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Open enrollment is September 30 – October 25, 2024. Any changes made during this period will be effective January 1, 2025. Make the most of open enrollment:

Medical Premium Increases

The overall medical insurance premium increase will be 7.3% for the state program and 11% for the local program. The actual rate increases for members may differ due to health plan choice and/or employer premium contributions.

Local employers establish the premium contribution for their employees. The Department of Administration’s Division of Personnel Management determines both the state employee share of the premium and the employer contribution to the Health Savings Account.

Learn More About Premium Increases

State Maintenance Plan

The State Maintenance Plan (SMP) is a health plan that offers Uniform Benefits. SMP is designed to provide a health plan option for members who live or work in areas without adequate access to in-network providers or hospitals.

State Employees and Retirees

SMP will continue to be offered in Florence County. Use the health plan search to find health plans and covered providers where you receive care.

Local Employees and Retirees

13 new counties are now SMP counties for 2025, designated with an asterisk (*) below. Two counties, Waupaca and Waushara, no longer qualify as SMP counties beginning in 2025. 

SMP will be offered in the following counties:

  • Adams
  • Ashland
  • Barron* 
  • Bayfield
  • Buffalo*
  • Burnett
  • Clark
  • Columbia
  • Douglas
  • Dunn*
  • Florence
  • Forest
  • Grant*
  • Green
  • Iowa*
  • Iron
  • Jefferson*
  • Juneau
  • Lafayette*
  • Langlade
  • Lincoln
  • Marathon
  • Marquette
  • Menominee
  • Oneida
  • Pepin*
  • Pierce 
  • Polk
  • Portage
  • Price
  • Richland
  • Rock* 
  • Rusk*
  • Sauk
  • Sawyer
  • St. Croix*  
  • Taylor
  • Vilas
  • Walworth*
  • Washburn
  • Wood

Use the health plan search to find health plans and covered providers where you receive care.

Medical Benefit Changes

The Group Insurance Board approved the following medical benefit changes effective January 1, 2025:

  • Expanded the lifetime limit to 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.

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. If you are currently enrolled, no action is required to continue coverage with the health plan.

High Deductible Health Plan (HDHP) Deductible Increase

The annual medical deductible for the HDHP, Local HDHP, and Access HDHP plans has increased to comply with federal requirements:

  • Individual: increased to $1,650
  • Family: increased to $3,300

State Employees: Health Savings Account (HSA) Employer Contribution Increase

The 2025 annual HSA employer contribution will increase to:

  • Individual : $828
  • Family: $1,650

To receive the full employer contribution, you must be covered by an HDHP for the entire 2025 plan year.

Wellness

WebMD continues to be a resource for well-being for our members. Along with coaching programs for chronic conditions, mental health, physical activity, nutrition, and stress, they also offer a focused weight management program. Participants have access to resources to support them in reaching their well-being goals. 

  • Diabetes Prevention Program for those at risk of developing diabetes
  • Positively Me, a year-long program helping to support participants with losing weight
  • meQuilibrium for stress management and resilience building support

Login at WebMD ONE Wellness Portal to learn more or contact WebMD customer service at 1-800-821-6591.

Pre-Tax Savings Accounts

These changes apply to state employees and retirees only.

Contribution Limits

ProgramContribution LimitChange
Health Savings Account (HSA)$4,300 per year (individual) / $8,550 per year (family)Increase of $150 / $250 per year
Health Care Flexible Spending Account (FSA) and Limited Purpose FSA$3,200 per yearIncrease of $150 per year
Parking Account and Transit Account$315 per monthIncrease of $15 per month

Carryover Limits

The carryover limit for FSAs and Limited Purpose FSAs has changed to $640; an increase of $30 from the 2024 limit.

Minimum Elections and Carryover Amounts

Accounts Impacted:

  • Health Care FSA
  • Limited Purpose FSA
  • Parking account
  • Transit account

Minimums

RequirementAmount
Minimum Annual Contribution$50 each year

Minimum Account Balance for Carryover

(Only impacts you if you don't reenroll in your account)

$50

Learn More About Account Minimums