The Group Insurance Board today approved the addition of Aspirus Health Plan to the State of Wisconsin Group Health Insurance Program for plan year 2022. Aspirus will provide coverage in select counties in central Wisconsin. Complete service and provider network information for all plans will be available in the 2022 open enrollment materials. 

The Board also approved various minor benefit changes for 2022. The benefit changes were recommended by the Department of Employee Trust Funds, based on feedback from members, health plans, and professional associations.

Summary of Benefit Changes

  • Adding coverage for medically necessary orthognathic surgeries (i.e., corrective jaw surgeries).
  • Updating the medical maximum out-of-pocket limit to follow the annual federal maximum updated values.
  • Applying all medical benefits to the maximum out-of-pocket limit.
  • Removing the timeframe requirement for extractions/dental repairs due to accidents.
  • Updating and specifying telehealth coverage.
  • Allowing coverage of Continuous Glucose Monitors on both the medical and pharmacy benefit.
  • Removing Level 4 pharmacy benefit out-of-pocket limits.
  • Adding coverage for composite resin fillings for posterior teeth to the uniform dental benefit.

Pre-Tax Savings Account Changes

Several optional pre-tax savings account changes were recently introduced via federal law. ETF received member correspondence requesting the Board approve these changes, given the continued impact of COVID-19. These largely retroactive changes were approved, including:

  • The increase of multiple annual carryover limits for 2021;
  • Contribution and dependent eligibility changes for the Dependent Care Account program for 2021; and
  • The addition of Personal Protective Equipment as eligible expenses for the Health Care Flexible Spending Account and the Health Savings Account for 2021 and beyond.

ConnectYourCare, the pre-tax savings account administrator, will provide additional details to impacted members soon.

Other Board Action

The Board also approved:

  • The selection of Delta Dental of Wisconsin as the Supplemental Dental vendor through plan year 2023.
  • The selection of HealthChoice and Mutual of Omaha to administer the Long-Term Care insurance program through 2022.
  • The approval of a 50% premium decrease for the state Income Continuation Insurance Program and an extension of the local ICI premium holiday for 2022.

The Board’s next regularly scheduled meeting is set for August 18, 2021.

For More Information

Was this page helpful?