of employment, layoff, divorce, a dependent By using providers within your network, your health care costs will be significantly lower than if you use providers outside your network. Kaiser Permanente Washington offers health insurance and medical care in Washington state. Washington State students: Students needing to purchase health insurance can go through the Washington State marketplace. | Privacy Policy attaining age 26 and not being disabled, or death. In the United States, Puerto Rico and U.S. Virgin Islands. See ETF Response to COVID-19 for updates on services. The health insurance employer standards, guidelines and administration manual is a reference source intended to aid your administration of and participation in the Wisconsin group health insurance program. Office of Group Benefits ⋯ 1201 N. 3rd St, Suite G-159, Baton Rouge, LA 70802 ⋯ 1-800-272-8451 P.O. Do not receive State Group Health Insurance through a parent or spouse through another State agency (e.g. Non-Exchange plans are plans you buy through an insurance agent, broker or directly from a company. If you are not finding what you need, go to the Publications page to search through all publications. Medicaid ( Apple Health ), a government health insurance plan for low-income people who are US citizens or green card holders of 5 years or more. Eligibility requirements for health insurance and other state-provided benefits Health insurance options for those ineligible for UW coverage Find health insurance options that are available for people who are not eligible for one of the University's health insurance programs. Wisconsin statutes, administrative code and group health contract language are reviewed on an ongoing basis and may be revised. The Benefits Office supports UW employees with a variety of health plan options, generous retirement plans, life insurance and long-term disability coverage, and more. The State of Wisconsin Group Health Insurance Program is an employer-sponsored program offering group health coverage to employees of state agencies, the UW System, UW Hospital & Clinics Authority, participating local government employers, and annuitants … You may also apply for coverage within 30 days of certain life events. You may elect coverage of up to five times your eligible earnings, up to $20,000 of spouse coverage and up to $10,000 of child coverage. As long as you meet the enrollment deadline, you’re eligible to continue your health insurance after you retire from UW. 2021 State of Wisconsin Group Health Insurance Program Certificate of Coverage IYC Health Plan 21ET-2107cc Open PDF. All Rights Reserved, All Sites Washington group health insurance. UMP Classic: $104 / $105 $218 / $220 $182 / $184 $296 / $299 UMP Plus: $69 / $72 $148 / $154 $121 / $126 $200 / $208 UMP Select – / $37 – / $84 – / $65 – / $112 UMP CDHP: $25 / … Cover Photo: North Point Lighthouse; Lake Park, Milwaukee All photos courtesy of the Wisconsin Department of Tourism To browse each plan’s network or to find a s… Kaiser WA (formerly Group Health) plans Kaiser WA offers four plans to UW employees: Classic, Value, SoundChoice, and a CDHP Kaiser Permanente NW plans Only employees who live in Clark county or Cowlitz county can enroll in the Kaiser Permanente NW plans Box 44036, Baton Rouge, LA 70804 If you feel your Pharmacy Benefits Manager (PBM) has “steered” you to use a specific pharmacy over your chosen pharmacy, call the Office of Group Benefits (OGB) at 1-800-272-8451 to report the issue. 2021 health benefits decision guide for state of Wisconsin employees. Or go to our All Benefits Available page to explore Health Plan Program Options. event of conflicting information, state statute, state health contracts, and/or policies and provisions established by the State of Wisconsin Group Insurance Board shall be followed. However, if your retirement plan is PERS 2, PERS 1, TRS 1, or LEOFF 2, before you’re eligible to continue your insurance, you must first elect to begin receiving your retirement income. Information for employers about the Group Health Insurance program, how to participate, and administer the program, Employer Forms, Brochures and Publications, IYC Health Benefits 2021 Virtual Benefit Forums for Employers, Health Insurance It’s Your Choice 2021 Information for State Employers, Health Insurance It’s Your Choice 2021 Information for Local Employers in the Program, 88% tables and full premium rates by program option, It's Your Choice Health Benefits 2021 Preview Information for State Employers, It's Your Choice Health Benefits 2021 Preview Information for Local Employers, State Employer: IYC 2021 Kickoff Meeting Information, Local Employer: IYC 2021 Kickoff Meeting Information, Health Insurance It’s Your Choice Information for State Employers, Health Insurance It’s Your Choice Information for Local Employers in the Program, State Employer: IYC 2020 Kickoff Meeting Information, Local Employer: IYC 2019 Kickoff Meeting Information, ALEX® Employer Toolkit (For state employers), State Agency Health Insurance Standards, Guidelines and Administration Employer Manual (ET-1118), State of Wisconsin Supplemental Benefit Plan Administration Manual (ET-1158), Local Employer Health Insurance Standards, Guidelines and Administration Manual (ET-1144), Group Health Insurance Application/Change Form for Retirees & COBRA Continuants (ET-2331), Continuation - Conversion Notice (ET-2311), Group Health Insurance Application/Change Form (ET-2301), State of Wisconsin Supplemental Benefit Plans Administration Manual (ET-1158), Supplemental Benefits for State Employers, Recovery of Overpaid Benefits– State Employers Only, Employee Reimbursement Account Contributions, Income Continuation Insurance for Employers, Wisconsin's 218 Agreement with Social Security, 105% rates available upon request; contact your ETF case manager, Group Health Insurance information: Go to, Presentation from the employer kickoff meetings, Security Health Plan Transition Resources. Please refer to the Student Handbook for information regarding health insurance options in each WWAMI state. The Department of Employee Trust Funds Group Insurance Board met on May 19, 2015 and approved changes to the state employee health insurance program. State Group Life (SGL) Insurance offers term life insurance to you, your spouse and eligible children. An optional preventive dental plan (called Uniform Dental) is available, at extra cost. A plan’s network consists of doctors, clinics, hospitals, specialists, and other health care providers. Filter plans by county Eligible for coverage under the WRS 2. Summary. If you enroll in State Group Health (SGH) Insurance, you may elect the Uniform Dental Benefit (UDB) for routine preventive and basic dental services. | Contact Webmaster, 2020 Health Insurance Application/Change Form (ET-2301), 2021 Health Insurance Application Change/Form (ET-2301), Affidavit for Insurance Purposes (UWS 93), 2020 Comparison of Health & Pharmacy Benefits, Glossary of Health Coverage and Medical Terms, How to Get Care When You Need It eLearning (ETF), 2020 Health Plan and High Deductible Health Plan (HDHP). UW System, UW Hospital and Clinics) In 2015, were eligible for an employer premium contribution to their health insurance and were enrolled in a State Group Health Insurance plan. You have 30 days from the date your employment begins to enroll. The Consolidated Omnibus Budget Reconciliation Act (COBRA) allows participants and their eligible UW Medicine is considered "in-network" for several health insurance plans offered on the Exchange. Staying healthy is easier with the right support. Medical. State Group Health (SGH) insurance provides comprehensive medical, hospital, pharmaceutical, mental health, and behavioral benefits. The State of Wisconsin Group Health Insurance Program is an employer-sponsored program offering group health coverage to employees of state agencies, the UW System, UW Hospital & Clinics Authority, participating local government employers, and annuitants (and their insured survivors). Includes health information, provider directory, and searchable formulary. BadgerCare Plus, a Wisconsin Medicaid program, provides health care benefits for people ages 0–64 who have a limited income. Find contact info from the Washington state Office of the Insurance Commissioner for small business health insurance companies that sell in Washington state. Groups of 2 to 50. their health insurance coverage in the event they lose eligibility under the program. Serves businesses and individuals. We have a variety of group coverage options for small businesses in Washington. Employees must meet the following requirements to enroll in this plan: 1. In addition to benefits payable in the event of a death, this plan provides the following components: 1. © 2020 Board of Regents - University of Wisconsin System. Summary. Under age 70 at the time of initial enrollment (if 70 or older when initially eligible, can only apply for coverage through Evidence of Insurability) 3. The Navitus SpecialtyRx Program is offered through Lumicera Health Services and UW Health Specialty Pharmacy for non-Medicare participants. State Group Health Insurance: Department of Employee Trust Funds | 1-877-533-5020. Specialty medications are marked with “ESP” on the “Navitus Formulary List.” In Washington State, private insurance is only available for purchase through Washington Health Plan Finder (see below for details). Where to buy a health plan. If you are not enrolled in SGH, you may elect the Preventive Dental plan to cover basic and preventive dental services. Contact ETF if you have questions related to eligibility for COBRA and the duration of COBRA coverage. Pharmacy Benefits: Navitus Health Solutions | 1-866-333-2757. For more information, see our Companies and Licenses page. To begin receiving specialty medications from one of the specialty pharmacies, call Lumicera Health Services at 855-847-3553 or UW Health Specialty Pharmacy at 866-894-3784. Coverage is based on your eligible earnings. | Accessibility Policy The Washington State Health Insurance Pool (WSHIP) Options for people with disabilities; Appealing a health insurance denial; Your health insurance rights. Outside the United States. Use the forms on this page to administer the Group Health Insurance program. ETF administers retirement, insurance and other benefit programs for state and local government employees and retirees of the Wisconsin Retirement System. The monthly premiums for spouse and dependent coverage will decrease about 25 cents per month. 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. Information will be added and linked here as soon as it becomes available. Some students may qualify for low-cost options through Apple Health, Washington State’s Medicaid program. Communications Center at 1-877-533-5020 or ETFSMBEmployerInsurance@etf.wi.gov. Group Health Cooperative of South Central Wisconsin (GHC-SCW) ghcscw.com MK20-85-0(7.20)O Quick Reference Card in Back Group Health Cooperative of South Central Wisconsin 2021 State of Wisconsin Group Health Insurance Program 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.Dependents: The State Group Health Insurance program allows an employee’s eligible dependents to be covered by one group health insurance program only. COBRA requires that employees and their eligible dependents who lose coverage eligibility for one of these reasons be offered the opportunity to temporarily extend their coverage under the program for a maximum of 18 months due to termination or up to 36 months due to divorce, a dependent attaining age 26 and not being disabled, layoff or death. Group Health Insurance Program. For more information about the program, see specific year information listed at the top of this page. dependents covered under the State Group Health Program to continue or convert It's Your Choice 2021 Decision Guide: State of Wisconsin Group Health Insurance for Employees 21ET-2107 Open PDF. Employee coverage is based on your eligible earn… This document will be updated regularly. Certificate of Coverage for the 2021 plan year, for the State of Wisconsin Group Health Insurance Program. An additional cost will be added to your monthly health insurance premium. If you have a small business with 1-50 employees, you have several options: Small employer market: Any business with 1-50 employees can buy health insurance in the small employer market. Local participant premiums will … The Classic and CDHP plans share the same large network that includes providers both nationwide and worldwide. Starting on October 1 2020, GHC-SCW Members can receive their flu shot at a Navitus Pharmacy or during any scheduled UW Specialty Care Appointment. Benefits Enrollment Opportunities New Employee >> Employment Change >> Life Events >> Open Enrollment >> Benefits News News feed from UW Service Center Article Item News Post Insurance Plans Health Insurance State Group Health Insurance Disability Insurance AD&D ICI Savings Plans Health Savings FSA HSA Retirement Savings WRS TSA 403(b) WDC 457(b) Leave Legal… The 2020 annual open enrollment period to buy an individual and family health plan is closed, unless you qualify for Apple Health (www.hca.wa.gov) or a special enrollment period. The Plus plan networks are smaller, as each consists of regional providers spread throughout western Washington. Its contents are based on state statute and administrative code. If questions remain, contact the Employer Eligibility can be lost due to termination Uniform Dental Benefits: Delta Dental of Wisconsin | 1-844-337-8383. last updated: 01/24/2020. Select Blue Cross Blue Shield Global™ or GeoBlue if you have international coverage and need to find care outside the United States. You buy directly from an insurance company or from an insurance agent or broker. Consult this manual as a first-step resource when you encounter group health insurance program-related questions or concerns. Beginning April 1, 2020, State Group Life Insurance participants will see a 5%, or approximately $1 per month for a typical employee, increase in their premiums. Search for Doctors, Hospitals and Dentists Blue Cross Blue Shield members can search for doctors, hospitals and dentists:. It includes group health contract language and instructions relevant to the administrative and reporting practices of the group health insurance program. 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