Get Started!
Open enrollment is September 30 – October 25, 2024. Any changes made during this period will be effective January 1, 2025. Make the most of open enrollment:
- Review this page to see what's changing in 2025.
- Review health premiums, provider availability, how to enroll in a new health plan, and more:
- Use Benefits Available to Me to find your health program, or select your program option if you know it.
- If you can't find your health program, ask your employer. If retired, call ETF.
- Sign up for an insurance benefits forum or watch an on-demand video to learn more about your insurance benefits.
- Consider supplemental benefits such as dental insurance, vision insurance, or Accident Plan.
Medical Premium Increases
The overall medical insurance premium increase will be 7.3% for the state program and 11% for the local program. The actual rate increases for members may differ due to health plan choice and/or employer premium contributions.
Local employers establish the premium contribution for their employees. The Department of Administration’s Division of Personnel Management determines both the state employee share of the premium and the employer contribution to the Health Savings Account.
State Maintenance Plan
The State Maintenance Plan (SMP) is a health plan that offers Uniform Benefits. SMP is designed to provide a health plan option for members who live or work in areas without adequate access to in-network providers or hospitals.
State Employees and Retirees
SMP will continue to be offered in Florence County. Use the health plan search to find health plans and covered providers where you receive care.
Local Employees and Retirees
13 new counties are now SMP counties for 2025, designated with an asterisk (*) below. Two counties, Waupaca and Waushara, no longer qualify as SMP counties beginning in 2025.
SMP will be offered in the following counties:
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Use the health plan search to find health plans and covered providers where you receive care.
Medical Benefit Changes
The Group Insurance Board approved the following medical benefit changes effective January 1, 2025:
- Expanded the lifetime limit to orthoptic eye training from two to no more than twelve.
- Clarified nutritional counseling coverage. The certificate language was clarified to allow for nutritional counseling services related to weight management.
Health Plan Name Change
Dean Health Plan - Prevea360 West and Mayo Clinic will now be known as Dean Health Plan- Medica West and Mayo Clinic Health System. If you are currently enrolled, no action is required to continue coverage with the health plan.
High Deductible Health Plan (HDHP) Deductible Increase
The annual medical deductible for the HDHP, Local HDHP, and Access HDHP plans has increased to comply with federal requirements:
- Individual: increased to $1,650
- Family: increased to $3,300
State Employees: Health Savings Account (HSA) Employer Contribution Increase
The 2025 annual HSA employer contribution will increase to:
- Individual : $828
- Family: $1,650
To receive the full employer contribution, you must be covered by an HDHP for the entire 2025 plan year.
Wellness
WebMD continues to be a resource for well-being for our members. Along with coaching programs for chronic conditions, mental health, physical activity, nutrition, and stress, they also offer a focused weight management program. Participants have access to resources to support them in reaching their well-being goals.
- Diabetes Prevention Program for those at risk of developing diabetes
- Positively Me, a year-long program helping to support participants with losing weight
- meQuilibrium for stress management and resilience building support
Login at WebMD ONE Wellness Portal to learn more or contact WebMD customer service at 1-800-821-6591.
Pre-Tax Savings Accounts
These changes apply to state employees and retirees only.
Contribution Limits
| Program | Contribution Limit | Change |
|---|---|---|
| Health Savings Account (HSA) | $4,300 per year (individual) / $8,550 per year (family) | Increase of $150 / $250 per year |
| Health Care Flexible Spending Account (FSA) and Limited Purpose FSA | $3,200 per year | Increase of $150 per year |
| Parking Account and Transit Account | $315 per month | Increase of $15 per month |
Carryover Limits
The carryover limit for FSAs and Limited Purpose FSAs has changed to $640; an increase of $30 from the 2024 limit.
Minimum Elections and Carryover Amounts
Accounts Impacted:
- Health Care FSA
- Limited Purpose FSA
- Parking account
- Transit account
Minimums
| Requirement | Amount |
|---|---|
| Minimum Annual Contribution | $50 each year |
Minimum Account Balance for Carryover (Only impacts you if you don't reenroll in your account) | $50 |