It’s Your Choice Open Enrollment is September 30 - October 25, 2019
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. 2020 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 2020 later in this bulletin for more information.
The It’s Your Choice Decision Guides will be delivered to all employers at the end of September. Up-to-date and easily accessible, interactive information will be available in the 2020 health benefits pages, which will be available online at etf.wi.gov/benefits-by-employer – which will go live and be available to employers and members at the end of September.
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 It’s Your Choice Guides section below. This sample email contains direct links to where members will be able to find 2020 information; since these webpages will not be available until the end of September, please do not send this email to your employees until the last week of September.
It’s Your Choice eLearning and Kick-Off Meeting Reminder
New and updated online tools will be available to help employees select their benefits the week of September 16:
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.
ETF will present a live webinar of the annual It’s Your Choice kick-off meeting from the Alliant Energy Center in Madison. Employers can attend in person or remotely via live webinar. Webinar participants can use the chat function to ask questions online during the presentation. Answers to all non-case-specific questions will be posted on ETF’s website along with a recorded version of the meeting.
Pre-registration is not required to attend in person. However, employers must register to view the meeting online via webinar. Due to the high demand, please register as soon as possible.
State It’s Your Choice Kick-off Meeting
Details for this year’s It’s Your Choice kick-off meeting:
Date: Tuesday, September 17, 2019
Time: State Employer Representatives: morning session 9:00 a.m. - 12:00 p.m.
Location: Alliant Energy Center of Dane County, Exhibition Hall Mendota Rooms 1-4, 1919 Alliant Energy Center Way, Madison, WI 53713. For a map and directions, please refer to Employer Bulletin Vol. 36, State A.
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, 2020. These representatives will be available for questions and information beginning at 8:30 a.m. and again after the meeting.
Note: ETF will not have paper decision guides at the event.
Important Plan and Program Changes
Plan and Network Changes
No Longer Available
- Security Health Plan - Central
- Security Health Plan - Valley
If an employee is currently enrolled in one of these health plans, they must enroll in a new plan during open enrollment. If they do not, they will not have coverage as of January 1, 2020. Provider directories will be available on our website.
Service Area Changes
Dean Health Plan - Prevea360 will expand to include the following western counties: Barron, Buffalo, Chippewa, Dunn and Eau Claire. Prevea360 will also offer limited provider availability in Pepin County.
WEA Trust - East will expand to include the following counties: Langlade, Lincoln, Oneida, Price, Taylor and Vilas. WEA Trust - East will also offer limited provider availability in Forest County.
Network Health will expand to include Marathon County.
The State Maintenance Plan (SMP) will continue to be offered in Forest County for 2020. There will be fewer providers; employees should make sure their providers are in-network or select another plan. The provider directory will be available on the ETF website.
Vaccines at Pharmacies Covered
Vaccines will be covered under the pharmacy benefits at in-network retail pharmacies. Find an in-network pharmacy at etf.benefits.navitus.com (no login required).
Participants can still choose to get vaccines through their medical provider instead, which will be covered under the medical benefit.
New Medical Benefit Changes
Bariatric surgery and weight loss services will be provided for participants with a body mass index (BMI) of 35 or greater, or as determined by the health plan.
Uniform Dental Benefits
New benefits include:
- No-cost periodontal maintenance (special cleaning procedure for those with periodontal disease; helps maintain gum and bone health)
- Pulp-vitality test (helps a dentist determine a treatment plan)
- Caries assessments (helps predict future dental health)
Delta Dental PPO Plus PremierTM-Preventive Plan
The Preventive Plan provides the same benefits as Uniform Dental, and is only available to participants not enrolled in the State of Wisconsin Group Health Insurance Program. It is an employee pay-all supplemental plan. Coverage includes:
- No deductible
- $1,000 per person annual benefit maximum
- 100% coverage for routine evaluations, dental cleanings, fluoride treatments, fillings and other preventive and maintenance procedures
- $1,500 orthodontics lifetime maximum for those under age 19
Mutual of Omaha Long-Term Care (administered by HealthChoice)
No new enrollments will be allowed after December 31, 2019. Current participants can continue their policies and do not need to take any action. To make changes to or cancel already exist long-term care policies, participants can contact HealthChoice at 1-800-833-5823.
AD&D by Zurich
Accidental Death and Dismemberment (AD&D) policies with Zurich will end December 31, 2019. The UW System and UW Hospital and Clinics will continue to offer their own AD&D Plan to their employees.
Accident Plan by Securian Financial
The plan pays money directly to participants to help cover the unexpected, such as concussions, burns, dislocation, fracture, emergency care, hospitalization, loss of a limb, surgery, accidental death and dismemberment.
Disclaimer: UW system and UW Hospital and Clinics employees may have different supplemental benefits.
Supplemental Benefit Plans Continuing in 2020
Dental Plans: Delta Dental of Wisconsin will continue to provide the Select and Select Plus Supplemental Dental Plans in 2020.
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 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.
Vision: Vision Service Plan (VSP) benefits include no charge for standard progressive lenses, an annual contact lens exam and $150 allowance for contacts or frames.
New Administrator for Pre-Tax Savings Accounts
ConnectYourCare (CYC) is the new administrator for pre-tax savings accounts which include:
- Health Care Flexible Spending Account (FSA)
- Limited Purpose Flexible Spending Account (LPFSA)
- Health Savings Account (HSA)
- Dependent Day Care Account
- Parking Account
- Transit Account
Employees need to re-enroll for 2020. Elections do not carry forward from year to year. Eligible existing accounts with carryover balances except for the HSA will automatically transition from TASC to CYC, no action required. If employees have an HSA with TASC, they can transfer their accounts to CYC through an online portal e-consent process between September 30, 2019 and December 31, 2019. If employees do not transfer their HSA from TASC, a $3/month administrative fee will be deducted from their account each month starting February 2020.
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 2020 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 2020 annual individual limit for an HSA contribution will increase by $50 (from $3,500 to $3,550). The annual family contribution limit will increase by $100 (from $7,000 to $7,100).
Employee Reimbursement Account Contribution Limit
The IRS has not yet released Employee Reimbursement Account (ERA) maximums and limits applicable for 2020. Limits for 2020 are expected to be released after the start of open enrollment. ETF will review the maximums and limits for 2020 when the information becomes available. For the Health Care Flexible Spending Accounts (FSA) and Limited Purpose FSA, ETF will match the current 2019 limits of $2,700. For the Parking Account and Transit Account, ETF will match the current 2019 limits of $265 per month. In the event of significant changes, ETF may choose to alter the current annual contribution limits for 2020.
Well Wisconsin and Staywell®
The deadline to earn the 2019 Well Wisconsin incentive is October 11, 2019. Incentives earned by October 11, 2019 must be claimed in the StayWell wellness portal by October 25, 2019. Participants may choose to have the $150 gift card sent to their email or by postal mail to their home address.
Note: In preparation for the 2020 program year, the StayWell wellness portal will not be available from December 20, 2019 through the first week of January 2020.
The 2020 Well Wisconsin incentive will continue to be available through StayWell to enrolled employees and their enrolled spouse.
New for 2020: StayWell will have a new online platform with new resources available. The website, wellwisconsin.staywell.com will remain the same. To earn the $150 in 2020, participants must create a new portal account, complete a health screening, health assessment and well-being activity through StayWell. If participants do not use a computer or smart phone, they may call StayWell at 1-800-821-6591 to request to complete the activities via paper. StayWell will send mailers to all eligible households in early 2020 with additional program information.
StayWell will begin taking requests from employers for 2020 on-site health screening events in mid-November 2019. The earliest date employers may hold a 2020 event is February 3, 2020 due to the portal availability date of early January.
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, in what quantities and in what language. Send to email@example.com.
Income Continuation Insurance Update
Updated contact information for the plan administrator, The Hartford, is below:
Toll Free Phone: 1-800-960-0052
P.O. Box 14869
Lexington, KY 40512-4869
The state ICI brochure will be updated this fall when the 2020 premium rates are updated.
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 25, 2019.
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 2020 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 It’s Your Choice 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, 2020 or later, must complete their It’s Your Choice applications as active employees. Changes for retiree and continuant coverage are handled by ETF.
It’s Your Choice Decision Guides Distribution
It’s Your Choice Decision Guides must be distributed in a timely manner to all employees, including:
- 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. There's a new shortened checklist in the guides for employees who don't want to make changes. We encourage you to point employees there.
- 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 It’s Your Choice Decision Guides
Employers distributing the It’s Your Choice 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: ETF recommends that you give new employees paper copies of the guides. In addition, employees who do not have access to a computer and 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 on the Online Network for Employers (ONE) Internet site 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 2020 to continue their current health insurance.
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 25, 2019. If an employer accepts a paper application, the employer must enter that application into the myETF Benefits system on behalf of their employee on the ONE site. 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 15, 2019.
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.
- 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 25, 2019 must be entered electronically by November 15, 2019. 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, 2020.
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 2020 application by notifying their employers in writing prior to December 31, 2019. The written request should be filed with the employee’s records. When you receive a request to rescind, make two copies of the application initially submitted by the employee to select a change and write “Rescind” across each copy. Forward one copy of the application along with a copy of the employee’s written request to rescind to ETF. 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, 2019. 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 It’s Your Choice 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 via email at 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 available on the ETF website. 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 information to your employees:
Important Information about Your Health Benefits for 2020
The It's Your Choice open enrollment period, which begins on September 30 and ends on October 25, 2019, 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, 2020.
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/benefits-by-employer for information about your 2020 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 2020 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 25, 2019. (Employer, replace this bullet with information about your electronic enrollment system, and/or alter the deadline time if your office is open later.)