State Group Health Insurance

Getting Started

Contact the HR office in your school, college, or division and alert them to the changes you plan to make.

Enrollment Deadline

You have 30 days from your date of hire or qualifying life event to enroll in and/or make changes to your health insurance.

If you are a new hire and eligible for Self Service, complete your election by going to the Benefit Information tile on MyUW. If you are making a mid-year change (ie. qualifying life event) or are not eligible for Self Service, you should complete a State Group Health Insurance Application and submit it to your HR office.

Health Plan Designs

Employees covered by the Wisconsin Retirement System (WRS) have four health plan designs to choose from:

• Health Plan
• Access Health Plan
• High Deductible Health Plan (HDHP) with mandatory Health Savings Account (HSA)
• Access High Deductible Health Plan (Access HDHP) with mandatory Health Savings Account (HSA)

Graduate Assistants and Short-Term Academic Staff have two plan design options:

• Health Plan
• Access Health Plan

See also: Steps to Choosing Your Benefits

Monthly Premiums

For University Staff

You must have two months of WRS state service before you can receive the employer contribution toward health insurance. If you choose to begin coverage before you are eligible for the employer contribution, you pay 100 percent of the total premium until the first of the month following two months of WRS state service.

For WRS Employees Working Less Than 50 Percent

You pay 50 percent of the total premium.

For University Staff Temporary Employees

If you hold only one temporary appointment, you pay 50 percent of the total premium.

See also: Benefits Premiums

Provider Networks

If you are enrolling in the Health Plan, you choose one provider network as your network (i.e., the doctors you may visit) for the year. It is recommended you contact the health plan(s) you are considering to discuss any personal specialist needs, their availability to provide the needed service, and the time it may take to get an appointment.

All health plans offer the same uniform benefits. See the Certificate of Coverage for covered benefits and exclusions. If a provider is unable to provide a covered service (due to a lack of a particular specialist available in their network) they will give you a referral and/or authorization to another provider.

Go to the Health Plan Search page to find health plans in your county or the counties in which you’d like to receive care. Search results include major health care systems and provider directories.

A few questions to keep in mind:

• Is your health plan still available? Health plans may merge or change their service areas.
• Is your doctor, clinic, and hospital still covered? Verify with the provider directory.
• All health plans cover the same in-network benefits, but are there additional services, requirements, or programs that are important to you? Review the information for each health plan you are considering and contact the health plan with any questions.

Provider Networks Available in Dane County

• Dean Health
• Group Health Cooperative of South Central Wisconsin – Dane Choice
• Quartz UW Health

Provider Networks Available Outside Dane County

• Use the Health Plan Search to locate networks outside of Dane County.

Statewide and National Provider Networks

• Access Plan administered by Dean

Uniform Dental Benefits

You may add preventive dental coverage to your State Group Health insurance plan. This plan is the only preventive dental offered. It cannot be elected on its own, but must be combined with State Group Health insurance enrollment.

See also: Uniform Dental Benefits

Pharmacy Benefits

If you enroll in State Group Health insurance, your pharmacy benefits will be through a company called Navitus, regardless of which provider network or plan design you elect.

See also: Pharmacy Benefits

Wellness Incentive

The Well Wisconsin Program is available to eligible employees, retirees, and their spouses enrolled in the group health insurance program. It provides services and resources through WebMD and rewards participants with a cash incentive after completion of the WebMD health assessment, health screening, and a well-being activity. The incentive is taxable.

See also: Well Wisconsin for Members

Opt-Out Incentive

If you opt out of State Group Health coverage, you may be eligible to receive an opt-out incentive. Only WRS eligible employees are eligible for the incentive. You must submit a timely opt-out election. Annual re-enrollment is required to continue the opt-out incentive.

See also: Opt Out of Medical Benefits