The Group Insurance Board today approved benefits for 2021 and discussed the impact of the global coronavirus pandemic (COVID-19) on the State of Wisconsin Group Health Insurance Program.

 The Board approved the following minor benefit changes for 2021:

  • Pharmacy Program – Secure electronic prescribing, prior authorization, and drug benefit checks. This should allow participants to begin treatments sooner and prescribers to find the best drug for the best price.
  • Uniform Benefits – Coverage of biofeedback services for urinary incontinence. 
  • Supplemental Programs – Local government employees will be offered the vision and accident plans. The vision plan will also be offered to local government retirees.
  • Health Plan Pilot Programs – Addition or continuation of programs for the management of diabetes, acupuncture, back pain, and integrated care.
  • Wellness Program – Replacement of the current health screening requirement with a choice of different health checks, such as a preventive dental exam. No longer allowing non-Medicare Advantage health plans to offer wellness incentives that do not qualify as medical expenses, such as reimbursements for gym membership, due to administrative burden.

Since the COVID-19 outbreak and the state’s Safer at Home order, ETF has promoted the use of telehealth and mail order pharmacy services. Nearly all health plans have reported a substantial increase in telehealth use.

“ETF continues to work with providers to assure our 250,000 program participants have access to needed care in this rapidly changing environment,” said Eileen Mallow, Director of the Office of Strategic Health Policy.

ETF and the Board’s consulting actuary are analyzing the possible long-term impact of COVID-19 on the program. The findings and rates for 2021 will be presented at the August Board meeting.

Other Board Action
The Board also approved:

  • Delta Vision as the supplemental vision plan provider for 2021-2022.
  • HealthChoice as the long-term care plan provider for state government employees and retirees, effective in July.
  • Scheduling an additional Board meeting on June 29, 2020 to continue discussions on COVID-19 as well as the necessity for a premium increase for the Local Annuitant Health Program.

The Board’s next regularly scheduled meeting is on August 19, 2020.

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