You may enroll or change your benefits during the annual health benefits open enrollment period, when you start a new job, or when you experience a life event.
This page will walk you through choosing your benefits during these events.
Introducing Benefits Mentor
IBM Benefits Mentor is the new interactive benefits counselor for active state employees and non-Medicare retirees.
Powered by ETF’s secure data warehouse, Benefits Mentor will use your claims information (if available) as a basis for personalized plan design recommendations. Benefits Mentor also considers your medical needs and what is most important to you when choosing a health plan.
You will need to register and verify your email address prior to using Benefits Mentor for the first time.
Choose a Plan Design
Key factors to consider:
Monthly Payment (Premiums)
Premiums can change every year. Review your premium for next year on the Health Care Premiums page.
- Generally, the less you pay per visit, the more you pay per month for your premium.
- If you choose a High Deductible Health Plan (HDHP), which has a lower premium, consider putting the premium savings in a Health Savings Account (HSA) pre-tax to pay for health care services.
See the HSA page under the Pre-Tax Savings Accounts menu for eligibility information and possible tax advantages.
Cost Per Visit (Deductibles & Copays)
How often do you visit your doctor? Do you need surgery next year? Review the Breakdown of Your Costs pages.
With a High Deductible Health Plan, the medical deductible must be met before copays and coinsurance begin.
- Example: Before meeting his $1,500 deductible, Joe must pay the full cost of the office visit, including any services or labs. After his deductible, he will only be responsible for 10% of his medical costs.
With a non-high deductible plan, office copays begin before the deductible is met.
- Example: Maria chose a health plan with a $250 deductible. Before meeting her deductible, she will pay a $15 copay for an office visit plus the costs of any labs or services. After her deductible, she will continue paying the office visit copay but only be responsible for 10% of labs and services costs.
Do you or your dependent(s) need access to a doctor outside of the health plan’s service area or out of state?
- Active employees and retirees without Medicare: Review the Access Plan.
- Retirees with Medicare: Review Medicare Plus and Medicare Advantage
All non-Medicare plan designs and health plans offer the same in-network Uniform Benefits. Medicare Advantage and Medicare Plus plans vary slightly, review the Key Differences Between Medicare Plan Design Options page to learn more.
All pages mentioned in this section can be found under the Health Insurance menu.
- Enroll in Medicare Parts A and B. Medicare Part D enrollment is automatic through the State Group Health Insurance Program.
- Notify ETF immediately, or your Medicare-coordinated coverage may be delayed.
Choose a Health Plan
Skip this step if: you chose the Access Plan, Access HDHP, Medicare Advantage or the Medicare Plus plan. Those plans are administered by a single health plan.
Complete this step if: you chose the IYC Health Plan, HDHP or Health Plan Medicare. These plan designs have several health plans to choose from.
Go to the health plan search page to find health plans in your county or the counties you’d like to receive care. Results include major health care systems and provider directories. Keep travel time in mind if you select a plan that’s not offered nearby.
A few questions to keep in mind:
- Is your health plan available next year? Health plans may merge or change their service areas.
- Is your doctor, clinic and hospital still covered? Verify with the provider directory.
- All health plans cover the same in-network benefits, but are there additional services, requirements or programs that are important to me? Go to the Health Plan Search page and click on a health plan to learn more.
- How satisfied are current health plan participants? Compare ratings on the Health Plan Search page.
Consider Supplemental Benefits
Supplemental benefits such as dental, vision or long-term care are a great way to add coverage. Pre-tax savings accounts, such as an HSA, can put more money in your pocket through pre-tax savings. Review the Supplemental Benefits and Pre-Tax Savings Accounts pages to see what's available.
Things to consider:
- Do you want basic dental coverage (Uniform Dental Benefit)?
- Only available if you enroll in health insurance. Your dental coverage will mirror your health coverage. For example, if you elect family health insurance with dental, you will be enrolled in family dental coverage.
- Included as part of your premium if you choose your health plan with dental.
- Will you need additional dental coverage for a crown, root canal, bridge, dentures or orthodontics? Review the supplemental dental plans page for options available to you.
- Do you need any additional benefits such as vision or accident plan coverage?
- Active state employees: Enroll in a pre-tax savings account to set aside money pre-tax to pay for health care, dependent care and parking/transit expenses.
- Note: UW System and UWHC employees are not eligible for parking/transit accounts.
You must re-enroll every year to continue participation. Elections do not carry forward from year to year.
Enroll or Make Changes
Learn how to enroll or make changes to your health insurance and supplemental benefits.Read More about Enroll or Make Changes
Note: This is an annual requirement. See eligibility requirements.