It’s Your Choice Open Enrollment is September 27 - October 22, 2021.
The annual health benefits open enrollment allows uninsured but eligible employees and retirees to enroll for coverage effective the following January 1. In addition, this is 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 and retirees to electronically submit their enrollment changes via the myETF Benefits Online Health Insurance Enrollment System. Retirees may use myETF Benefits or complete the Health Insurance Application/Change for Retirees and COBRA Continuants (ET-2331) form, which will be included in the It’s Your Choice 2022 health benefits decision guides mailed to retirees. Employees will find step-by-step information on how to submit an electronic request on ETF’s website. Please see the Employer ’s Application Processing Instructions for It’s Your Choice 2022 later in this bulletin.
Note: If retirees are electing Medicare Some, they must complete a paper application (ET-2331) and submit it to ETF.
The 2022 health benefits decision guides will be delivered to all employers at the end of September, if requested. The 2022 health benefits web pages will be available online to employers and members by the end of September. Visit etf.wi.gov for open enrollment information.
Please consider using the sample email at the end of this employer news to notify employees of open enrollment and important changes. To comply with federal notification requirements, see the Electronic Distribution of the It’s Your Choice guides section later in this bulletin. 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.
Local Employer Kick-Off Meeting Reminder
Local Insurance Q&A Session Reminder
Important Plan and Program Changes
Federal Section 1557 Non-Discrimination Information
General It’s Your Choice Information
2022 Health Benefits Decision Guides Distribution
Additional It’s Your Choice Instructions and Information
Local Employer Kick-Off Meeting Reminder
Reminder! ETF will host several It's Your Choice 2022 employer kickoff events for local government employers for plan year 2022. All kickoff events will be held virtually. These events will follow a similar agenda as in previous years, and a recording will later be available on the ETF website for viewing anytime.
See the previous employer news for more local employer information and registration links.
Employers must pre-register to attend these events online via webinar. Due to the high demand, please register as soon as possible.
The It’s Your Choice employer kickoff meeting provides an opportunity to hear from the health plans, pharmacy benefit manager, supplemental plans, wellness vendor (WebMD), and ETF employees about the benefit program changes that are effective January 1, 2022.
Local Insurance Q&A Session Reminder
ETF will host its first annual local government employer insurance question and answer session on September 24. All local employers may register to ask ETF staff any insurance (health, life, income continuation insurance) benefit-related questions.
Employers must pre-register to attend this event online via webinar. Due to the high demand, please register as soon as possible.
2022 Virtual Benefit Webinars
ETF is hosting a series of virtual webinars for employers and members to connect with health benefits vendors during the 2022 open enrollment period. These virtual webinars 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.
Additional details and registration information will be provided in the near future. Attendees must pre-register to attend these events online via webinar. Due to the high demand, please register as soon as possible.
2022 What’s Changing Video
A video outlining important changes for plan year 2022 is now available. Please share with your employees the last week of September.
Important Plan and Program Changes
Health Plan Changes
New Health Plan: Aspirus Health Plan will be available for plan year 2022. This new health plan will cover select counties in north-central Wisconsin.
- Covered counties: Clark, Florence, Forest, Iron, Langlade, Lincoln, Marathon, Oneida, Portage, Price, Shawano, Taylor, Vilas, Waushara, and Wood.
- Key provider systems include: Aspirus Health, Ascension North & Central, ThedaCare, and Bellin Health.
Service Area Change: The current Quartz Community network will be discontinued at the end of plan year 2021. It is being replaced by two new network offerings – Quartz Central and Quartz West.
Current Quartz Community members should select a new health plan during open enrollment. If a new health plan is not selected, current Quartz Community members will be assigned to either the Central or West network, depending on the location of their primary care provider.
Quartz Central covers select counties in the middle and eastern parts of Wisconsin – outside of Dane County.
- Covered counties: Adams, Columbia, Dodge, Fond du Lac, Grant, Green, Green Lake, Iowa, Jefferson, Juneau, Lafayette, Marquette, Richland, Rock, Sauk, Walworth, Waukesha, Waushara, and Wood.
- Key provider systems include: Aurora Health System, ProHealth Care, and ThedaCare.
Quartz West covers select counties in western Wisconsin.
- Covered counties: Buffalo, Chippewa, Clark, Crawford, Eau Claire, Jackson, La Crosse, Monroe, Pepin, Trempealeau, and Vernon.
- Key provider systems include: Gundersen Health System, as well as other local and regional providers.
Note: The Quartz – UW Health network, providing coverage to Dane County, will not be impacted by this network change. Quartz – UW Health members will automatically continue their current enrollment unless they change their elections during open enrollment.
State Maintenance Plan: The State Maintenance Plan (SMP) will experience a significant premium rate increase for 2022, due to high claims experience without sufficient premiums in 2021.
SMP will no longer be available in the following counties: Buffalo, Crawford, Jackson, La Crosse, Monroe, Pepin, and Trempealeau.
SMP will be newly offered in the following counties: Forest and Wood.
SMP will continue to be offered in the following counties: Florence, Pierce, Polk, Rusk, and St. Croix.
Benefit Changes
Medical Benefit Changes: There are several minor medical benefit changes for plan year 2022, including:
- Adding coverage for medically necessary corrective jaw surgeries,
- Removing the timeframe requirement for tooth extractions or dental repairs due to accidents, and
- Updating and specifying telemedicine coverage
The updates and specifications to telemedicine coverage for plan year 2022 include new service category definitions and cost-sharing. These new categories better reflect health plan coding classifications and are intended to improve the member experience, especially as telemedicine options continue to be used more frequently.
Visit the ETF website for more details about telemedicine coverage, including service category definitions and cost-sharing details.
Limit Changes: Several limit changes were also approved for plan year 2022, including:
- Updating the medical maximum out-of-pocket limit to match the annual federal maximum,
- Applying all medical benefits to the maximum out-of-pocket limit, and
- Removing Level 4 pharmacy benefit out-of-pocket limit for commercial members.
Continuous Glucose Monitors: Continuous Glucose Monitors, or CGMs, will be covered under the pharmacy benefit during plan year 2022 for commercial members.
CGMs are wearable devices for diabetes management. They are currently covered under the medical benefit – and will be available under both the medical and pharmacy benefit in 2022.
Members will only receive a CGM under one of the benefits. CGM model availability varies between health plans and the pharmacy benefit.
New Uniform Dental Benefit: Coverage for composite resin fillings for back teeth has been added to the uniform dental benefit effective January 1, 2022. Composite resin fillings are also known as white fillings.
The uniform dental benefit already covers composite resin fillings for front teeth. Soon, both your front and back teeth will be able to benefit from these natural looking fillings.
The uniform dental benefit and all supplemental dental benefits will continue to be administered by Delta Dental.
Supplemental Benefit Plans
Accident Plan by Securian Financial: There are two notable changes to the Accident Plan for plan year 2022:
- Most claim payment amounts will increase. This means members will receive a greater cash payment amount to help cover accident-related expenses than in prior plan years – at the same monthly rate.
- Physical therapy visits have been added as a covered claim type for 2022. Physical therapy visits will need to be related to a covered accident type to receive payout.
See www.LifeBenefits.com/plandesign/WIETF for detailed plan information. Employers must opt-in during open enrollment to offer this benefit to active employees. Local WRS retirees are not eligible for the Securian Accident Plan. If you have questions, please contact madisonbranch@securian.com.
Supplemental Dental by Delta Dental: Delta Dental of Wisconsin will continue to provide the Preventive Plan, Select and Select Plus Supplemental Dental Plans in 2022.
Employers must opt-in by October 22, 2021, to offer this benefit to employees for plan year 2022. If you have questions, please contact ETFsales@deltadentalwi.com or call 715-343-7679.
Note: Employers currently offering this benefit do not need to opt-in again. Opt-in elections automatically continue to the subsequent plan year.
Local WRS retirees are eligible for supplemental dental coverage even if their former employer doesn't opt into the program.
Supplemental dental rates are changing effective January 1, 2022:
Active Employee 2022 Monthly Dental Rates
| Uniform Dental Benefit | Preventive Plan | Select Plan | Select Plus Plan | |
|---|---|---|---|---|
| Individual | $30.20 | $34.72 | $9.76 | $20.98 |
| Individual + Spouse | n/a | n/a | $19.52 | $41.96 |
| Individual + Child(ren) | n/a | n/a | $13.16 | $38.96 |
| Family | $75.50 | $86.80 | $23.40 | $64.28 |
Retiree 2022 Monthly Dental Rates
| Uniform Dental Benefit | Preventive Plan | Select Plan | Select Plus Plan | |
|---|---|---|---|---|
| Individual | $30.20 | $34.72 | $16.22 | $31.12 |
| Individual + Spouse | n/a | n/a | $32.96 | $62.24 |
| Individual + Child(ren) | n/a | n/a | $22.26 | $57.58 |
| Family | $75.50 | $86.80 | $39.56 | $94.94 |
Vision Plan by DeltaVision: DeltaVision, with EyeMed Vision Care, will continue to provide supplemental vision coverage in 2022.
Employers must opt-in by October 22, 2021, to offer this benefit to employees for plan year 2022. If you have questions, please contact ETFsales@deltadentalwi.com or call 715-343-7679.
Note: Employers currently offering this benefit do not need to opt-in again. Opt-in elections automatically continue to the subsequent plan year.
Local WRS retirees are eligible for supplemental vision coverage even if their former employer doesn't opt into the program.
Well Wisconsin Program
The deadline to earn the 2021 Well Wisconsin incentive is October 8, 2021. Participants will receive the $150 gift card by postal mail to their home address.
Two new Well Wisconsin web resources are available on the ETF website:
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 etfhealthandins@etf.wi.gov.
General It’s Your Choice Information
To change health plans or coverage levels or decline dental coverage, employees must submit a completed electronic or paper health insurance application to their employers no later than Friday, October 22, 2021.
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 2022 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.
ETF mails health benefits decision guides directly to retirees and former employees who have continued their health insurance coverage. Employees who wish to change health plans and who will retire effective January 1, 2022 or later, must complete their health benefits applications as active employees. Changes in annuitant coverage are handled by ETF when the employee applies for retirement benefits.
ETF will publish the 88% premium rate tables prior to open enrollment. ETF does not publish the 105% rate tables on the website. Employers may request the 105% rate tables from ETF at etfsmbemployerinsurance@etf.wi.gov; be prepared to discuss which employee group you are using the rates for as these rates should only be used for Public Safety Employees (and their management) under a valid collective bargaining agreement.
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. Local employer-paid annuitants should submit the Group Health Insurance Application/Change for Retirees and COBRA Continuants (ET-2331) form, which will be available in the health benefits decision guide and on the ETF website.
2022 Health Benefits Decision Guides Distribution
The 2022 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 2022 Health Benefits Decision Guides and on 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 2022 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 open enrollment 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.
Employee Responsibilities
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 Wisconsin Public Employer Group Health Insurance Program subscriber in order to receive information pertinent to the program administered by ETF. It’s also beneficial if they state which program option they are offered; please provide this information to employees.
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.
Processing Changes
Employers are responsible for keying changes submitted on paper by using the myETF Benefits system found through the Online Tools link found on the ETF website by November 12, 2021. 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 dependents who remain eligible in 2022 to continue their current health insurance.
Note: If retirees are electing Medicare Some, they must complete a retiree paper application (ET-2331) and submit to ETF.
Employer’s Application Processing Instructions for It’s Your Choice
During the open enrollment period, employers have three options for handling requests from their employees:
Employers can require employees to use the Online Network for Members (ONM) site to file their requests through the myETF Benefits system. Employees must submit their electronic request no later than October 22, 2021. ETF strongly encourages employers to direct their employees to use the myETF Benefits system. Retirees may use myETF Benefits or complete the Health Insurance Application/Change for Retirees and COBRA Continuants (ET-2331) form, which will be included in the It’s Your Choice 2022 health benefits decision guide. Retirees electing Medicare Some must complete and submit a retiree application (ET-2331) to ETF by October 22, 2021.
Employers may require employees to file their requests by completing a Group Health Insurance Application/Change (ET-2301) form and submit the application to the employer no later than the end of the business day on October 22, 2021. If an employer elects to require a paper application, the employer must enter that application into the myETF Benefits system on behalf of their employee accessed through the Online Tools link 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 12, 2021.
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.
Either accept an electronic request from an employee or a paper Group Health Insurance Application/Change (ET-2301) form. Again, this is at the employer’s discretion to determine what will be acceptable.
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 Group Health Insurance Application/Change (ET-2301) forms received by the employer on or prior to October 22, 2021, must be keyed into the myETF Benefits system by November 12, 2021. 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, 2022.
Note: If retirees are electing Medicare Some, they must complete a paper application (ET-2331) and submit it to ETF.
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 2022 application by notifying their employers in writing prior to December 31, 2021. 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. 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, 2021. 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 Local Employer Health Insurance Standards, Guidelines and Administration Manual (ET-1144):
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 an It’s Your Choice application.
Information on the process to follow if you receive a late It’s Your Choice application, an application received after the last day of the It’s Your Choice open enrollment period. ETF reviews all late It’s Your Choice requests. Note that documents for late It’s Your Choice 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 via email at etfhealthandins@etf.wi.gov.
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 Wisconsin Public Employers Group Health Insurance Program when calling the health plans.
Sample Employee Email
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 2022
The It's Your Choice open enrollment period, which begins on September 27 and ends on October 22, 2021, is right around the corner.
This is your chance to:
- Enroll or make changes to your health insurance.
- Add or decline Uniform Dental (Employer, if you offer Uniform Dental Benefits include this bullet. Strike it from your email if you do not offer Uniform Dental Benefits.)
- Enroll in supplemental dental coverage. (Employer, reminder you must opt into the Supplemental Dental Program before your employees can register for it. Strike this line from your email if you are not opting into the program.)
- Enroll in supplemental vision coverage. (Employer, reminder you must opt into the supplemental vision benefit before your employees can register for it. Strike this line from your email if you are not opting into the program.)
- New: Enroll in the Securian Accident Plan. (Employer, reminder you must opt into the Securian Accident Plan before your employees can register for it. Strike this line from your email if you are not opting into the program.)
Changes you make during open enrollment become effective January 1, 2022.
Your To-Do List:
Visit etf.wi.gov for information about your 2022 benefits.
- Attend a health benefit webinar. ETF will host a number of webinars during the open enrollment period for you to learn about the 2022 plan year. You’ll have the opportunity to ask questions directly to health plans and vendors. Visit etf.wi.gov/health to register.
- Watch the 2022 Open Enrollment Preview video 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 22, 2021. (Employer, replace this bullet with information about your electronic enrollment system, and/or alter the deadline time if your office is open later.)
Language assistance is available.