ETF is committed to establishing and maintaining quality, long-term partnerships with participating local government employers. Our goal is to empower employers by providing accessible, high-quality insurance solutions.
Health and Prescription Drug Insurance
Income Continuation Insurance (ICI)
Health and Prescription Drug Insurance
Have you heard about the Wisconsin Public Employers Group Health Insurance Program? This program is authorized by the Group Insurance Board and available to local employers participating in the Wisconsin Retirement System, and local government employers that do not participate in the WRS and are separate Social Security entities. Learn more about how to build a rewarding employee experience through understanding the value of the Group Health Insurance Program.
Watch a 10-minute recorded webinar about joining the WPE Group Health Insurance Program to learn more.
The program is administered by the Department of Employee Trust Funds and offers the following benefits:
- Competitive health insurance premium rates.
- Four benefit designs (or program options), all with or without dental, to choose from.
- One-stop shopping for access to many provider networks statewide.
- A prescription drug benefit program administered by a pharmacy benefits manager (PBM) credited with saving state and local employers millions of dollars in prescription drug costs.
- Support for employers, employees, and retirees with their health insurance needs.
- A wellness and chronic condition management program that has demonstrated positive impacts on health outcomes for participants.
Health Benefit Program Options
ETF offers four benefit designs, called program options, all with the option of with or without dental, for employers to choose from.
For benefit details, see page 5 of the How to Become a Participating Employer Under the Wisconsin Public Employers’ Group Health Insurance Program (ET-1139) manual.
Note, employers with collective bargaining units may offer different program options to different bargaining units. Individual employees cannot choose between program options. There are separate pharmacy benefit out-of-pocket maximums that apply to all program options, except the High Deductible Health Plan (P07/PO17).
The monthly premium rates, as well as a map showing plans available by county, are available on the ETF website. The map helps members to choose health plans offered where they receive health care services. They can also find links to each health plan’s covered provider directory when viewing the map within their chosen program option.
2024 Health Plan Year Information
See the landing page links for each local Program Option (PO) that excludes dental coverage below. Note: Uniform Dental is optional and you as the employer must choose to offer it, or not, to your employees. More information about the dental benefit appears in a dedicated section, below
The program options are also outlined in chapter 201A of the Local Employer Health Insurance Standards, Guidelines and Administration Manual (ET-1144).
Health Insurance Participation Process
Although every employer has different coverage needs and budget preferences, it makes sense to explore your options when looking for health insurance. Wondering how to get started? Joining the local group health insurance program consists of the following steps, depending on the size of the employer:
Large Employers, with 50 or More Employees
Large employers, with 50 or more employees, must complete the group underwriting process to learn what, if any, surcharge your group will have to pay for a limited time. The underwriting process begins 120 days prior to your effective date and takes about 30 days to complete. Groups can join the program effective January, April, July, or October 1 of any year. The surcharge will not last more than 27 months if one is applied. To begin coverage effective January 1, 2025, large employers must begin the underwriting process by August 31, 2024 and your resolution must be received by September 30, 2024.
All of your WRS-eligible employees, or WRS-eligible equivalent employees for non-WRS employers, must be offered the health insurance coverage, including part-time WRS eligible employees. Eligibility includes current and future WRS or WRS-equivalent retirees covered under your current group health insurance plan.
Underwriting determines if a large group may join at the rates published in the annual health benefits materials, or if a large group will receive an additional per-contract, per-month surcharge, as determined by the Group Insurance Board’s consulting actuary, for no more than 27 months. The surcharge will be applied if the group’s risk is determined to be detrimental to the existing pool of covered members.
Once ETF receives the required information from the employer, the information is forwarded to the Group Insurance Board’s consulting actuary for review and surcharge determination.
ETF will provide final rates to the employer. Following underwriting and ETF notification of the final rates, the employer’s governing body must decide whether to pass a resolution for inclusion (ET-1324) to join the program. Upon filing the resolution with ETF, coverage is effective on the first day of the quarter following the 120-day process.
Small employers, with 49 or less employees
Small employers, with 49 or less employees, do not have to complete underwriting. They do need to:
- File a resolution 60 days prior to your chosen effective date: January, April, July, or October 1.
- Select a program option to offer your employees and retirees (see program options listed in this news item for details).
The employer’s governing body must pass a resolution for inclusion (ET-1324) to join the program. The employer must submit the resolution at least 60 days before the first day of the quarter they wish to have participation begin.
Annual Open Enrollment
As a participating employer in the local group health insurance program, your employees have the option to choose any health plan offered by this program. During the annual open enrollment period lasting for four weeks in late September into October, employees and insured retirees may elect, without restriction, to change to a different participating health plan within their program option or to change from individual to family coverage, or family to individual coverage, effective the following January 1.
Wellness
The Well Wisconsin Program is available to subscribers and spouses enrolled in the Group Health Insurance Program. It provides various levels of wellness and chronic condition management support to participants including, but not limited to: annual $150 incentive, various coaching programs (e.g., lifestyle management, mental health, weight management, chronic condition management, pain management, diabetes prevention), health assessment and web portal, biometric health screenings, flu vaccines, and more.
Local employers who offer the Group Health Insurance Program to their employees also have access to robust consultative support, toolkits, and a library of presentations and interactive events available to help build a culture of well-being at the workplace. Annual wellness grants are also available to offset the cost of environmental/building upgrades to support employee well-being, costs associated with professional development, and more.
Dental
Uniform Dental Benefits
Uniform Dental, administered by Delta Delta®, is available to those enrolled in health insurance under the State of Wisconsin Group Health Insurance Program. Employers must opt into offering this benefit to their employees.
Uniform Dental coverage mirrors your health insurance coverage (if the member selects family health insurance coverage, they will have family Uniform Dental coverage). Uniform Dental provides coverage for basic dental services like exams, X-rays, cleanings, and simple restorations like fillings, and orthodontia coverage for dependents under the age of 19.
For more information on offering Uniform Dental contact the Employer Communication Center at 1-877-533-5020 or email at ETFSMBESSNewEmployer@etf.wi.gov.
Supplemental Dental Benefits
Supplemental dental benefits, administered by Delta Delta®, provides complimentary dental coverage to Uniform Dental benefits. There are three supplemental dental plans to choose from:
- Preventive Plan: Available to those that are not enrolled in Uniform Dental; it offers the same benefits as Uniform Dental. Coverage does not need to mirror your health insurance coverage; employees can choose between individual and family coverage.
- Select Plan: Covers major dental services like root canals, crowns, bridges, dentures, and implants.
- Select Plus Plan: More robust benefits than the Select Plan, it covers major dental services like root canals, crowns, bridges, dentures, and implants. It also offers orthodontia benefits for participants of any age.
Employers are not required to participate in the Group Health Insurance Program to offer supplemental dental benefits. Employers must opt into supplemental dental with Delta Dental prior to the start of the annual open enrollment period.
For more information about offering supplemental dental, email sales@deltadentalwi.com.
Vision
Supplemental vision, administered by DeltaVision®, with EyeMed Vision Care, provides coverage for annual eye exams and allowances towards glasses or contact lenses. Discounts are also available for laser vision correction. Employers opt-in to the vision plan with Delta Dental of Wisconsin. Employers are not required to participate in the GHIP to offer the vision plan.
For more information about offering the vision plan, email sales@deltadentalwi.com.
Accident
The Accident Plan, administered by Securian Financial, provides a cash benefit paid directly to you to help cover out-of-pocket expenses regardless of health insurance coverage. This plan does not disqualify you from high deductible health plan (HDHP) or traditional medical coverage.
Employers opt in to the accident plan with Securian. Employers are not required to participate in the Group Health Insurance Program to offer the accident plan.
For more information about offering the accident plan, email madisonoffice@securian.com.
Life Insurance
Employees can protect their loved ones by enrolling in the Wisconsin Public Employers Group Life Insurance Program. The program offers different types of coverage to meet your employee’s needs. Employees can elect up to five times of their annual earnings for their benefits. Employees may even be able to continue coverage in retirement.
Additional benefits include accidental death, dismemberment, and loss of life provisions, living benefit provision, conversion to pay for health insurance premiums, and a disability waiver or premium provision. Participants also have access to legal, financial, grief assistance, travel assistance, and legacy planning resources.
Employers must complete a Resolution for Inclusion Under Group Life Insurance (ET-1303). See the ETF webiste for more information about the Life Insurance Program.
Income Continuation Insurance (ICI)
The Wisconsin Public Employers (WPE) Income Continuation Insurance Program is authorized by the Group Insurance Board and available to local employers participating in the WRS. The program is administered by ETF and offers continued income for employees on leave of absence due to illness or injury of extended duration.
Now is a great time to consider offering this benefit to your employees. The Group Insurance Board has extended the Income Continuation Insurance (ICI) Program premium holiday through March 31, 2025, based on the strong financial position of the local ICI plan. This means that employers and employees will not pay premiums for ICI coverage. There has been a premium holiday in effect since January of 2012.
Who will pay the premium when the holiday ends? The total ICI premiums are based on an employee’s WRS-reported earnings in the preceding calendar year (or projected annual earnings for those employees noted in subchapter 400 of the Income Continuation Insurance Administration Manual (ET-1145) and the employee’s selected elimination period. Employers must pay a minimum contribution equal to the total premium for the 180-day elimination period. An employer may elect to contribute a greater amount toward the premium.
To join the WPE ICI program, employers must file a resolution 90 days prior to the date they wish to begin offering the coverage. Coverage always begins on the first of a month. For more information on this process, please review the How to Become a Participating Employer Under the WPE Group ICI Program (ET-1140) manual.
Contact
We’re here to help you. For more information on joining the local group health insurance program, contact the Employer Communication Center at 1-877-533-5020 or email at ETFSMBESSNewEmployer@etf.wi.gov.