The Group Insurance Board today voted to increase rates in 2024 to offset rising health benefit costs and to maintain reserve funds of the State of Wisconsin Group Health Insurance Program. The Board also approved health plan service area qualifications and conducted other business. 

The overall medical insurance premium increase will be 11.8% for state government employees and 15.1% for local government employees. The actual rate increases for individual non-Medicare GHIP members and employers will differ due to contributions by local employers and health plan choice. The Department of Administration, Division of Personnel Management determines both the state government employee contribution to the premium and the employer contribution to the Health Savings Account. 

The GHIP State and Local reserves are outside of the target range established by Board policy, largely due to investment losses in 2022.  The Board has a multi-year plan to bring reserves back to an acceptable target range and was factored into setting 2024 rates. 

“Unfortunately, unlike previous years, there are not surplus reserve funds available to reduce rate increases in 2024,” said Eileen Mallow, director of the Office of Strategic Health Policy at the Department of Employee Trust Funds. “The reserves protect the insurance program against possible adverse experience or negative market trends and risk of not being able to pay claims or premiums.” 

GHIP members can watch for premiums and health insurance information in their 2024 Health Benefits Decision Guides and other communications during the annual open enrollment period, set for September 25-October 20.

Health Plan Service Area Qualifications

Health plans are evaluated and tiered 1 through 3 based on pricing to serve members in each county. For counties where there is no Tier 1 health plan, a state health plan option, referred to as the State Maintenance Plan, is available as a Tier 1 plan along with other qualified health plans.

For the 2024 plan year, all health plans met Tier 1 status for the State program. Only nine of the 19 available health plans met Tier 1 status for the Local program.

The Board also approved the following health plan service area qualifications for 2024: 

  • Tier 2 designation for Dean Health Plan and Group Health Cooperative of South Central Wisconsin Neighbors in the Local program.

  • Tier 3 designation for Aspirus Health Plan; Common Ground Healthcare Cooperative; Group Health Cooperative of Eau Claire Greater Wisconsin; HealthPartners Southeast; HealthPartners West; Robin with HealthPartners; Quartz Central; and Security Health Plan in the Local program. 

  • The State Maintenance Plan will be available in Florence County for the State program and in 30 counties for the Local program. 

Other Business

  • The Board approved a premium reduction for spouse and dependent coverage in the State Group Life Insurance Program from $2.26 to $2.10 per unit, effective April 1, 2024.
  • ETF reported there was an increase in health plan quality scores from 2022 to 2023 for all but two plans. The quality credit, as part of the rate-setting process, is factored into all health insurance premium rates presented to the Board. ETF plans to expand measures in the future to better evaluate the quality of care in the GHIP and identify areas for cost savings and program improvements.
  • The Board reviewed experience reports for three vendors in plan year 2022. Delta Dental and Securian Financial Group met or exceeded all performance standards. WebMD met all performance standards, including risk change related standards for participants in the Well Wisconsin Program.
  • Optum Financial continues to work with ETF to amend contracts to include audit recommendations related to performance standards and to adjust the per member per month administrative fees in the 2024-2025 plan year contract extensions. 

The Board’s next regularly scheduled meeting is November 15, 2023.  

 For More Information 

Group Insurance Board August 16, 2023, Meeting Agenda and Materials