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Department of Employee Trust Funds
November 19, 2015

GIB Reviews Final Report from
Health Care Benefits Consultant

Segal Consulting presented its final report and recommendations to the Group Insurance Board this week, focusing on long-term strategic initiatives for the State of Wisconsin Group Health Insurance Program. Review the consultant’s presentation to the GIB and full report.

The GIB did not take action on any of the consultant’s recommendations. The purpose of the presentation was to solicit general feedback from the board and provide guidance for future proposals ETF may develop and bring to the board for consideration.

The consultant presented a number of high-level recommendations and concepts, including:

  • Total Health Management: focuses on employee wellness, engagement and disease management
  • Program Structure: focuses on health plan participation in the program and benefit design
  • Pharmacy: focuses on pharmacy program structure
  • Data Management: focuses on recommended strategies pertaining to the collection of data to help guide plan design changes
  • Market Observations: compares the benefits and costs of the state’s health insurance program to other employers, states and programs
  • Self-Insurance: discusses alternatives to the current purchasing structure
  • Retiree Coverage: focuses primarily on improving the affordability of Medicare coverage
  • Local Government Program: suggests alternative program structures and purchasing strategies
  • Affordable Care Act: provides details on the state’s exposure to the 2018 “Cadillac Tax”

Some of the program changes are recommended for implementation in 2017. Other longer-term initiatives will require further analysis and development, and target implementation dates of 2018 and beyond. Throughout 2016 ETF will provide the board with status reports on the development of the longer-term initiatives.

Segal Consulting was hired as the benefits consultant for the state’s health insurance program in November 2014, and this is the second of two contracted reports. The first report, presented to the GIB in March 2015, focused primarily on program changes for 2016.

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