Your sick leave credits can only pay for premiums through the State Group Health Insurance Program. If you have insurance through somewhere else, you can save your credits for future use by escrowing them.
Who is Eligible
To escrow your credits, you must:
- Have comparable coverage and
- Be enrolled in the State Group Health Insurance Program at retirement and
- See enrollment opportunity if you are not currently enrolled.
- Take an immediate annuity..
For your plan to be comparable, it must have benefits similar to the Access Plan or Medicare Plus.
- Generally, if your health insurance plan has similar deductibles, out-of-pocket limits and pharmacy benefits, your coverage may be comparable.
- If you are covered through your spouse who is working for the state, comparable coverage includes:
- IYC Health Plan
- Access Plan
- Health Plan Medicare
- Medicare Advantage
- Medicare Plus
- High Deductible Health Plans if your spouse’s employer is adding money to their health savings account.
Non-Comparable Coverage includes:
- Health plans with no pharmacy benefits
- Veteran’s Administration benefits (except unique circumstances)
- Medicare; Medicaid; Badgercare
Before retirement, you have a special opportunity to enroll in the Access Plan. You must enroll by the first of the month in which you retire. Once your escrow application is approved, your coverage will end. If your application is not approved, your coverage will continue.
How to Escrow your Credits
The steps you need to take depend on from whom you receive health insurance.
Coverage through a Spouse Who Works for the State
This section applies to you if your spouse works for a state agency, the UW or UW Hospitals & Clinics. If your spouse works for a local employer, such as a city, school district or local government, see Coverage through Another Organization.
If your spouse is the subscriber, there is no paperwork. Your credits will be automatically placed on hold.
If your spouse is not the subscriber, you can change that. You and your spouse should turn in the Health Insurance Application (ET-2301). You should mark that you are cancelling coverage due to a “spouse-to-spouse transfer”. Your spouse should mark that they are adding coverage due to “spouse-to-spouse transfer”. Your credits will be placed on hold.
If both you and your spouse are retired, the subscriber will automatically have the premiums deducted from their sick leave credits. The other spouse’s credits will be placed on hold. When the subscriber’s sick leave credits are gone, the other spouse becomes the subscriber. Premiums are then deducted from their account. There is no paperwork.
Coverage through Another Organization
- Enroll in the Access Plan by the first of the month that you retire. Talk to your employer benefit specialist about your specific enrollment deadline.
- Turn in the Sick Leave Credit Escrow Application (ET-4305) along with the schedule of benefits from your spouse’s coverage.
- If approved, you’ll receive a confirmation letter and your state health insurance will terminate.
- If your coverage is not considered comparable, your coverage through the Access Plan will continue. If you choose to cancel your state health insurance without comparable coverage, you will lose your sick leave credits.
How to Re-Enroll in Health Insurance
After escrowing your sick leave credits, you can re-enroll in the Group Health Insurance Program during one of the following times:
- During the yearly open enrollment period or
- If you lose coverage of your comparable plan, you have 30 days after it ends to enroll.
During Open Enrollment
Turn in a Health Insurance Application/Change For Retirees & COBRA Continuants (ET-2331) form.
You can choose any date in the following year for your health coverage to start.
After Losing Comparable Coverage
You must re-enroll no later than 30 days after your comparable coverage ends. To re-enroll, you must submit the following:
- Sick Leave Credit Re-enrollment Application (ET-4317)
- Summary of Benefits from comparable coverage
- Loss of coverage letter
- Health Insurance Application/Change For Retirees & COBRA Continuants (ET-2331)