Benefits Mentor

It depends. Benefits Mentor recommendations are tailored to your medical needs and level of care. It may only take a few minutes if you have already entered information, or you can spend more time providing additional details or learning more about various plan design options.

Remember, you do not need to complete your Benefits Mentor experience in one session. Once you complete the Benefits Mentor login and verification process, your account can be accessed any time. See How to Sign Up for Benefits Mentor for more details about how to create an account. 

The information that you view and enter into Benefits Mentor is completely confidential and is not shared in any way. Furthermore, claims summary information displayed by Benefits Mentor can only be viewed by you or your spouse/dependent following the account verification process. 

Benefits Mentor does include explanations of the common insurance terms as it explains how the plan designs work. Click here for a Glossary of Health Coverage and Medical Terms, provided by the U.S. Department of Labor.

Visit the ETF Benefits Available to Me page. From there, you can find health insurance available to you, and then the Health Plan Search. When you search for a county, you will see the available health plans, the health plans' five major health system, and provider directories. By clicking on a health plan name, you will be directed to a page that includes a link to the health plan’s provider directory and plan contact information if you want to confirm whether a particular provider is in the plan’s provider network.

Benefits Mentor is designed to help you choose a plan design based primarily on your estimated out-of-pocket costs. If the plan design you choose offers several health plans to pick from, you will need to consider which ones are available where you receive health care and cover the health care providers you prefer. 

HDHPs are right for some, and not for others. Before enrolling in an HDHP, be sure you understand that you are financially responsible for all non-preventive medical expenses you incur, including prescriptions, until you reach the annual deductible. A deductible is the amount of money you have to pay for medical costs before your health insurance starts picking up a greater portion of the tab. So, for instance, if you’re in an HDHP with a $3,000 deductible, you’ll have to cover $3,000 in medical costs out of your own pocket, or your Health Savings Account (HSA), before your insurance starts to pay benefits.

If you enroll in an HDHP, you are required to enroll in an HSA. An HSA is an individually-owned, tax-advantaged savings account that you may use to pay for medical, dental, prescription, and vision expenses for you, your spouse, and qualifying dependents.

In order to enroll in an HDHP and an HSA, you must be eligible for both plans.

View our Plan Design Options eLearning to help determine if an HDHP is right for you.

All plan designs have deductibles before benefits are payable. The difference is the amount of that deductible and what it applies to. All plan designs will cover an annual preventive exam at no cost to you (there may be expenses from the exam, however, that do not qualify as preventive).

If you have family coverage with an HDHP:

• You will pay for all non-preventive medical services until you meet your annual $3,000 family deductible ($1,500 if you have single coverage). This includes visits to medical providers, including chiropractor, physical therapy, etc., tests, procedures and facility charges. Benefits are payable once the deductible is met.
• Prescription drugs are subject to the deductible.

If you have family coverage with an IYC Health Plan:

• You will pay for all non-preventive medical services until you meet your annual $500 family deductible ($250 if you have single coverage). If an individual within a family plan meets the annual individual $250 deductible, the Uniform Benefits will take effect for that individual.
• This includes tests, procedures, and facility charges. Benefits are payable once the deductible is met.
• Visits to medical providers, including chiropractor, physical therapy, etc., are subject to the office visit copay only even if the deductible has not been met.
• Prescription drugs are not subject to the deductible.

The intent of offering Benefits Mentor is to provide you with tools and resources to help you make the best benefits choices for you and your family - including recommending plans that best match your priorities.

Because of the lower monthly employee premium contribution and the employer's contribution to a Health Savings Account (HSA), it is not unusual for the HDHP to have lower estimated out-of-pocket costs.

The Access Plans are more costly because they offer a national provider network and coverage if you use non-network providers. These are the plans that people tend to select when they want to have access to out-of-network providers like Mayo Clinic, John Hopkins, or other specialty providers. They are also the plans that retirees who live outside of Wisconsin may select. These two groups tend to have higher than average claims costs, which has directly led to higher premium costs. The health plans also have limitations when negotiating for reduced pricing when non-network providers are used.

The Access Plans are not usually considered unless one of the situations described above apply or if there are dependents who reside or attend school outside of the health plans’ service areas and their expected medical costs exceed the additional premium costs for the Access Plans.