Annual Benefit Enrollment
Starts October 7th.

State Group Health

Important Changes for 2014

You should review the following documents for detailed health plan and coverage information.

Health plans may expand or reduce their network annually and access to providers can change. Be sure to verify that your current providers will still be available to you in 2014. See the Health Plan Contact Information webpage for the phone number and website of your health plan.

Benefit Changes for 2014

  • Uniform Dental Benefits: All health plans, except the Standard Plan and SMP, will offer the same level of dental benefits in 2014.  Previously health plans were able to offer different levels of dental coverage.  You should review your new coverage levels under Uniform Dental benefits (see Uniform Dental tab) to ensure it fits your needs.

  • All health plans will offer a $150 incentive for the completion of a Health Risk Assessment (HRA) and a biometric screening. Prior to 2014, the incentives offered differed by health plan. Your adult dependents are also eligible for the $150 incentive. Contact your health plan or visit wellwisconsin.wi.gov for more information on wellness benefits.
Summary of 2014 Health Plan Changes
Health Plan What’s New in 2014? Action Needed During ABE
Anthem Blue Northwest Plan  will no longer be available If currently enrolled in this plan, you MUST select a new plan during ABE as your health plan for 2014.  If you fail to elect a new plan, you will be moved to the Standard Plan, which is the most expensive plan offered.
Dean Prevea 360 New plan May enroll for plan in Brown, Kewaunee, Manitowoc, Marinette, Oconto, Outagamie, Sheboygan and Menominee Counties
UnitedHealthCare – Northeast
and United HealthCare – Southeast
Merging into one plan If currently enrolled in either plan and you want to keep UnitedHealth Care for 2014, you do not need to do anything.
WEA Trust PPO – Northwest Offering two distinct provider networks – the Chippewa Valley or the Mayo Health System Current and new members must select one of the provider networks during the ABE period.  If a network is not selected, the member’s previous medical services will determine their network for 2014 (all family members will be placed in the same network).  The employee may change networks once per calendar year.
WEA Trust PPO –
South Central
New plan May enroll for plan in Dane County

Uniform Dental Benefits

To ensure that all members receive the same level of dental coverage through their health insurance, health plans (except the Standard Plan and SMP) will offer the same dental coverage in 2014.  This is called Uniform Dental Benefits.  Your health plan still decides if you need to see certain dentists (in-network) to have benefits paid. See the Uniform Dental Benefits Certificate of Coverage for details about what dental services will be covered in 2014 and to determine if there are any changes in your dental coverage for 2014.

The Uniform Dental Benefit is included in your health insurance coverage at no additional cost to you. It is intended to provide coverage for diagnostic, preventive and restorative services (such as fillings).  It does not include coverage for major dental services, such as crowns, root canals or implants.

For more information on Uniform Dental Benefits, see Frequently Asked Questions 2 through 7 beginning on Page 9 of the It's Your Choice 2014 Decision Guide.

If you are enrolled in EPIC Benefits+ or Dental Wisconsin, or are considering enrolling in EPIC Benefits+ for 2014, see a Dental Comparison Chart to learn how Uniform Dental Benefits may affect your other dental plans.

Summary of Uniform Dental Benefits
  Key Plan Provisions
In-Network Provider Designated Out-of-Network
Provider*
Deductible $0 $0
Annual Benefit Maximum
(per person)
$1,000 $1,000
Diagnostic/Preventive
(E.g. Routine evaluations, x-rays,
flouride treatment)
100% 75%
Restorative
(E.g. Fillings)
100% 50%
Periodontal
(Maintenance Only)
80% 50%
Adjunctive Services
(E.g. Local Anesthesia)
80% 50%
Orthodontia
(Children Only)
50% 50%
Ortho Lifetime Maximum $1,500 $1,500

* A health plan may designate and authorize out-of-network providers so that at least one dentist is available in each county or major city, if applicable.

NOTE: Coverage provided by Uniform Dental Benefits is a decrease in coverage for the following health plans: Gundersen Lutheran, Health Tradition, Humana and WEA Trust plans.

 

2014 Premiums

All health plans are in Tier 1 (lowest monthly cost), except WPS Metro Choice Southeast and the Standard Plan, which are both in Tier 3 (highest monthly cost) for 2014.
The monthly employee premium contribution is increasing for 2014.  The premiums listed below do not apply to those who are required to pay less than half-time rates or pay the total premium.

2014 Monthly Employee Premiums
Tier
Employees Covered by WRS Non-WRS Employees Covered by
Graduate Assistant / Short-Term Academic
Single Family Single Family
Tier 1 (all plans not listed in Tier 3) $88.00 $219.00 $44.00 $109.50
Tier 2 (Standard Plan - required
to work out of state)
$129.00 $324.00 $64.50 $162.00
Tier 3 (Standard Plan,
WPS Metro Choice Southeast)
$239.00 $596.00 $119.50 $298.00

*WRS covered employees who are working less than 50% and Classified LTE's with one appointment pay 50% of the total premium.