconsin.

  • It's Your Choice Medicare Advantage with UnitedHealthcare is a new option for Medicare participants and their Medicare-enrolled dependents.

  • State employees: The State Maintenance Plan (SMP) will be newly available in Forest County and no longer available in Florence County. Local employees: For SMP coverage area changes by county for 2019, please see the It's Your Choice 2019 Decision Guide. Make sure your providers are in-network or select another plan.

  • If you are currently enrolled in a supplemental dental plan, you must enroll in a new plan to continue coverage in 2019. The following supplemental benefit plans will not be available in 2019:

    • Current Anthem DentalBlue participants in any of the three Anthem plans must choose a new Delta Dental plan to have supplemental dental coverage in 2019.

    • Current EPIC Benefits+ participants must choose a new Delta Dental plan to have supplemental dental coverage in 2019, VSP to have supplemental vision coverage and Zurich for Accidental Death and Dismemberment coverage. There will be no hospital and surgical indemnity coverage option for 2019.

    • Current EPIC Dental Wisconsin participants must choose a new plan to have supplemental dental coverage in 2019.

    • New enrollments will not be accepted for Mutual of Omaha Long-Term Care Insurance, administered by HealthChoice, in 2019. Current participants can continue their long-term care policies and do not need to take any action.

  • Pharmacy benefits – There will be increased cost sharing for "dispense as written" (DAW-1) brand name level 3 drugs for non-Medicare participants, unless the generic equivalent cannot be used due to medical necessity.

  • Medical benefits – Telehealth services will be covered 100% except for It's Your Choice High Deductible Health plan participants who pay the full cost until their deductible is met. The exclusion related to benefits or services based on gender identity is removed for 2019.

For More Information
Visit the It's Your Choice 2019 section of the Department of Employee Trust Funds website for more information and helpful tools. The website will be live the week of September 17.

Attend a benefit/health fair this fall. This is your chance to ask questions about all ETF-administered benefit programs, retirement as well as health insurance. To find one near you use the interactive map or call ETF at 1-877-533-5020 or send a secure email.