WRS News Online

Health Insurance Program Update

For State of Wisconsin Group Health Insurance Program Participants

Health Benefits Update

Woman and Child

The It's Your Choice open enrollment period for all group health insurance participants is October 17-November 11, 2016. This is your opportunity to change from one health plan to another, switch from single to family coverage, or add/delete certain dependents. The open enrollment period is two weeks later than usual, largely due to efficiencies created by the state's new STAR system, which processes transactions in real time. The shift also provides an opportunity for members to weigh other insurance coverage options (e.g., employers of spouses or domestic partners). Changes become effective January 1, 2017.

Watch for your It's Your Choice materials in early October. In the meantime, here are a few things to know about your health insurance benefits:

  1. Members' out-of-pocket costs for insulin decreased significantly August 1, due to a formulary change. This change was a result of ETF researching the impact of the $35 increase in cost sharing from 2015 to 2016, and overall concerns about insulin adherence. The following insulin products moved to cost-share Level 1 ($5 copay) from Level 2 (20% coinsurance with a $50 maximum) on the Navitus commercial and MedicareRx formularies: Lantus, Levemir, Novolin, Novolog, and Tresiba.
  2. The Group Insurance Board approved an overall 1.6% increase in State non-Medicare premium rates for 2017. This was due to an extremely successful negotiation process with participating health insurance plans. The 1.6% overall increase is also good news in light of much higher premium increase trends in Wisconsin and nationwide.
  3. Total monthly premium rates have been posted for both state and participating local government entities. Information about employee premium cost shares will be available in mid-September.
  4. Regarding the Group Insurance Board's evaluation of self-insuring the group health insurance program and setting regional and statewide service areas: In July ETF invited prospective vendors to submit proposals to administer the program. Bids are due in September; results and evaluations will be presented to the Group Insurance Board in November, for possible adoption beginning January 1, 2018.
  5. Uniform Benefits changes for 2017 relate to nondiscrimination on the basis of gender identity and other requirements for accessibility and limited English proficiency under new federal regulations of the Affordable Care Act.
  6. Zurich has replaced Hartford for accidental death and dismemberment supplemental coverage. Members currently enrolled in Hartford will be automatically moved to Zurich, unless they cancel during open enrollment.
  7. Starting in 2017, all aspects of the Well Wisconsin Program will be administered by StayWell® - not your individual health plan. The wellness and disease management services provided by StayWell will be comprehensive and include such things as health risk assessments, biometric screenings, health coaching, online tools and more.
  8. Keep checking our website for the latest information regarding rates, optional plan enrollment opportunities and rate changes, answers to frequently asked questions and much more.

Stay connected by subscribing to ETF Email Updates. By signing up for your It's Your Choice Health and Wellness E-alerts, you will receive important information about your benefits year-round. And don't forget to follow ETF on Twitter!