It’s Your Choice Open Enrollment is September 28 - October 23, 2020
The annual health benefits open enrollment period allows uninsured but eligible employees and retirees to enroll for coverage effective the following January 1. This is also an opportunity for currently insured subscribers (active employees, retirees and continuants) to change health plans, enroll or remove adult children from family coverage, change from individual to family coverage, change from family to individual coverage or cancel coverage.
We encourage employees to electronically submit their enrollment changes. The enrollment process may vary between employers. Employers must verify their enrollment process and communicate instructions to employees. There is targeted enrollment information in the health benefits sections of the ETF web site. 2021 health insurance information will be available at the end of September prior to the open enrollment period. Please see the Employer’s Application Processing Instructions for It’s Your Choice 2021 later in this bulletin for more information.
The 2021 health benefits decision guides will be delivered to all employers at the end of September, if requested. The 2021 health benefits web pages will be available online to employers and members by the end of September. Visit etf.wi.gov for 2021 open enrollment information.
Please consider using the sample email below to notify employees of open enrollment and important changes. To comply with federal notification requirements, see the Electronic Distribution of the 2021 Health Benefits Decision Guides section below. Since these web pages will not be available until the end of September, please do not send this email to your employees until the last week of September.
State It’s Your Choice Kick-off Meeting
The It's Your Choice 2021 employer kickoff event for plan year 2021 will be held virtually. This kickoff meeting will follow a similar agenda as in previous years, and a recording of this event will later be available on the ETF website for viewing anytime.
Date: Thursday, September 17, 2020
Time: 9:00 a.m. - 12:00 p.m.
Registration: September 17 kickoff registration link
The It’s Your Choice kick-off meeting provides an opportunity to receive information from representatives from the health plans, pharmacy benefit manager, supplemental plans, wellness vendor (StayWell) and ETF employees regarding benefit program changes effective January 1, 2021.
2021 Virtual Benefit Forums for Employers
ETF is hosting a series of virtual forums for employers to connect with health benefits vendors in advance of the It's Your Choice 2021 open enrollment period. These virtual forums with the vendors will provide the same personal interaction with a vendor as a benefit fair or kickoff event from the safety of your own home or office.
Employers must pre-register to attend these events online via webinar. Due to the high demand, please register as soon as possible.
2021 Sneak Peek Coming Soon
The 2021 version of ALEX, Virtual Benefits Counselor, and an open enrollment Sneak Peek video will launch the week of September 14. Visit etf.wi.gov/ALEX for more information.
An ALEX toolkit for employers is available from the Employers page of the ETF website. The toolkit contains emails, fliers, posters and other resources that are ready to use.
Important Plan and Program Changes
Plan and Network Changes
No Plan Offering Changes
The same health plans will be offered for plan year 2021 as in 2020. No health plans are joining or departing the Group Health Insurance Program.
Service Area Changes
The State Maintenance Plan (SMP) will no longer be offered in Forest County for 2021. No counties require the SMP for 2021. Employees should make sure their providers are in-network or select another plan.
New Medical Benefit
Biofeedback for urinary incontinence will now be covered.
New Administrator for Vision
DeltaVision, in partnership with EyeMed Vision Care, is the new administrator for the supplemental vision benefit. Current member enrollments with VSP will be automatically transfer to DeltaVision for plan year 2021, unless the member cancels coverage during open enrollment.
Mutual of Omaha Long-Term Care (administered by HealthChoice)
Long-term care insurance is open for new enrollments with HealthChoice. Enrollment is available throughout the plan year. Current participants can continue their policies and do not need to take any action. See the ETF website for more details.
Accident Plan by Securian Financial
The Accident Plan’s accidental death and dismemberment (AD&D) payment amount has been increased for members up to $100,000.
Disclaimer: UW system and UW Hospital and Clinics employees may have different supplemental benefits.
Supplemental Benefit Plans Continuing in 2021
Dental Plans: Delta Dental of Wisconsin will continue to provide the Preventive Plan, Select and Select Plus Supplemental Dental Plans in 2021.
Delta’s plans will offer different coverage tiers that do not duplicate any of the preventive care coverage offered in the Uniform Dental Benefit. The Preventive PlanTM covers routine evaluations, dental cleanings, bitewings, panoramic X-rays and sealants. The Delta Dental PPOTM-Select Plan covers major services (bridges, crowns, dentures, root canals, surgical extractions and periodontics) at 50%. Delta Dental PPO Plus PremierTM-Select Plus Plan covers those same services at 60%-80% and orthodontia for all ages up to a $1,500 lifetime maximum.
Group Health Insurance Opt-Out Option
Employees who wish to claim the opt-out incentive must complete the Health Insurance Application/Change (ET-2301) form (complete Sections 1, 12 and 13) unless the employer has an ETF approved electronic system to gather and report this information (for example, STAR). Employees must complete this opt-out request each year.
It’s Your Choice HDHP Reminders
To be eligible to enroll in the High Deductible Health Plan (HDHP) or Access HDHP, the subscribing employee must be enrolled in the Health Savings Account (HSA). In addition, the subscriber cannot:
- Have any other health coverage that pays for out-of-pocket health care expenses before they meet their plan deductible, including Medicare A and B.
- Be covered by TRICARE.
- Be claimed as a dependent on another person’s tax return (unless it’s their spouse).
- Have a Health Care Flexible Spending Account (FSA) in the same year (also applies to spouse). Some health care FSAs can be converted; the subscriber should contact the administrator of their Health Care FSA for more information.
Note: If a subscriber has Veterans Administration (VA) benefits, this is not disqualifying health care coverage. However, a subscriber is unable to contribute to an HSA if they have accessed their Veterans Administration (VA) benefits in the past 90 days. (It is the subscriber’s responsibility to know when they can and cannot contribute. If the subscriber has questions, they should speak with their tax consultant.)
If the employee/subscriber meets all eligibility criteria and does not have any disqualifying health care coverage, but the spouse and/or dependent(s) have other health insurance coverage (such as non-HDHP health insurance, Medicare, Medicaid or TRICARE), the subscriber and their spouse and/or dependent(s) are eligible for the family HDHP/HSA. The subscriber can contribute up to the HSA family maximum amount and the $1,000 catch-up, if applicable. HSA funds can be used for the spouse’s and/or eligible tax dependent’s eligible medical expenses if the same expenses are not being reimbursed in another way.
Reminder: An HSA application must be accepted, not just submitted, to be eligible for an HDHP.
HSA Employer Contributions: Employer contributions for the HSA for 2021 remain $750 per individual coverage and $1,500 per family coverage. Employer contributions must be made in accordance with instructions provided by the Department of Administration’s Division of Personnel Management (DPM).
HSA Employee Contribution Limits: The 2021 annual individual limit for an HSA contribution will increase by $50 (from $3,550 to $3,600). The annual family contribution limit will increase by $100 (from $7,100 to $7,200).
Pre-Tax Savings Account Limit Changes
The IRS has not yet released Pre-Tax Savings Account maximums and limits applicable for 2021. Limits for 2021 are expected to be released after the start of open enrollment. ETF will review the maximums and limits for 2021 when the information becomes available. In the event of significant changes, ETF may choose to alter the current annual contribution limits for 2021.
The following limit changes are currently approved for plan year 2021:
Health Care Flexible Spending Accounts (FSA) and Limited Purpose FSA Contribution Limit: The 2021 annual individual limit for an FSA contribution will increase by $50 (from $2,700 to $2,750).
Parking Account and Transit Account Contribution Limit: The 2021 monthly contribution limit for Parking and Transit accounts will increase by $5 (from $265/month to $270/month).
Well Wisconsin and Staywell®
The deadline to earn the 2020 Well Wisconsin incentive is October 9, 2020. Participants may choose to have the $150 gift card sent to their email or by postal mail to their home address.
New “Health Check” Activities
Members will have more options to complete their “health check” activity, including a routine dental exam or a health coaching call, to earn their $150 Well Wisconsin incentive in 2021.
Health Plan-Offered Wellness Incentives
Due to ongoing tax administration concerns, health plans will no longer be offering wellness incentives effective January 1, 2021. The $150 wellness incentive will continue to be available through StayWell to enrolled employees and their enrolled spouse.
Federal Section 1557 Non-Discrimination Information
Reminder: Please notify ETF of requests for health benefit information to be translated into languages other than English. Please share data about which information is being requested and in what language. Send to email@example.com.
General It’s Your Choice Information
To change health plans or coverage levels or opt-out of medical or decline dental coverage, employees must submit a completed electronic or paper health insurance application to their employers no later than Friday, October 23, 2020.
Employees may select any health plan regardless of their county of residence, but should consider whether the providers are within a reasonable distance for medical care. The 2021 Health Plan Search page will identify counties covered by each health plan, as well as a listing of their major providers and links to provider directories.
The updated Group Health Insurance Application/Change (ET-2301) form can be downloaded from ETF’s Internet site or you may order applications by completing the Online Forms Order page found on the employer forms page on the ETF website.
Retirees & Continuants: ETF mails decision guides directly to retirees and former employees who have continued their health insurance coverage. These mailed guides will have the Health Insurance Application/Change for Retirees and COBRA Continuants (ET-2331) enclosed. Employees who wish to change health plans and who will retire effective January 1, 2021 or later, must complete their It’s Your Choice applications as active employees. Changes for retiree and continuant coverage are handled by ETF.
2021 Health Benefits Decision Guides Distribution
The 2021 health benefits decision guides must be distributed in a timely manner to all employees. The distribution method (hard copy, link to web version, PDF file) is determined by the employer. It is acceptable for employers to distribute health benefits decision guides using an electronic method during the COVID-19 outbreak. Employee distribution should include:
- Employees who have indicated they do not wish to make a change during the It’s Your Choice open enrollment period.
Remind these employees that they remain responsible for understanding the information contained in the guides and the ETF website, and that their certificate of coverage is available on the ETF website. We encourage you to point employees to the enrollment checklist on the inside cover of the Health Benefits Decision Guide for important reminders.
- Insured employees on temporary layoff or leave of absence and those on permanent layoff paying premiums through the employer.
Employees who allowed health insurance coverage to lapse while on a leave of absence or a temporary layoff that encompassed the entire open enrollment period should be advised they are eligible to make a health benefits election within 30 days of returning from the leave or layoff.
Electronic Distribution of the 2021 Health Benefits Decision Guides
Employers distributing open enrollment information electronically must incorporate the following as part of their electronic distribution procedures:
- Develop a list of all eligible employees and use that list to match against their file of employee email addresses.
- Verify the list and then send the employee an email (see sample email below) with the link to the guides and online information. Employers should send the email with a “return receipt.” This will establish a record of when the employee opened the email.
- Due to federal regulations, employers must retain the list of employees who received an electronic copy of the IYC materials. For each employee who is sent an email message, the employer should receive a “reject” notice if the email address is no longer in existence.
Note: While ETF generally recommends that you give new employees paper copies of the guides, distributing links to web versions or PDF files of the health benefits decision guides during the COVID-19 outbreak is acceptable. However, if employees who do not have access to a computer and/or employees who receive the electronic distribution but request a paper copy, must be given one.
Employees must contact health plans directly to request the most up-to-date information regarding service area and/or provider availability related to open enrollment.
Note: When contacting a health plan or Navitus, employees must identify themselves as a State of Wisconsin Group Health Insurance Program subscriber in order to receive information pertinent to the program administered by ETF.
Health plans often report they are unable to contact current subscribers due to incorrect addresses on file. Please remind employees who participate in the group health insurance program that they are responsible for providing address changes and revisions of other relevant information, such as marital status changes, to you via a myETF Benefits update or the Group Health Insurance Application/Change (ET-2301) form.
Employers are responsible for keying changes submitted on paper by using the myETF Benefits system found in the Online Tools section of the ETF website or by electronic file transmission if the employer uses this method. Once mailing addresses are updated, employees will receive provider information in a timely fashion, including information for the annual disabled dependent verification process, which enables members whose dependents remain eligible in 2021 to continue their current health insurance. If an employer uses electronic file transmission, employee address updates must be sent separate from the annual open enrollment election or manually keyed by the employer into the myETF Benefits System.
Employer’s Application Processing Instructions for It’s Your Choice
During the open enrollment period, employees should be directed to self-service enrollment options whenever possible. Employers should direct employees to the appropriate payroll center for directions on how to process any application materials.
Employers must either provide their own electronic method of enrollment to transmit to ETF, allow their employees to enroll online or accept paper applications and enter them into myETF on behalf of the employee.
Employers that accept a paper copy of the Group Health Insurance Application/Change (ET-2301) form must collect the applications no later than the close of business on October 23, 2020. If an employer accepts a paper application, the employer must enter that application into the myETF Benefits system on behalf of their employee through the Online Tools link to the myETF Benefits System found on the ETF website. The application is not to be mailed or faxed to ETF for processing and keying. The deadline for employers to enter It’s Your Choice applications into the myETF Benefits system is November 13, 2020.
If the employee submits a paper application to their employer, ETF does not require that a copy of the application be submitted to ETF. Employers are not to make entries on behalf of their employee without an application as documentation of the employee’s request. The employer is to maintain a copy of the paper application in the employee’s file.
If employers are going to accept a Group Health Insurance Application/Change (ET-2301) form, the following steps in processing the application are required:
- Verify the employee completed the application in its entirety, including signing the application. The application should be promptly returned to the employee if it is incomplete. The application may be signed electronically, as long as the employer can verify the signature. A secure email from the employee stating their intent to apply for health insurance or change their coverage along with a complete health insurance application provided to ETF in the normal manner is acceptable in lieu of a signature.
- Complete the employer section of the application in its entirety. Do not leave requested information blank.
- Return a completed copy of the application to the employee. Do not send a copy of the application to ETF or the health plan.
- All applications received by the employer on or prior to October 23, 2020 must be entered electronically by November 13, 2020. This deadline must be met by the employer to ensure health plans and Navitus receive the contract information timely so employees receive their health plan information and identification cards prior to January 1, 2021.
Withdrawing/Rescinding an It’s Your Choice Application
Entry into myETF Benefits of an employee’s request to withdraw or rescind a health benefits application must be completed by ETF. Employees may rescind a 2021 application by notifying their employers in writing prior to December 31, 2020. The written request should be filed with the employee’s records. Forward one copy of the employee’s written request to rescind to ETF. An employee may also rescind their request by writing “Rescind” across the top of their original application and initialing. Forward a copy of this updated application to ETF for processing and keep a copy for the employee’s file. If the employee enrolled through an employer’s human resources benefit application, a copy of the enrollment screen must be submitted, with “Rescind” across the top and initialed by the employee. Retain a copy for your employee’s records. ETF will update myETF Benefits by deleting the request and reinstating the employee’s original coverage.
If an employee submitted his/her request through the myETF Benefits system and now wants to rescind that request, the employee must submit a written request to their employer by December 31, 2020. Employers are to make a copy of that written request and forward it to ETF while retaining a copy for your employee’s records. ETF will update myETF Benefits by deleting the request and reinstating the employee’s original coverage.
Additional It’s Your Choice Instructions and Information
Specific instructions are found in the State Agency Health Insurance Standards, Guidelines and Administration Employer Manual (ET-1118):
- Information if you have an employee initially eligible for coverage in November or December.
- Instructions on completing the Continuation - Conversion Notice (ET-2311) if you have an employee who terminates employment in November or December after filing a health benefits application.
- Information on the process to follow if you receive a late application (an application received after the last day of open enrollment period). ETF reviews all late requests. Note that documents for late applications can be faxed to 1-608-266-5801, attention Employer Services.
Contact the Employer Communication Center at 1-877-533-5020 with questions or email firstname.lastname@example.org.
Contacting the Health Plans
The updated Health Plan Contact List (ET-1728) is meant for employers to use when contacting the health plans for assistance with membership, supplies, etc. The contact list includes email addresses and fax numbers when available.
Note that employees who need assistance should contact the health plan directly, using the health plan contact information for members that will be available on the updated health plan pages soon and in the decision guides. These are customer service lines and are fully staffed to handle a large number of phone calls. Employees should specify they are enrolled in the State of Wisconsin Group Health Insurance Program when calling the health plans.
Sample Employee Emails
You can use the below sample email to provide It’s Your Choice health benefits information to your employees:
Important Information about Your Health Benefits for 2021
The It's Your Choice open enrollment period, which begins on September 28 and ends on October 23, 2020, is right around the corner.
This is your chance to:
- Enroll or make changes to your health insurance
- Add or decline Uniform Dental
- Enroll in or make changes to supplemental coverage such as dental or vision insurance
- Enroll in a pre-tax savings account to save money on health care or dependent day care expenses
Changes you make during open enrollment become effective January 1, 2021.
You should note:
There are new supplemental plans, including an accident plan and a preventive dental plan.
Your To-Do List:
Visit etf.wi.gov for information about your 2021 benefits.
- Talk to ALEX®, your virtual benefits counselor. This anonymous and fun online tool can help you figure out which benefits plans are going to be best for you and your family—all in about seven minutes or so.
- View Important Changes for 2021 to learn about changes that may impact you in the upcoming plan year .
- The deadline to submit your electronic request or your completed paper application to your benefits office is 4:30 p.m. on October 23, 2020. (Employer, replace this bullet with information about your electronic enrollment system, and/or alter the deadline time if your office is open later.)