As you may be aware, the Group Insurance Board (GIB) approved a motion on February 8, 2017 to move to a self-insured health insurance model for State Group Health effective January 2018. Under the self-insured model, the Department of Employee Trust Funds (ETF) would hold health insurance funds in a reserve to pay individual health care claims instead of paying health insurance companies a fixed dollar amount for employee health insurance. ETF has developed a 5 minute video that helps explain the self-insurance concept. The proposed self-insured funding model requires approval by the State Legislature.
Along with moving to a self-insured model, the GIB also approved changes to the service model to regionalize the health plans, dividing the state into four regions. This regionalization will move the State Group Health Insurance from 17 options to 6 regional options. In addition, there will be 1 statewide/nationwide option. Brown County and the greater Green Bay area will be under the Eastern region, with two regional vendors, Anthem Blue Cross Blue Shield and Network Health Administrative Services.
Why the change?
The Board’s decision was based on a potential taxpayer savings of an estimated $60 million over the 2017-2019 biennium, with additional savings predicted in future years. The new structure will provide the same level of benefits to employees, while retaining access to 98% of current plan providers, according to the Board’s consulting actuary.
Will my health insurance premiums increase?
A self-insurance model or moving to regions does not mean higher premiums or out-of-pocket costs. Uniform benefit cost sharing (copay/deductible/coinsurance) is expected to stay the same in 2018 and premium contribution amounts are not available yet, but will be provided during the Annual Benefits Enrollment period this fall.
Will I need to choose a new health plan?
Yes, all employees enrolled in the State Group Health Insurance will need to evaluate health plan information and providers when the information is provided during the Annual Benefits Enrollment period this fall.
How can I learn more?
For more information on coverage areas, providers and an action step timeline, please visit the ETF Site.
We will continue to communicate with you as we have more information available. As always, please contact out office at (920) 465-2390 or email@example.com with any quesitons.