1. What is the opt-out incentive and how do I get it?
If you are a WRS state employee: You may be eligible to receive $2,000 from your employer if you opt out of state group health insurance program coverage. To be eligible you cannot have opted out in 2015, meaning you must have been covered through the last day of 2015 if you were eligible for coverage and an employer contribution. In addition, you cannot be covered under the State of Wisconsin Group Health Insurance Program as a dependent. You are required to submit a paper Health Insurance Application/Change (ET-2301) form during open enrollment to receive the opt-out incentive for the next calendar year. Some employees may be able to elect the opt-out incentive electronically; check to see if your employer allows this.
2. Will I receive the opt-out incentive in a lump sum?
No, incentive payments will be spread out over all applicable pay periods in the year.
3. If I opted out of state group health insurance coverage at any time in 2015, will I ever be eligible for the opt-out incentive?
No, not as the law is currently written.
4. Am I eligible for the opt-out incentive if I am covered under the Wisconsin Public Employers (WPE) Group Insurance Program (local government)?
Yes, if you meet the eligibility criteria in question 1 (What is the opt-out incentive and how to I get it?).
5. Will I be eligible for the opt-out incentive during any year if I am covered by the program for even one day in that year?
No, unless you were insured as a graduate assistant and left that position to begin a WRS eligible position during the same plan year.
6. Can I keep receiving the $2,000 each year if I keep opting out of coverage?
Yes, as long as you meet the other eligibility requirements, you can receive the $2,000 opt-out incentive for each year that you opt out. You must submit a paper Health Insurance Application/Change (ET-2301) form each year during open enrollment in order to receive the incentive for the following year. Some employees may be able to elect the opt-out incentive electronically; check to see if your employer allows this.
7. Can I opt in one year, then opt out the next and receive incentive, then opt in the following year, and continue this pattern to be eligible for the incentive every other year?
8. Am I eligible for the opt-out incentive if I am:
- A limited-term employee? Yes, if you are eligible to participate in the State of Wisconsin Group Health Insurance Program, you are eligible for an employer contribution and you meet the other eligibility requirements. However, you must wait until your employer contribution would have begun until you are eligible to start receiving incentive payments.
- Graduate Assistants and Short-Term Academic staff? No, because you are not eligible for the WRS. If you are hired into a WRS eligible position with a state employer, you would be eligible for the opt-out incentive at a prorated amount.
- A less than half-time employee? Yes, as long as you meet the other eligibility requirements.
- On a leave of absence? Yes, if you are eligible to participate in the State of Wisconsin Group Health Insurance Program and you meet the other eligibility requirements. Once your health insurance employer contributions end, any opt out incentives also end.
- A Craftworker? Yes, effective January 1, 2022, if you are eligible (See Question 1. What is the opt-out incentive and how do I get it?). If you want to opt-out of coverage for 2022, file an application with your employer during open enrollment.
9. Is the opt-out incentive taxable as income?
Yes, and it will appear on employees’ W-2 statements. The incentive payment is not considered Wisconsin Retirement System earnings.
10. Does the opt-out incentive affect sick leave conversion rules?
The eligibility criteria for sick leave conversion for state employees remains the same. You must be in the State of Wisconsin Group Health Insurance Program to be able to convert unused sick leave time to credits that can be used to purchase health insurance at retirement. Keep in mind, if you opt-out of the health insurance program and unfortunately pass away, your unused sick leave time will not be eligible to be converted to sick leave credits by your dependent like it would if you passed away and had family health insurance coverage. Please see the Sick Leave Conversion Credit Program (ET-4132) brochure for more information on eligibility requirements related to retirement and death benefits for spouse and dependents.
11. If my spouse and I were covered together under a State Group Health Insurance family plan in 2015, would the dependent spouse at that time be ineligible for the opt-out incentive now, if we meet the other eligibility criteria?
No, being covered as a dependent under a state family plan is not the same as having opted-out in 2015, which would disqualify you or your spouse.
12. If, since 2015, either I or my spouse worked for the state, and the other spouse worked for a local employer under the Wisconsin Public Employers Group Health Insurance Program, and we were covered under the local plan in 2015, is the state employee ineligible for the opt-out incentive now?
Yes, the state employee is ineligible for the opt-out incentive if they were eligible for an employer contribution through the state and they waived state coverage.