An Explanation of Benefits (EOB) is a statement that shows claims information about the services provided during your health or dental visits. An EOB is created by your insurance carrier to show you the total cost of your services. It also shows you the portion that was paid by insurance, the discounts for obtaining services within an approved network of providers, and the amount that you will need to pay. Your EOB will show how much of your deductible and out-of-pocket has been met for the calendar year.
Review the following samples for what to expect on an EOB:
How do I access my EOB and who should I contact with questions?
You may access your EOB by logging into your health or dental insurance plan carrier’s website. If you have questions about the information on your EOB, you should contact your health or dental insurance plan carrier. The website and contact information is on your EOB or your insurance cards.
When will I receive an EOB?
You will receive an EOB every time you obtain medical or dental services. It is important that you show your health or dental insurance ID card whenever you receive services. It may take a few weeks for your insurance carrier to create your EOB.
Do I need to submit payment to my doctor’s or dentist’s office when I receive my EOB?
An EOB is not a bill. You should not submit payment when you receive an EOB. Your doctor or dentist will send you an invoice after they receive payment from your insurance. The invoice sent to you by your doctor or dentist should match the amount indicated as your responsibility on your EOB.
What should I do with my EOB?
Review your EOB for accuracy and save it in a secure place since it may contain personal health information. Remember to use your EOBs as follows:
- If you have a Health Savings Account (HSA), your EOB is an ideal document to:
- Estimate how much to contribute to your HSA. Since an HSA is a component of your High Deductible Health Plan, you should be financially prepared to pay 100% of most services, except preventive services (since you must meet your deductible before the insurance will pay).
- If you have a Flexible Spending Account (FSA), your EOB is an ideal document to:
- Substantiate your claims with the FSA administrator
- Estimate how much to put into your FSA on an annual basis
Reminder: Save your EOBs as documentation to show you are using your funds for IRS eligible expenses.
Source: UW System Human Resources
The Annual Benefits Enrollment (ABE) period is your annual opportunity to review your benefits and enroll or make changes. Changes made during ABE are effective January 1, 2023.
Act NOW before the ABE period ends on October 21, 2022.
- Review your current benefit enrollments in the MyUW portal (Benefit Information tile).
- Visit the ABE web page for the following information and resources:
- ABE 2023 Highlights video
- Department of Employee Trust Funds (ETF) Health Benefits Decision Guide
- Benefit plan comparisons
- Virtual benefit sessions and onsite benefit fair schedules
- You may be eligible to enroll in, change, or cancel coverage for the plans listed below. For some plans you can add or remove dependents. Visit the ABE web page for additional information.
- State Group Health Insurance
- Dental Insurance
- Vision Insurance
- Individual & Family Life Insurance (current enrollees only)
- Accidental Death & Dismemberment (AD&D) Insurance
- Accident Insurance
- Flexible Spending Accounts (FSAs): Health Care FSA, Limited Purpose FSA, and Dependent Day Care
- Health Savings Account (HSA)
- You must re-enroll in these plans each year to participate:
- Flexible Spending Account (FSAs): Health Care FSA, Limited Purpose FSA, and Dependent Day Care
- Health Savings Account (HSA): Required if you enroll in a High Deductible Health Plan (HDHP)
- State Group Health Insurance Opt-Out Incentive
- Enroll on the MyUW portal for UW System institutions or for UW-Madison.
- Go to the Benefit Information tile
- Click on the Enroll Now button
- The ABE Self-Enrollment Guide provides instructions for how to enroll through the MyUW portal.
- All enrollments and changes must be submitted by 4:30 p.m., Friday, October 21, 2022.
After you enroll, you will receive an e-mail within 24-48 hours with instructions on viewing your Confirmation Statement for elections effective January 1, 2023. Review your Confirmation Statement to ensure your elections are accurate.
For more information review the ABE web page. If you have questions after reviewing the available resources, contact Human Resources at firstname.lastname@example.org.
Source: UW System Human Resources
Virtual benefit sessions are being offered by a number of benefit vendors throughout the annual open enrollment period (9/26-10/21). Vendors will be providing information and an opportunity to ask questions in a group setting. Click here to see a list of live benefit sessions being hosted by the vendors during ABE. Vendors include the Department of Employee Trust Funds (ETF), Health Insurance Carriers, Delta Dental, DeltaVision and Optum (FSA/HSA).
The Office of Human Resources & Workforce Diversity will be offering Benefit Open Lab Sessions during the Annual Benefit Enrollment period (September 26 – October 21) at the following times and locations. Please mark your calendar to stop by and get your questions answered or receive help with the online benefits election process from one of our Benefits Specialists.
UW-Green Bay Open Labs Sessions
- Thursday, September 29th – 3:00-4:00 p.m.
- Wednesday, October 5th – 10:00-11:00 a.m.
- Friday, October 7th – 8:00-9:00 a.m.
- Tuesday, October 11th – 9:00-10:00 a.m.
- Thursday, October 13th – 11:00-12:30 p.m.
- Thursday, October 20th – 2:30-4:00 p.m.
Location: Instructional Services, IS1129E
Benefits staff will also be on the additional campus locations throughout the open enrollment period. Employees can schedule one-on-one in-person meetings using the following links:
Sheboygan Campus – Thursday October 6th
Manitowoc Campus – Wednesday, October 12th
Marinette Campus – Friday, October 14th
Please click here for additional information on virtual benefits counseling options. If you have any other questions, please contact HR at email@example.com or (920) 465-2390.
Need assistance as you review your current benefits and make changes for 2023? Have a question or two that you would like to talk through with a benefits specialist? Register here for a 15-minute appointment.
Can’t make one of the individual session times or have a question that you would like answered now? Submit your questions directly to firstname.lastname@example.org and one of our benefits specialists will respond back to you as soon as possible.
Employees eligible for the State Group Health Insurance are encouraged to attend the 2023 State Group Health Plan Fair.
When: Wednesday, September 28, 2022
Time: 11:00 a.m. to 2:00 p.m.
Where: University Union, Phoenix Room A
State Group Health plan carriers with networks located across Northeast Wisconsin will be on-site and available to talk to during this fair. Health plan carriers attending include:
- Dean Health Plan –
- Prevea 360 East
- Access Health Plan administrator for 2023
- Robin with HealthPartners
- Network Health Plan
- Common Grounds Healthcare Cooperative (new network area for 2023)
- Medicare Advantage & Medicare Plus by UnitedHealth (available for retirees)
Delta Dental will be attending and available for information related to both the dental and vision plans offered to UW employees and retirees.
Well Wisconsin/WebMD will also be attending, to help with questions about wellness and the wellness incentive.
Questions? Please contact us at email@example.com or (920) 465-2390.
The State Group Health Insurance premiums will be increasing slightly in 2023. The health plan designs (health plan vs. high deductible health plan) and most health plan components will remain the same (for example, deductibles, copays, coinsurance). There will be health plan carrier changes (WEA Trust will no longer be available) and covered services enhancements. 2023 Health Plan Provider Directories are now available on ETF’s website: https://etf.wi.gov/its-your-choice/2023/health-plan-search/state
Premium changes will be effective January 1, 2023 with deductions beginning on the 12/15/2022 paycheck. More information pertaining to the State Group Health Insurance program can be found on the UW System Annual Benefits Enrollment website.