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Department of Employee Trust Funds
December 8, 2015

ETF Addresses Health Insurance Program Model, Potential Changes

The broader goals underlying recent and potential changes to the State of Wisconsin Group Health Insurance Program center on providing quality affordable benefits while leveraging the state’s position as a major health insurance benefits purchaser, stated Lisa Ellinger, director of the Department of Employee Trust Funds Office of Strategic Health Policy, in a recent segment of Wisconsin Public Television’s Here and Now.

In the interview, Elllinger also talked about:

  • Strategies for avoiding exposure to the 2018 “Cadillac Tax” under the federal Affordable Care Act. ETF has worked hard “to make sure we stay below the premium thresholds that are part of that tax,” Ellinger stated. “In fact, our premiums since the ACA went into effect have only gone up by an annual average of 2.5% and for state employees in 2016 are going down 2.5%.”
  • A recommendation of the Group Insurance Board’s health care benefits consultant (Segal Consulting) to transition from the current fully-insured model to a self-insured model beginning in 2018. “Self-insurance is about the relationship between the purchaser (the employer) and the insurer (the health plan),” she said. “It is not about which health plans or which doctors are participating in our system.”

In November Segal Consulting presented a number of high-level recommendations for program changes in 2017 and other longer-term initiatives to the GIB.

The GIB is holding a special meeting next month to continue its review of recommended program changes and to determine next steps. ETF staff will present proposed program changes for board action at the regularly-scheduled February 17, 2016 meeting.

For future updates, watch our website or follow ETF on Twitter. You can also subscribe to It’s Your Choice e-alerts for information on health insurance benefits and health and wellness related topics.

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