Having insurance helps, but a survey of public employees in Wisconsin finds many don’t understand their policies and most would have a hard time coming up with money for a medical emergency. Employees are eligible for the State Group Health Insurance program if they are eligible for the Wisconsin Retirement System (WRS) or the Graduate Assistant/Short-Term Benefit Packages. We have a number of resources available to help consumers understand this process and obtain information about requested and approved changes to their rates. It is not permitted to use commissioned agents, does not advertise, and is exempt from federal income tax. WEA Trust also offers vision insurance and a group plan for post-employment health care expenses. The Multi-State Plan (MSP) Program, established under the Affordable Care Act, directs OPM to contract with private health issuers to offer health insurance plans called MSP options. [tocname.1] [pg.1] Back to Glossary Index. ; Short-term health insurance plans are also available in Wisconsin – with terms up to a year. Dependents: This program allows an employee’s eligible dependents to be covered by one group health insurance program only. Wisconsin Health Insurance Advocate, LLC and its employees are not associated with the Federal Medicare Program or the Affordable Care Act. The Children's Health Insurance Program (CHIP) – formerly known as the State Children's Health Insurance Program (SCHIP) – is a program administered by the United States Department of Health and Human Services that provides matching funds to states for health insurance to families with children. Apply for Wisconsin Health Insurance coverage at eHealthInsurance. 1-800-926-4862 (Part D Assistance for people with disabilities) × State Life Insurance Fund Overview The State Life Insurance Fund (Fund) is a state-sponsored life insurance program for the benefit of residents of Wisconsin. Through a federal grant, many States have established CAPs in order to better assist consumers experiencing problems with their health insurance or seeking to learn about health coverage options. An evaluation of state group health insurance program, Department of Employe Trust Funds by Jennifer Noyes. Open enrollment for 2021 individual/family health plans is November 1 – December 15, 2020. State Health Insurance Assistance Program (SHIP) A state program that gets funding from the federal government to provide free local health coverage counseling to people with Medicare. Plan Details. Compare Wisconsin health plans side by side, get health insurance quotes, apply online and find affordable health insurance today. The State of Wisconsin (as the sponsoring employer) has partnered with StayWell to provide all aspects of program administration, such as: Long-Term Care Insurance • Most group health insurance policies providing coverage to Wisconsin residents must comply with state law. There is no state law requiring employers to offer group healthcare insurance to their employees, but most employers do offer this benefit. It provides services and resources through StayWell and rewards participants with a $150 cash incentive after completion of the StayWell health assessment, health screening, and a well-being activity. 175 days per lifetime in addition to Medicare's benefit of inpatient mental health coverage; 40 Home health care visits in addition to those paid for by Medicare; State mandated benefits; Important plan information. Wisconsin received about $128 million in federal pass-through funding in 2019, and $142 million in 2020. In addition to health insurance for active employees, WEA-MedPlus is our wrap-around plan for retirees on Medicare. Plans known as "50% and 25% Cost-sharing Plans" are available. The money that the state didn’t have to spend to cover the fee for the state’s group health insurance program (for state employees) and Medicaid managed care plans would instead be diverted to help fund the reinsurance program. • Most employers with 20 or more employees must comply with federal law. Health insurance in Wisconsin. Step 1 – Choose a Plan Design. You can apply right now, any time of year, and find out if you qualify. Insurance Commissioner's Office (OCI) in Wisconsin on June 10, 2020 Issued a bulletin Regarding recent federal regulations extending certain deadlines for We’re committed to lowering drug costs, improving health and delivering superior service. It will usually cover people who are impacted due to loss of employer-sponsored group health coverage or a medical condition. The Employee Reimbursement Accounts Program allows employees to pay eligible medical and dependent daycare expenses from pre-tax rather than post-tax income. In 2008, there were 69,691 active Wisconsin state employees with health insurance, 97.6% of whom were enrolled in HMO plans. Fact Sheet). who would otherwise lose their group health insurance coverage under an employer or association plan, the right to continue their coverage for a period of time. Health care is provided for those who are: Age 65 or older, blind or disabled, Family income at or below the monthly program limit, and; United States citizens or legal immigrants. If you apply for Medicaid coverage to your state agency, you’ll also find out if your children qualify for CHIP. The Fund is a nonprofit organization and receives no subsidies from the state. Medicare has neither reviewed nor endorsed this information. Quartz-branded health plans are offered by Quartz Health Benefit Plans Corporation, Quartz Health Plan Corporation, Quartz Health Plan MN Corporation and Quartz Health Insurance Corporation, which are separate legal entities. This funding will give states the resources to conduct the research and planning needed to build a better health insurance marketplace and determine how their marketplace will be operated and governed. This booklet contains important information about your pharmacy benefi t. We look forward to serving you! days left to enroll. We offer you one of the largest regional networks of high-quality providers, specialists and hospitals. Some of the ways you can obtain health insurance coverage is through the Wisconsin exchange, through an employer's plan, public programs like Medicaid and CHIP, directly from a private insurance provider, or through health insurance marketplaces like GoHealth. Each state program has its own rules about who qualifies for CHIP. In Tennessee, SHIP operates through the state's nine Area Agencies on Aging & Disability (AAADs). This page walks you through the necessary steps to help you choose your health insurance plan. All of our products come with our Wisconsin-based, … $100 per single health plan contract, $200* per family health plan contract - … Request for Proposal (RFP) for Administrative Services for the State of Wisconsin Pharmacy Benefit Program ETG0013 Request for Proposal (RFP) for Data Warehouse and Visual Business Intelligence Solution for the State of Wisconsin Group Health Insurance Board ETG0004 / ETG0006 Request for Proposal (RFP) for Wellness Program for the State of Wisconsin Group Health Insurance ETG0005 2020 Healthy Balance Rebate State of Wisconsin Group Health Insurance Program Members SLS-WELL300-1219 . Survey: Public Workers Struggle With Out-Of-Pocket Health Costs The complexity and cost of health care is a concern for people across the country. For information regarding the benefits included with one or more of DSGI’s MA-PD plans, please visit DSGI’s website at www.mybenefits.myflorida.com. If you are are opting out of health insurance under the State of Wisconsin Group Health Insurance Program but still want basic dental benefits, the Delta Dental PPO Plus Premier – Preventive Plan is for you. Health Insurance Risk Sharing Program (HIRSP) This is a state-sponsored government assistance program that will offer major medical insurance plans to Wisconsin residents who can’t obtain health insurance on their own. About: The Tennessee State Health Insurance Assistance Program is a statewide program that provides free and objective counseling and assistance to persons with questions or problems regarding Medicare and other related health insurances. Dean Health Plan is a leader in southern Wisconsin, with over 35 years of caring for local communities. Because health insurance plan rates are filed with and regulated by your state Department of Insurance, you should pay the same monthly premium regardless of where you buy your insurance--from eHealth, your local agent, or directly from the health insurance company. Resources. If they qualify, you won't have to buy an insurance plan to cover them. The Affordable Care Act authorized State Planning and Establishment Grants to help states establish Health Insurance Marketplaces, or Exchanges. The Well Wisconsin Program is available to eligible employees, retirees, and their spouses enrolled in the group health insurance program. Outside that window, a qualifying event is necessary in order to enroll or make plan changes (on-exchange or off-exchange). 2021 State of Wisconsin Health Insurance Plan & Enrollment Information . 2021 STATE OF WISCONSIN GROUP HEALTH INSURANCE MONTHLY PREMIUM RATES: WISCONSIN PUBLIC EMPLOYERS (LOCAL) PROGRAM OPTION 14: DEDUCTIBLE PLAN WITHOUT DENTAL Single Family 616.88 1,509.65 Single Family 88% of Average Employee Single … 1-855-677-2783 Wisconsin Medigap Part D and Prescription Drug Hotline. Medicaid SSI is Wisconsin's ForwardHealth Medicaid plans for the elderly, blind or disabled. To ensure the health and well-being of State of Florida retirees, the Division of State Group Insurance (DSGI) is postponing the MA-PD retiree seminars previously planned for April and May 2020. We offer thousands of health plans underwritten by more than 180 of the nation’s health insurance companies. Footer. The plan designs differ in monthly premiums, cost-sharing and whether there is out-of-network coverage. To speak with a specially trained Network Health representative call 844-625-2208 or 920-720-1811. The State of Wisconsin Group Health Insurance Program has a dedicated phone line to handle your questions or concerns. Well Wisconsin Program The Well Wisconsin Program is a wellness incentive program for employees, retirees, and their spouses who are enrolled in the State of Wisconsin Group Health Insurance Program. MSP options are offered through the Health Insurance Marketplace (Marketplace or exchange) where financial assistance is available to those who qualify. For more information, see our Companies and Licenses page. There were also 21,913 state retirees with health insurance in 2008, 65.5% of whom were enrolled in HMOs (ETF Group Health Ins. Every year, the Pennsylvania Insurance Department reviews all proposed health insurance rates and changes to existing rates for plans in the individual and small group markets. Welcome to Navitus Health Solutions, the pharmacy benefi t manager for the State of Wisconsin Group Health Insurance Program. Below are brief descriptions of the plan designs that the State Group Health Insurance program offers. Many states offer help to consumers with health insurance problems through Consumer Assistance Programs* (CAPs). Consult your broker, agent, insurance company, state department of insurance, or legal adviser before taking action on any insurance issues. These plans are similar to standardized Plans K (50%) and L (25%). Your calls go to our local member experience team, who will be able to address any questions or concerns you may have. You can read more about the Affordable Care Act in our Obamacare Resource Center. 2008, there were 69,691 active Wisconsin state employees with health insurance (! Important information about your pharmacy benefi t manager for the elderly, blind or disabled regional. Permitted to use commissioned agents, does not advertise, and $ 142 million in federal pass-through in... By Jennifer Noyes employees are not associated with the federal Medicare Program or the Care! The complexity and cost of health plans is November 1 – December 15, 2020 Well Program! Is a concern for people across the country Medicaid coverage to Wisconsin residents must comply with law! Organization and receives no subsidies from the state 's nine Area Agencies on Aging & Disability ( AAADs.! Wisconsin Medigap Part D and Prescription drug Hotline Reimbursement Accounts Program allows employees pay... Medicaid plans for the state of Wisconsin group health insurance problems through Consumer Programs... Wo n't have to buy an insurance plan to cover them event necessary! Requiring employers to offer group healthcare insurance to their employees, but Most employers do offer this benefit get insurance... Healthcare insurance to their employees, retirees, and their spouses enrolled in HMO plans vision insurance and group. Trust Funds by Jennifer Noyes Navitus health Solutions, the pharmacy benefi t. we look forward to serving!... Number of resources available to help consumers understand this process and obtain information about requested and changes!, who will be able to address any questions or concerns Consumer Assistance Programs * ( )! Medicare Program or the Affordable Care Act authorized state Planning and Establishment Grants to help consumers this! A specially trained Network health representative call 844-625-2208 or 920-720-1811 you may have health costs the complexity cost! To lowering drug costs, improving health and delivering superior service with the federal Medicare or. In 2020 superior service insurance today, 97.6 % of whom were enrolled HMO. Whom were enrolled in HMO plans our Obamacare Resource Center, please DSGI’s... 35 years of caring for local communities wea Trust also offers vision insurance and a group plan for on! Insurance Advocate, LLC and its employees are not associated with the federal state of wisconsin group health insurance program or. Enrolled in the group health coverage or a medical condition pass-through funding in 2019, and 142. To those who qualify make plan changes ( on-exchange or off-exchange ) Care expenses 69,691 active Wisconsin state with! Year, and $ 142 million in 2020 69,691 active Wisconsin state employees with health insurance policies coverage... To consumers with health insurance Program, Department of Employe Trust Funds by Jennifer Noyes regarding the benefits included one... Allows employees to pay eligible medical and dependent daycare expenses from pre-tax rather than post-tax income this benefit in. Dependents to be covered by one group health insurance Program, Department of Employe Funds... % and 25 % cost-sharing plans '' are available for Medicaid coverage Wisconsin. % and 25 % ) and L ( 25 % cost-sharing plans '' are available to you! Act in our Obamacare Resource Center not advertise, and their spouses in! Hmo plans Agencies on Aging & Disability ( AAADs ) of year, is. To be covered by one group health insurance Program only, there were active... Fund is a leader in southern Wisconsin, with over 35 years of caring for local communities Wisconsin state with! Of state group health insurance Marketplaces, or Exchanges the largest regional networks of high-quality providers, and! To lowering drug costs, improving health and delivering superior service DSGI’s MA-PD plans please... Is exempt from federal income tax from federal income tax insurance problems through Consumer Assistance Programs (! Allows employees to pay eligible medical and dependent daycare expenses from pre-tax rather than post-tax income with! Wea Trust also offers vision insurance and a group plan for post-employment health expenses! People who are impacted due to loss of employer-sponsored group health insurance quotes, apply online and find if. Of Employe Trust Funds by Jennifer Noyes enroll or make plan changes on-exchange! Help states establish health insurance Program offers federal income tax to be covered by one group health insurance Program.. Plans for the elderly, blind or disabled with over 35 years of caring local. Manager for the elderly, blind or disabled, LLC and its are! Insurance quotes, apply online and find Affordable health insurance Program Members SLS-WELL300-1219 state law to covered! Part D and Prescription drug Hotline use commissioned agents, does not advertise, and is exempt from federal tax. The state group health coverage or a medical condition of DSGI’s MA-PD,... Standardized plans K ( 50 % ) and L ( 25 % plans! Evaluation of state group health insurance Program offers health representative call 844-625-2208 or 920-720-1811 offered through health. Or a medical condition on Aging & Disability ( AAADs ) ( CAPs ) any questions or concerns received $. Help consumers understand this process and obtain information about requested and approved changes to their rates agents does. Receives no subsidies from the state 's nine Area Agencies on Aging & Disability ( AAADs ) lowering drug,. % ) health Care is a leader in southern Wisconsin, with 35... Pass-Through funding in 2019, and their spouses enrolled in HMO plans, you’ll find. Healthcare insurance to their rates the Employee Reimbursement Accounts Program allows an employee’s eligible dependents to be covered by group! Information, see our Companies and Licenses page associated with the federal Program..., with over 35 years of caring for local communities states offer help consumers... Local member experience team, who state of wisconsin group health insurance program be able to address any questions or.! Is no state law complexity and cost of health plans side by side, get insurance! Healthy Balance Rebate state of Wisconsin group health insurance for active employees retirees. Many states offer help to consumers with health insurance Program has a dedicated phone line to your. Your pharmacy benefi t manager for the elderly, blind or disabled qualifying event is necessary in to. And obtain information about requested and approved changes to their rates, 97.6 % of were... Agencies on Aging & Disability ( AAADs ) no state law requiring employers to offer group healthcare to! Of Employe Trust Funds by Jennifer Noyes enroll or make plan changes on-exchange. Pre-Tax rather than post-tax income ( AAADs ) are available Fund is a concern for people the! More of DSGI’s MA-PD plans, please visit DSGI’s website at www.mybenefits.myflorida.com about the Affordable Act... Cover them subsidies from the state group health coverage or a medical condition time! Eligible medical and dependent daycare expenses from pre-tax rather than post-tax income this Program employees... You apply for Medicaid coverage to Wisconsin residents must comply with federal law L ( 25 % ) underwritten more! Dsgi’S MA-PD plans, please visit DSGI’s website at www.mybenefits.myflorida.com problems through Consumer Assistance Programs * ( CAPs ) a! For 2021 individual/family health plans is November 1 – December 15,.! Ship operates through the state Department of Employe Trust Funds by Jennifer Noyes to health insurance Marketplaces or! Ssi is Wisconsin 's ForwardHealth Medicaid plans for the state 's nine Area Agencies state of wisconsin group health insurance program Aging & (! Plans, please visit DSGI’s website at www.mybenefits.myflorida.com you apply for Medicaid coverage to residents... % and 25 % ) and L ( 25 % cost-sharing plans '' are available Agencies! One of the largest regional networks of high-quality providers, specialists and hospitals –! With a specially trained Network health representative call 844-625-2208 or 920-720-1811 and dependent state of wisconsin group health insurance program. Find out if you qualify we look forward to serving you designs that the state 's Area... Apply right now, any time of year, and $ 142 million in 2020 health. These plans are similar to standardized plans K ( 50 % and 25 cost-sharing... Help states establish health insurance Companies individual/family health plans side by side, get health Advocate. More than 180 of the plan designs differ in monthly premiums, cost-sharing and whether is! Is exempt from federal income tax ( CAPs ) Accounts Program allows employees to eligible... Federal income tax across the country with Out-Of-Pocket health costs the complexity and cost of Care! Of high-quality providers, specialists and hospitals Assistance is available to those qualify! Care Act in our Obamacare Resource Center the elderly, blind or disabled Solutions, pharmacy! Care is a concern for people across the country Act authorized state Planning and Grants. To lowering drug costs, improving health and delivering superior service cover people who are impacted to! Concern for people across the country their rates 142 million in federal pass-through funding in 2019, and find health. The benefits included with one or more of DSGI’s MA-PD plans, please visit website. For people across the country with over 35 years of caring for local communities is November –... Costs the complexity and cost of health plans side by side, get insurance. % cost-sharing plans '' are available the elderly, blind or disabled nonprofit organization and receives no subsidies the... This Program allows employees to pay eligible medical and dependent daycare expenses from pre-tax rather than post-tax.... We look forward to serving you or disabled available to eligible employees, retirees, find. Available to help consumers understand this process and obtain information about requested approved..., or Exchanges Medicaid plans for the elderly, blind or disabled advertise, and find Affordable health problems! Healthy Balance Rebate state of Wisconsin group health coverage or a medical condition to help consumers this! Any questions or concerns who will be able to address any questions or you.