Updated June 18, 2024
The Group Insurance Board (GIB) has set premium rates for 2025, while taking action to stabilize the reserve of the State of Wisconsin Group Health Insurance Program. The Board also approved health plan service areas for the 2025 plan year at its meeting yesterday.
Premium rates will increase next year due to the impact of lower-than-projected reserve balances, increased pharmacy and medical costs, higher administrative fees, and other factors. The GIB directed the Department of Employee Trust Funds (ETF) to include a stabilization charge in the premium to return the reserve to the midpoint range by the end of 2027.
ETF presented an initial analysis of the Local Program with the goal of restructuring the program to decrease volatility of rates and improve stability. Based on feedback from health plans and local employers, ETF will continue to explore solutions such as modeling the Local Program design options like the State Program and issuing a request for information on vendor options.
2025 Rates for Employees
The average non-Medicare premium increase will be 7.3% 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 11.0%. The premium contribution for local employees is determined by each individual employer.
These overall rates for the state and local programs include medical, pharmacy, and dental as well as the stabilization charge.
2025 Rates for Retirees
For Medicare-enrolled retirees, the medical with prescription drug premium increases will range from 5% to 20% for the State Program and from 6% to 26% for the Local Program.
The Medicare Advantage medical with prescription drug premium increase for both the state and local programs will be 20%. A member with individual coverage will pay an additional $54.66 (State) or $55.96 (Local) each month.
Over time, the Medicare Advantage rate has gone down and up, yet it remains the lowest-cost Medicare plan option for members.
The Medicare Plus medical premium increase for both the state and local programs will be 9%.
Historically, the Board has set premium rates at its August meeting. Beginning with the 2025 plan year, the rate setting is earlier to accommodate local employer budgeting cycles and the programming needs of ETF’s new Insurance Administration System.
The actual monthly premium costs for members and benefits information for 2025 will be made available prior to the annual open enrollment period, Sep. 30-Oct. 25.
Other Business
ETF provided an educational overview of the Board’s Pharmacy Benefits Program and industry trends as a prelude to the Board’s ongoing consideration of coverage of anti-obesity medications. ETF plans to present further analysis of costs and coverage alternatives at the Board’s meeting in August.
Following its review of the annual actuarial valuation of the State and Local Income Continuation Insurance (ICI) Program for 2023, the Board approved:
- A 10% reduction in the State ICI Program premium rate for the 2025 and 2026 plan years.
- Continuation of the premium holiday for the Local ICI Program for the 2025 plan year.
The GIB also approved several changes for the Wisconsin Public Employers Group Life Insurance Program to allow for an open enrollment and streamline program administration as ETF modernizes its Insurance Administration System.
Further, the Board suspended its November 2023 motion regarding new vendor information security requirements starting in late 2025. The Board requested that ETF identify options for acceptable alternatives. Current security requirements remain in place.
The Board’s next regularly scheduled meeting is Aug. 14, 2024.