Getting Started

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

Benefits Mentor

IBM Benefits Mentor is the 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.

Get Started with Benefits Mentor

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.

If you choose an HDHP, you must enroll in an HSA every year, even if you don’t make any contributions yourself. See the Health Savings Accounts (HSAs) page 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 In-Network Health Services page.

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.

Out-Of-Network Availability

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

Uniform Benefits

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 Medicare Plan Designs Quick Comparison page to learn more.

Retirees eligible for Medicare must:
  1. Enroll in Medicare Parts A and B. Medicare Part D enrollment is automatic through the State Group Health Insurance Program.
  2. Notify ETF immediately, or your Medicare-coordinated coverage may be delayed.
Medicare will be the primary payer of your covered medical services and prescription drugs.

Related Resources

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 still available? 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?  From the health plan search, click on a health plan to learn more.

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 dental, vision, long-term care, Accident Plan 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.
    • The Uniform Dental premium is added to your health insurance premium.
  • Will you need additional dental coverage for a crown, root canal, bridge, dentures or orthodontics? Review the Dental Insurance 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.
Pre-Tax Savings 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

Opt-Out Incentive

Annual Action Needed! If you are an active employee declining health insurance and electing to receive the $2,000 opt-out incentive payment in 2023, you must complete a paper Health Insurance Application/Change (ET-2301) form and submit to your payroll or benefits office during open enrollment, or check with your employer to see if you can opt out electronically. You may be required to provide proof of other minimum health care coverage for yourself and your dependents.

Note: This is an annual requirement. See eligibility requirements.