The annual insurance benefits open enrollment period is September 30 - October 25, 2024.

This period allows uninsured but eligible employees and retirees to enroll for coverage, effective January 1 of the following year. 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 submit their enrollment changes electronically. The enrollment process may vary between employers. Employers must verify their enrollment process and communicate instructions to employees. Targeted enrollment information can be found in the insurance benefits sections of the ETF web site. 2025 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 2025 in this bulletin for more information.

If requested, the 2025 insurance benefits decision guides will be delivered to all employers at the end of September. The 2025 insurance benefits web pages will be available online for employers and members before 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 information located in the 2025 Insurance Benefits Decision Guides Distribution 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 mid-September.

State Employer Open Enrollment Kickoff Meeting

State Insurance Q&A Session

2025 Virtual Benefits Vendor Forums

Important Plan and Program Changes

HDHP Reminders

Federal Section 1557 Non-Discrimination Information

General Open Enrollment Information

2025 Insurance Benefits Decision Guides Distribution

Employee Responsibilities

Additional Instructions and Information

Contacting the Health Plans

Sample Employee Emails

State Employer Open Enrollment Kickoff Meeting

ETF will host two open enrollment kickoff events for plan year 2025, and they will be held virtually. These events will follow a similar agenda as in previous years, and a recording of this event will be available later on the ETF website for viewing anytime. 

Session 1

Session 2

Employers must pre-register to attend these events online. Due to the high demand, please register as soon as possible.

The employer kickoff meeting provides an opportunity to receive information from the health plans, pharmacy benefit manager, supplemental plans, wellness vendor (WebMD), and ETF employees about benefit program changes effective January 1, 2025.

State Insurance Q&A Session

ETF will host its annual state employer insurance question and answer session. All state employers may register to ask ETF staff any insurance (health, life, income continuation insurance) benefit-related questions. 

2025 Virtual Benefits Vendor Forums

ETF is hosting a series of virtual forums for employers and members to connect with benefits vendors during the 2025 open enrollment period. New this year, there will be evening sessions available from 5:00-6:30 p.m. for those who are not able to join during work hours. These virtual forums with the vendors will provide the same personal interaction with a vendor as a benefit fair or informational 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 virtual forums. Due to the high demand, please register as soon as possible.

Important Plan and Program Changes

Health Plan Changes 

Health Plan Name Change: Dean Health Plan - Prevea360 West and Mayo Clinic will now be known as Dean Health Plan - Medica West and Mayo Clinic Health System. 

Benefit Changes 

Medical Benefit Changes: There are several medical benefit changes for plan year 2025, including:

  • Expanded the lifetime limit on orthoptic eye training from two to no more than twelve. 
  • Clarified nutritional counseling coverage. The certificate language was clarified to allow for nutritional counseling services related to weight management.
  • The annual medical deductible for the High Deductible Health Plan (HDHP) and Access HDHP has increased to comply with federal requirements: 
    • Individual: increased to $1,650 
    • Family: increased to $3,300
  • Increase in HSA Employer Contribution Limits: The 2025 annual HSA employer contribution for employees covered by an HDHP for all of 2025 will increase to:
  • Individual: $828
  • Family: $1,650

Dental

Uniform Dental Benefit: The uniform dental benefit and all supplemental dental benefits will continue to be administered by Delta Dental. The individual Uniform Dental Benefit premium will increase to $4 effective January 1, 2025.

Active Employee 2025 Monthly Dental Rates

 Uniform Dental Benefit Preventive PlanSelect PlanSelect Plus Plan
Individual$4$36.10$9.08$21.60
Individual + Spousen/an/a$18.16$43.22
Individual + Child(ren)n/an/a$12.24$40.12
Family$10$90.28$21.76$66.20

Pre-Tax Savings Accounts 

Vendor Microsite: Visit my.optum.com/etf to view resources and access the member portal. 

Pre-Tax Savings Account Limit Changes: Multiple contribution and carryover limits have changed.  

  • Health Care Flexible Spending Account (FSA) and Limited Purpose FSA Limits: The 2025 annual contribution limit for FSAs will increase by $150 (from $3,050 to $3,200). The annual carryover limit will increase by $30 (from $610 to $640).
  • Parking and Transit Account Contribution Limits: The 2025 monthly contribution limit for parking and transit accounts will increase by $15 (from $300 to $315). 
  • Health Savings Account (HSA) Employee Contribution Limits: The 2025 HSA annual contribution limit for individual coverage will increase by $150 (from $4,150 to $4,300). The 2025 HSA annual contribution limit for family coverage will increase by $250 (from $8,300 to $8,550).
  • HSA Employer Contributions: Employer contributions for the HSA for 2025 will increase to  $828 per individual coverage and $1,650 per family coverage. Employer contributions must be made in accordance with instructions provided by the Department of Administration’s Division of Personnel Management (DPM).

Minimum Election and Carryover Amount Requirements: There is a minimum election or carryover amount of up to $50 for the FSAs, Parking Account, and Transit Account, to help ensure members are actively engaging with the pre-tax savings accounts on an annual basis.

  • Members who enroll in a flexible spending or commuter benefit account will be required to have a minimum annual contribution amount of $50.
  • There must also be at least $50 in these accounts at the end of the run-out period for the 2024 plan year (March 31) for funds to automatically be carried over to 2025. If the funds are less than $50, it requires the member to re-enroll for the 2025 plan year or the funds are forfeited.

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 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 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. The subscriber may only utilize VA benefits for care of a service-related disability. If the subscriber does not have a service-related disability, they are unable to contribute to an HSA if they have accessed their VA benefits in the 90 days prior to open enrollment or if they access VA benefits during their enrollment in the HDHP/HSA benefit option. (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.

Well Wisconsin Program

The deadline to earn the 2024 Well Wisconsin incentive is October 11, 2024. Participants can choose to receive the $150 prepaid card virtually or by postal mail to their home address.

Participants can learn more about Well Wisconsin with a Well Wisconsin Program video or log into their account at webmdhealth.com/wellwisconsin.

Federal Section 1557 Non-Discrimination Information

Reminder: Please notify ETF of requests for insurance benefits 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 Open Enrollment 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, 2024.

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 2025 pages under the 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 website or you may order applications by completing the email form on the Employer Forms Order page on the ETF website.

Retirees & COBRA/Continuants: ETF mails insurance benefits 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 (ET-2331) enclosed. Employees who wish to change health plans and who will retire effective January 1, 2025 or later, must complete their insurance benefits application as an active employee. Employees who will retire prior to January 1, 2025 should submit their application to ETF. Changes for retiree and continuant coverage are handled by ETF.

2025 Insurance Benefits Decision Guides Distribution

The 2025 insurance benefits decision guides must be distributed in a timely manner to all employees. The distribution method (hard copy, link to web version, or PDF file) is determined by the employer. It is acceptable for employers to distribute decision guides using an electronic method. Employee distribution should include: 

  • Employees who have indicated they do not wish to make a change during the annual open enrollment period.
    • Remind these employees that they remain responsible for understanding the information contained in the 2025 insurance benefits decision guides and the ETF website, and that their certificate of coverage and schedule of benefits are available on the ETF website. We encourage you to point employees to the enrollment checklist on the inside cover of the insurance 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 2025 Insurance 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 insurance benefits 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: Distributing links to web versions or PDF files of the insurance benefits decision guides is acceptable. However, if employees do not have access to a computer and/or request a paper copy, they 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 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.

Processing Changes

Employers are responsible for keying in changes submitted on paper by using the myETF Benefits Administrator for Employees system found under the Online Tools on the Employer page 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 dependents who remain eligible in 2025 to continue their current health insurance. If an employer uses electronic file transmission, employee address updates must be sent separately from the annual open enrollment election or manually keyed by the employer into the myETF Benefits system.

Employer’s Application Processing Instructions

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 Benefits 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, 2024. If an employer accepts a paper application, the employer must enter that application on behalf of their employee into the myETF Benefits Administrator for Employees system found under the Online Tools on the Employer page of the ETF website. The application is not to be mailed or faxed to ETF for processing and keying. The deadline for employers to enter benefits applications into the myETF Benefits system is November 15, 2024.

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 25, 2024 must be keyed into the myETF Benefits system by November 15, 2024. This deadline must be met by the employer to ensure health plans and Navitus receive the contract information timely. This ensures that employees receive their health plan information and identification cards prior to January 1, 2025.

Withdrawing/Rescinding a Health Benefits Application

An employee’s request to withdraw or rescind a health benefits application must be entered into myETF Benefits by ETF. Employees may rescind a 2025 application by notifying their employers in writing prior to December 31, 2024. The written request should be filed with the employee’s records. Forward one copy of the employee’s written request to rescind to ETF. ETF will update myETF Benefits by deleting the request and reinstating the employee’s original coverage.

An employee may also rescind their request by writing “Rescind” across the top of their original application and initialing it. 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.

Additional Instructions and Information

Specific instructions are found in the State Agency Health Insurance Standards, Guidelines and Administration Employer Manual (ET-1118), including:

  • Information on what to do if you have an employee initially eligible for coverage in November or December.
  • Instructions on completing the COBRA 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 the 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 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 on the back cover of the decision guides. These customer service lines are fully staffed to handle high call volume. Employees should specify they are enrolled in the State of Wisconsin Group Health Insurance Program when calling the health plans.

Sample Employee Email

You can use the below sample email to provide insurance benefits information to your employees:

Important Information about Your Insurance Benefits for 2025
The annual open enrollment period, which begins on September 30 and ends on October 25, 2024, 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, or the Accident Plan (apply with applicable vendor, not ETF)
  • 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, 2025.

Your To-Do List:

Visit etf.wi.gov for information about your 2025 benefits.

  • Attend a benefit vendor forum. ETF will host a number of forums during the open enrollment period for you to learn about the 2025 plan year. You’ll have the opportunity to ask questions directly to health plans and vendors. Visit etf.wi.gov/insurance to register. 
  • The deadline to submit your electronic request or your completed paper application to your benefits office is 4:30 p.m. on October 25, 2024. (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.