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News

Department of Employee Trust Funds
May 17, 2018

GIB Approves No-Cost Telehealth Services, Other Changes for 2019

The Group Insurance Board yesterday approved offering telehealth services at no cost and other minor benefit changes for 2019 under the State of Wisconsin Group Health Insurance Program. The Board and ETF are also planning no increases in deductibles, copays or out-of-pocket limits for members.

Rates for 2019 could increase if premium bids from health plans come through higher than expected. Premiums and participating health plans for 2019 will be set in August.

Telehealth services will now be offered at no cost for participants not enrolled in a high deductible health plan. Telehealth services are often less expensive than in-person services. Federal rules require HDHP with Health Savings Account participants to pay the full cost of all services until they meet the deductible. After the deductible is met, telehealth services would also be free of charge for HDHP/HSA participants.

Summary of additional medical benefit changes:

  • The following will be newly covered by Uniform Benefits:
    • Home sleep studies
    • Initial set of hard contact lenses for participants diagnosed with keratoconus
  • The following will no longer be covered by Uniform Benefits:
    • Removal of erupted teeth (this will now be covered by the Uniform Dental Benefit)
    • Removal of skin tags (unless medically necessary)
  • Other changes to Uniform Benefits:
    • Annual limit for foot orthotics
    • Removal of certain limitations for transplants
    • Certain retirees who were covered under the Wisconsin Public Employers Group Health Insurance Program will now be allowed to re-enroll for coverage starting for 2019 if they previously cancelled their coverage

Summary of pharmacy benefit changes:

  • Uniform Pharmacy Benefits will be contained in a document separate from Uniform Medical Benefits
  • Increase cost sharing for Level 3 “dispense-as-written-code-1” drugs
  • Implement a value-based plan design with lower cost sharing for members who participate in a diabetes program offered by StayWell

Supplemental Benefits
The Board approved a supplemental benefit plan that will provide members with less costly options for 2019. Changes will also reduce administrative complexity for employers and duplication of benefits

Supplemental benefit plan offerings for 2019 include:

  • Supplemental dental offerings through Delta Dental
  • Supplemental vision through VSP
  • Accidental death and dismemberment through Zurich

Long-term care insurance may also be offered, pending contract negotiations with Mutual of Omaha.

Members currently enrolled in plans offered through EPIC or Anthem will have to choose a new supplemental plan during the It’s Your Choice open enrollment period to continue coverage next year.

Medicare Advantage
The Board approved the medical rate of $103.81 for a single Medicare Advantage plan, offered by UnitedHealthcare, for 2019. This rate is currently lower than the medical rates of the other Medicare plans available through the Group Health Insurance Program. The total MA plan monthly premium rate, including pharmacy and dental benefits and administrative fees, will be announced prior to the It’s Your Choice open enrollment period.

Watch for notices promoting statewide information sessions hosted by UnitedHealthcare this summer.

UW System Transportation Benefits
Based on an unanticipated change to the federal law that was effective earlier this year, the University of Wisconsin System faces a large tax liability for offering parking and transit benefits to its employees. Most UW employees participate in a UW-sponsored transportation benefits program that exists independent of ETF’s Commuter Benefits Program, which allows participants to set aside pre-tax contributions for work-related parking and transit expenses. As a result of this tax liability, the UW will make changes to its own transportation benefits program and notify affected employees.

The Board approved the UW’s request to opt out of ETF’s Commuter Benefits Program as of June 1, 2018. UW employees who are participating in the program as of May 31, 2018 will no longer be able to contribute to their parking or transit accounts, but they will be able to continue using account balances until they are depleted. UW employees who are not participating in the program as of May 31 will no longer be able to enroll.


For More Information

Group Insurance Board Meeting Agenda and Materials, May 16, 2018

 

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