2026 Insurance Changes

Open enrollment is October 6 – 31, 2025. Any changes made during this period will be effective January 1, 2026. Make the most of open enrollment:

• Review this page to see what's changing in 2026.
• 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.

The average non-Medicare premium increase will be 8% for the state program. The Department of Administration, Division of Personnel Management sets the premium contribution for state employees and the employer contribution to the Health Savings Account.

For the local program, the average non-Medicare premium increase will be 11.5%. Local employers establish the premium contribution for their employees. 

These overall rates include medical, pharmacy, and dental as well as the stabilization charge and administrative costs. 

Learn More About Premium Increases

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

Eight new counties have been designated as SMP counties for 2026, designated with an “*" below. Menominee county has been removed as an SMP county.

SMP is available in the following counties:

Use the health plan search to find health plans and covered providers where you receive care.

The Group Insurance Board approved the following medical benefit changes effective January 1, 2026:

• Coverage for Continuous Glucose Monitors (CGMs) will be under the pharmacy benefit through Navitus Health Solutions (Navitus) only.
• Medicare Advantage subscribers and spouses can earn the $150 Well Wisconsin incentive starting in 2026. Visit the Well Wisconsin page for more information and to get started.

Health Plan Name Change

• Dean Health Plan - Medica West and Mayo Clinic Health System will be Medica West and Mayo Clinic Health System.
• Common Ground Healthcare Cooperative will be CareSource offered in partnership with GHC of Eau Claire.
• Dean Health Plan-Prevea360 East will be Prevea 360 East.
• Dean Health Plan will be Dean Health Plan by Medica.
• The Access Plan by Dean will be the Access Plan.
• The State Maintenance Plan (SMP) by Dean Health Plan will be the State Maintenance Plan (SMP).

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 $1,700
• Family: increased to $3,400

State Employees: Health Savings Account (HSA) Employer Contribution Increase

The 2026 annual HSA employer contribution will increase to:

• Individual: $852
• Family: $1,704

To receive the full employer contribution, you must be covered by an HDHP for the entire 2026 plan year.

New Vision Vendor 

MetLife will administer the vision program starting January 1, 2026. If you are currently enrolled in the vision program your enrollment will continue with MetLife. Members will not receive or need an ID card for MetLife Vision Insurance; just let your provider know you have MetLife. 

New Administrator for Pre-Tax Savings Accounts

Total Administrative Services Corporation (TASC) is the new administrator for 2026 for pre-tax savings accounts:

• Health Savings Account (HSA)
• Health Care Flexible Spending Account (FSA)
• Limited Purpose Flexible Spending Account (LPFSA)
• Dependent Day Care Account
• Parking Account & Transit Account

Members must reenroll for 2026. Elections do not carry forward from year to year. Members who enroll in a flexible spending or commuter benefit account must have a minimum annual contribution amount of $50. If you do not reenroll and there is less than $50 in your account you may lose any money left. TASC will send direct communications to current members about 2025 HSA transfer of assets and carryovers to 2026.

These changes apply to state employees and retirees only.

Contribution Limits

Carryover Limits

The carryover limit for FSAs and Limited Purpose FSAs has changed to $660; an increase of $20 from the 2025 limit.

Minimum Elections and Carryover Amounts

Accounts Impacted:

• Health Care FSA
• Limited Purpose FSA
• Parking account
• Transit account

Minimums

Learn More About Account Minimums

WebMD continues to be a resource for well-being for our members. Participants have access to additional resources to support them in reaching their well-being goals. 

• Kaia Health for personalized therapy programs for joint and muscle pain
• WebMD health coaches to help members manage chronic conditions or live healthier

Login at WebMD ONE Wellness Portal to learn more or contact WebMD customer service at 1-800-821-6591.

This applies to Universities of Wisconsin employees only.

Dependent Reenrollment 

If you currently have a Securian Accident Plan that covers any dependents (spouse and/or children), you must reenroll the dependents in the Accident Plan during open enrollment to have coverage that continues past January 1, 2026. If you do not, your dependents will no longer have Accident Plan coverage and your plan will change to individual coverage for only you, as the subscriber.