Health Plans

New Health Plan

No Action Required: Aspirus Health Plan is newly available for the 2022 plan year. 

Service Area Change

Action Required for Quartz Community Members: Quartz Community is now Quartz Central and Quartz West. Members currently enrolled in Quartz Community should select a new health plan. If you don’t select a new health plan, you will be enrolled in a renamed Quartz offering based on the location of your current primary care provider/clinic. 

State Maintenance Plan

The State Maintenance Plan is newly available in Florence County. Make sure your providers are in-network or select another plan.

Benefit Changes

Medical Benefit Changes

Coverage added for medically necessary orthognathic surgeries (i.e., corrective jaw
surgeries).

  • The medical maximum out-of-pocket limit has been updated to follow the annual federal maximum updated values.
  • All medical benefits will be applied to the maximum out-of-pocket limit.
  • The timeframe requirement for extractions/dental repairs due to accidents has been removed.
  • Telemedicine coverage has been updated. See etf.wi.gov/telemedicine for more details.

Pharmacy Benefit Changes

For Non-Medicare Members:

  • Continuous Glucose Monitors are now covered on the pharmacy benefit. Coverage is now available under both the medical and pharmacy benefit.
  • Level 4 pharmacy benefit out-of-pocket limit has been removed.

Dental Benefit Changes

Coverage added for composite resin fillings for back teeth to the Uniform Dental benefit. White composite resin fillings will be covered for both front and back teeth in 2022.

Pre-Tax Savings Accounts

Vendor Name Change

Optum Financial has replaced the ConnectYourCare name and brand throughout the member experience.

  • Customer service offerings will remain the same.
  • Payment cards will not be reissued – use the same card until it expires.

Limit Increases 

Annual contribution limits have been raised for Health Savings Accounts.

New Eligible Expenses

Eligible expenses for Health Savings Accounts and Flexible Spending Accounts now include personal protective equipment (PPE) for the primary purpose of preventing the spread of COVID-19 (face masks, disposable gloves, hand sanitizer, sanitizing wipes, etc.).

Accident Plan

UW Hospital & Clinics employees are eligible to enroll in the Accident Plan for coverage beginning January 1, 2022.

Beginning January 1, 2022, cash payment amounts for most claims will increase. Outpatient rehabilitation therapy will be newly covered in 2022.

Wellness

Vendor Name Change

WebMD has acquired StayWell and is now the Well Wisconsin program vendor.