The Group Insurance Board today approved the issuance of a letter of intent to award contract(s) to WebMD Health Services for administering the Well Wisconsin Program, including well-being, mental health, and chronic condition management. An analysis of wellness benefits relative to current and proposed benefits under the Group Health Insurance Program will be presented at the May 17 GIB meeting, along with negotiation results, GHIP costs, and premium impact
The goals of Well Wisconsin are to:
- Ensure members have uniform, high-quality, cost-effective access to disease and lifestyle management programs
- Coordinate with medical, pharmaceutical, and uniform dental programs under the umbrella GHIP
- Decrease overall health risks and costs for the top five manageable conditions, including diabetes, coronary artery disease, depression, hypertension, and asthma
Manageable health conditions cost the group health insurance program more than $230.5 million in 2021.
The GIB also reviewed the status of Board initiatives to improve the GHIP. The Board evaluates insurance programs and initiatives based on its Healthcare Triple Aim guiding principles in order to improve member health, ensure access to quality care and services, and reduce costs.
Among recent Board initiatives are those designed to:
- Reduce or avoid unnecessary emergency room use
- Improve mental health parity and access to mental health services
- Evaluate the expansion of pre-tax savings account options for local employees and employers
In 2023-2024 the Department of Employee Trust Funds will also focus resources on the implementation of a new Insurance Administration System; work to enhance member education about and enrollment in the high-deductible health plan; and research ways to reduce the impact of social determinants of health on GHIP.
- Herschel Day and Nancy Thompson were re-elected as board chair and secretary, respectively. Rachel Cissne Carabell was elected vice-chair.
- Approved September 25 – October 20, 2023, as the open enrollment period for plan year 2024.
- Received an audit report on contract compliance of Securian, the GIB’s third-party administrator of the Wisconsin Public Employers Group Life Insurance Program, for plan years 2020-2021. The audit was conducted to ensure Securian has sound business practices, sufficient internal controls, and applies agree-upon procedures. The audit confirms Securian is compliant with policy and reporting elements of the administrative agreement.
- Received an audit report on contract compliance of Optum, the GIB’s third-party administrator of the pre-tax savings account programs, for calendar years 2020-2021. The audit was conducted to evaluate the design and operative effectiveness of internal controls over Optum’s compliance in several key areas, including elections and contribution limits; claims substantiation; billing; and performance standards. ETF and Optum have accepted all of the audit findings and developed a corrective action plan. ETF will provide written updates to the Board on progress towards implementing the plan.
The Board’s next regularly scheduled meeting is May 17, 2023.
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