Pharmacy Benefit Manager (PBM) FAQs

Find answers to the most frequently asked questions about the pharmacy benefit.

Program Option
  • Local Annuitant Health Program (LAHP)
  • Local Deductible Health Plan (PO14) & Supplemental Benefits
  • Local Deductible Health Plan with Uniform Dental (PO4) & Supplemental Benefits
  • Local Health Plan (PO16) & Supplemental Benefits
  • Local Health Plan with Uniform Dental (PO6) & Supplemental Benefits
  • Local High Deductible Health Plan (PO17) & Supplemental Benefits
  • Local High Deductible Health Plan with Uniform Dental (PO7) & Supplemental Benefits
  • Local Traditional Health Plan (PO12) & Supplemental Benefits
  • Local Traditional Health Plan with Uniform Dental (PO2) & Supplemental Benefits
  • State Employee and Retiree Health Plan & Supplemental Benefits
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Active Employee / Retiree / Local Employer / State Employer

Pharmacy Benefits Program Fact Sheet

The State of Wisconsin Group Insurance Board contracts with a Pharmacy Benefit Manager to provide administrative services to State of Wisconsin and Wisconsin Public Employer group health insurance program participants.

Find the Cost of Your Drugs

Employees and Retirees without Medicare: learn how much you can expect to pay at the pharmacy.

Program Option
  • State Employee and Retiree Health Plan & Supplemental Benefits
Plan Year
  • 2025

How an HDHP Works

High Deductible Health Plans (HDHPs) usually have lower monthly premiums than plans with lower deductibles. By using the untaxed funds in your Health Savings Account (HSA) to pay for expenses before you reach your deductible, you reduce your overall healthcare costs.

There are three types of expenses associated with an HDHP: deductible, coinsurance, and out-of-pocket limit. These may work differently than you expect if you haven't had an HDHP before.

Program Option
  • State Employee and Retiree Health Plan & Supplemental Benefits
Plan Year
  • 2025

Find the Cost of Your Drugs

Employees and Retirees without Medicare: learn how much you can expect to pay at the pharmacy.

Program Option
  • Local High Deductible Health Plan (PO17) & Supplemental Benefits
  • Local High Deductible Health Plan with Uniform Dental (PO7) & Supplemental Benefits
Plan Year
  • 2025

In-Network Health Services

Learn how much it will cost to visit the doctor, have labs drawn, get an X-ray and more.

Program Option
  • State Employee and Retiree Health Plan & Supplemental Benefits
Plan Year
  • 2025

Breakdown of Your Costs by Plan Design

Learn how much you can expect to pay when you visit the doctor, get an X-ray and more.
Plan Year
    2025
Program Option
    Local Traditional Health Plan (PO12) & Supplemental Benefits