Today, the Group Insurance Board set premium rates for the 2026 plan year. In addition, the Board approved the health plan service area qualifications and other benefits of the State of Wisconsin Group Health Insurance Program (GHIP).
“Preliminary bids from health plans for 2026 were showing a 13.4% premium increase that we were able to decrease to 5.4% through successful negotiations,” said Renee Walk, Director of the Office of Strategic Health Policy with the Department of Employee Trust Funds (ETF).
ETF and the Board’s actuary, Segal, presented different rate setting options that included a premium stabilization charge in support of the GHIP reserves.
The actual monthly premium costs for members and other benefits information for 2026 will be made available prior to the annual open enrollment period, October 6-31, 2025.
2026 Rates for Employees
The average non-Medicare premium increase will be 8% for the State program. The Department of Administration, Division of Personnel Management sets the premium contribution for state employees and the employer contribution to the Health Savings Account.
For the Local program, the average non-Medicare premium increase will be 11.5%. The premium contribution for local employees is determined by each individual employer.
These overall rates include medical, pharmacy, and dental as well as the stabilization charge and administrative costs.
2026 Rates for Retirees
The following rates for retirees exclude the stabilization charge.
For Medicare-enrolled retirees, the Medicare Advantage medical-only rates will increase $35.30 per member. The Medicare Plus medical-only rates will increase $45.02 per member for the State program and $47.83 for the Local program.
Pharmacy rates for retirees will increase $13.22 per member for the State program and $31.10 for the Local program.
For retirees who elect Uniform Dental, those rates will increase $1.40 for a single/$2.90 for a family.
Plan Service Area Qualifications for 2026
All health plans met Tier 1 status for the State program. The State Maintenance Plan (SMP) will be offered in Florence County only for the State program and 48 out of 72 total counties for the Local program.
Health plans are evaluated and tiered 1 through 3 based on provider access and operating experience to serve members in each county. For counties where there is no Tier 1 health plan, the SMP is offered as a Tier 1 plan along with other qualified plans.
Other Business
The Board approved:
- Three-year contract with Metropolitan Life Insurance Company for Supplemental Vision insurance coverage, effective January 1, 2026
- Three-year contract with Securian Financial for Group Accident insurance coverage, effective January 1, 2026
- A 10% premium decrease for the State Income Continuation Insurance (ICI) plan and a continuation of the premium holiday for the Local ICI plan for 2026
- The actuarial valuations of the State and Local ICI plans as of December 31, 2024
- Updated policy for managing the Wisconsin Public Employers Group Life Insurance Program reserves
ETF provided an update on its multi-year program to implement an insurance administration system (IAS), which is branded My Insurance Benefits. The IAS will launch first with the Universities of Wisconsin this summer and all other employers in 2026.
The Board’s next meeting is August 13, 2025.