Group Health Insurance Program. Medical. By using providers within your network, your health care costs will be significantly lower than if you use providers outside your network. If you are not finding what you need, go to the Publications page to search through all publications. Office of Group Benefits ⋯ 1201 N. 3rd St, Suite G-159, Baton Rouge, LA 70802 ⋯ 1-800-272-8451 P.O. In the United States, Puerto Rico and U.S. Virgin Islands. Select Blue Cross Blue Shield Global™ or GeoBlue if you have international coverage and need to find care outside the United States. The Navitus SpecialtyRx Program is offered through Lumicera Health Services and UW Health Specialty Pharmacy for non-Medicare participants. Washington group health insurance. State Group Health (SGH) insurance provides comprehensive medical, hospital, pharmaceutical, mental health, and behavioral benefits. Outside the United States. You have 30 days from the date your employment begins to enroll. Do not receive State Group Health Insurance through a parent or spouse through another State agency (e.g. Where to buy a health plan. It includes group health contract language and instructions relevant to the administrative and reporting practices of the group health insurance program. Kaiser WA (formerly Group Health) plans Kaiser WA offers four plans to UW employees: Classic, Value, SoundChoice, and a CDHP Kaiser Permanente NW plans Only employees who live in Clark county or Cowlitz county can enroll in the Kaiser Permanente NW plans Employees must meet the following requirements to enroll in this plan: 1. UW Medicine is considered "in-network" for several health insurance plans offered on the Exchange. Medicaid ( Apple Health ), a government health insurance plan for low-income people who are US citizens or green card holders of 5 years or more. The 2020 annual open enrollment period to buy an individual and family health plan is closed, unless you qualify for Apple Health (www.hca.wa.gov) or a special enrollment period. You may elect coverage of up to five times your eligible earnings, up to $20,000 of spouse coverage and up to $10,000 of child coverage. their health insurance coverage in the event they lose eligibility under the program. Quartz-branded health plans are offered by Quartz Health Benefit Plans Corporation, Quartz Health Plan Corporation, Quartz Health Plan MN Corporation and Quartz Health Insurance Corporation, which are separate legal entities. The State of Wisconsin Group Health Insurance Program is an employer-sponsored program offering group health coverage to employees of state agencies, the UW System, UW Hospital & Clinics Authority, participating local government employers, and annuitants … Includes health information, provider directory, and searchable formulary. If you are not enrolled in SGH, you may elect the Preventive Dental plan to cover basic and preventive dental services. Box 44036, Baton Rouge, LA 70804 If you feel your Pharmacy Benefits Manager (PBM) has “steered” you to use a specific pharmacy over your chosen pharmacy, call the Office of Group Benefits (OGB) at 1-800-272-8451 to report the issue. Coverage is based on your eligible earnings. UMP Classic: $104 / $105 $218 / $220 $182 / $184 $296 / $299 UMP Plus: $69 / $72 $148 / $154 $121 / $126 $200 / $208 UMP Select – / $37 – / $84 – / $65 – / $112 UMP CDHP: $25 / … Employees are eligible for the State Group Health Insurance program if they are eligible for the Wisconsin Retirement System (WRS) or the Graduate Assistant/Short-Term Benefit Packages.Dependents: The State Group Health Insurance program allows an employee’s eligible dependents to be covered by one group health insurance program only. Pharmacy Benefits: Navitus Health Solutions | 1-866-333-2757. BadgerCare Plus, a Wisconsin Medicaid program, provides health care benefits for people ages 0–64 who have a limited income. The Washington State Health Insurance Pool (WSHIP) Options for people with disabilities; Appealing a health insurance denial; Your health insurance rights. Specialty medications are marked with “ESP” on the “Navitus Formulary List.” In Washington State, private insurance is only available for purchase through Washington Health Plan Finder (see below for details). Employee coverage is based on your eligible earn… Information for employers about the Group Health Insurance program, how to participate, and administer the program, Employer Forms, Brochures and Publications, IYC Health Benefits 2021 Virtual Benefit Forums for Employers, Health Insurance It’s Your Choice 2021 Information for State Employers, Health Insurance It’s Your Choice 2021 Information for Local Employers in the Program, 88% tables and full premium rates by program option, It's Your Choice Health Benefits 2021 Preview Information for State Employers, It's Your Choice Health Benefits 2021 Preview Information for Local Employers, State Employer: IYC 2021 Kickoff Meeting Information, Local Employer: IYC 2021 Kickoff Meeting Information, Health Insurance It’s Your Choice Information for State Employers, Health Insurance It’s Your Choice Information for Local Employers in the Program, State Employer: IYC 2020 Kickoff Meeting Information, Local Employer: IYC 2019 Kickoff Meeting Information, ALEX® Employer Toolkit (For state employers), State Agency Health Insurance Standards, Guidelines and Administration Employer Manual (ET-1118), State of Wisconsin Supplemental Benefit Plan Administration Manual (ET-1158), Local Employer Health Insurance Standards, Guidelines and Administration Manual (ET-1144), Group Health Insurance Application/Change Form for Retirees & COBRA Continuants (ET-2331), Continuation - Conversion Notice (ET-2311), Group Health Insurance Application/Change Form (ET-2301), State of Wisconsin Supplemental Benefit Plans Administration Manual (ET-1158), Supplemental Benefits for State Employers, Recovery of Overpaid Benefits– State Employers Only, Employee Reimbursement Account Contributions, Income Continuation Insurance for Employers, Wisconsin's 218 Agreement with Social Security, 105% rates available upon request; contact your ETF case manager, Group Health Insurance information: Go to, Presentation from the employer kickoff meetings, Security Health Plan Transition Resources. event of conflicting information, state statute, state health contracts, and/or policies and provisions established by the State of Wisconsin Group Insurance Board shall be followed. Kaiser Permanente Washington offers health insurance and medical care in Washington state. Eligibility can be lost due to termination COBRA requires that employees and their eligible dependents who lose coverage eligibility for one of these reasons be offered the opportunity to temporarily extend their coverage under the program for a maximum of 18 months due to termination or up to 36 months due to divorce, a dependent attaining age 26 and not being disabled, layoff or death. The State of Wisconsin Group Health Insurance Program is an employer-sponsored program offering group health coverage to employees of state agencies, the UW System, UW Hospital & Clinics Authority, participating local government employers, and annuitants (and their insured survivors). It's Your Choice 2021 Decision Guide: State of Wisconsin Group Health Insurance for Employees 21ET-2107 Open PDF. Non-Exchange plans are plans you buy through an insurance agent, broker or directly from a company. of employment, layoff, divorce, a dependent Summary. All Rights Reserved, All Sites Some students may qualify for low-cost options through Apple Health, Washington State’s Medicaid program. A plan’s network consists of doctors, clinics, hospitals, specialists, and other health care providers. Summary. Use the forms on this page to administer the Group Health Insurance program. The monthly premiums for spouse and dependent coverage will decrease about 25 cents per month. Consult this manual as a first-step resource when you encounter group health insurance program-related questions or concerns. Benefits Enrollment Opportunities New Employee >> Employment Change >> Life Events >> Open Enrollment >> Benefits News News feed from UW Service Center Article Item News Post Insurance Plans Health Insurance State Group Health Insurance Disability Insurance AD&D ICI Savings Plans Health Savings FSA HSA Retirement Savings WRS TSA 403(b) WDC 457(b) Leave Legal… If questions remain, contact the Employer UW System, UW Hospital and Clinics) In 2015, were eligible for an employer premium contribution to their health insurance and were enrolled in a State Group Health Insurance plan. Its contents are based on state statute and administrative code. Eligible for coverage under the WRS 2. dependents covered under the State Group Health Program to continue or convert Certificate of Coverage for the 2021 plan year, for the State of Wisconsin Group Health Insurance Program. Uniform Dental Benefits: Delta Dental of Wisconsin | 1-844-337-8383. last updated: 01/24/2020. The Consolidated Omnibus Budget Reconciliation Act (COBRA) allows participants and their eligible In addition to benefits payable in the event of a death, this plan provides the following components: 1. Information will be added and linked here as soon as it becomes available. Wisconsin statutes, administrative code and group health contract language are reviewed on an ongoing basis and may be revised. The Plus plan networks are smaller, as each consists of regional providers spread throughout western Washington. Local participant premiums will … You buy directly from an insurance company or from an insurance agent or broker. 2021 health benefits decision guide for state of Wisconsin employees. attaining age 26 and not being disabled, or death. Communications Center at 1-877-533-5020 or ETFSMBEmployerInsurance@etf.wi.gov. Search for Doctors, Hospitals and Dentists Blue Cross Blue Shield members can search for doctors, hospitals and dentists:. If you enroll in State Group Health (SGH) Insurance, you may elect the Uniform Dental Benefit (UDB) for routine preventive and basic dental services. | Privacy Policy Cover Photo: North Point Lighthouse; Lake Park, Milwaukee All photos courtesy of the Wisconsin Department of Tourism | Accessibility Policy This document will be updated regularly. Eligibility requirements for health insurance and other state-provided benefits Health insurance options for those ineligible for UW coverage Find health insurance options that are available for people who are not eligible for one of the University's health insurance programs. Groups of 2 to 50. The health insurance employer standards, guidelines and administration manual is a reference source intended to aid your administration of and participation in the Wisconsin group health insurance program. 2021 State of Wisconsin Group Health Insurance Program Certificate of Coverage IYC Health Plan 21ET-2107cc Open PDF. However, if your retirement plan is PERS 2, PERS 1, TRS 1, or LEOFF 2, before you’re eligible to continue your insurance, you must first elect to begin receiving your retirement income. Please refer to the Student Handbook for information regarding health insurance options in each WWAMI state. Get a Quote. The Classic and CDHP plans share the same large network that includes providers both nationwide and worldwide. Or go to our All Benefits Available page to explore Health Plan Program Options. For more information about the program, see specific year information listed at the top of this page. Find contact info from the Washington state Office of the Insurance Commissioner for small business health insurance companies that sell in Washington state. | Contact Webmaster, 2020 Health Insurance Application/Change Form (ET-2301), 2021 Health Insurance Application Change/Form (ET-2301), Affidavit for Insurance Purposes (UWS 93), 2020 Comparison of Health & Pharmacy Benefits, Glossary of Health Coverage and Medical Terms, How to Get Care When You Need It eLearning (ETF), 2020 Health Plan and High Deductible Health Plan (HDHP). For more information, see our Companies and Licenses page. An optional preventive dental plan (called Uniform Dental) is available, at extra cost. An additional cost will be added to your monthly health insurance premium. See ETF Response to COVID-19 for updates on services. Contact ETF if you have questions related to eligibility for COBRA and the duration of COBRA coverage. Washington State students: Students needing to purchase health insurance can go through the Washington State marketplace. © 2020 Board of Regents - University of Wisconsin System. If you have a small business with 1-50 employees, you have several options: Small employer market: Any business with 1-50 employees can buy health insurance in the small employer market. Serves businesses and individuals. ETF administers retirement, insurance and other benefit programs for state and local government employees and retirees of the Wisconsin Retirement System. Not receiving a WRS annuity You may also apply for coverage within 30 days of certain life events. To begin receiving specialty medications from one of the specialty pharmacies, call Lumicera Health Services at 855-847-3553 or UW Health Specialty Pharmacy at 866-894-3784. The Department of Employee Trust Funds Group Insurance Board met on May 19, 2015 and approved changes to the state employee health insurance program. Staying healthy is easier with the right support. State Group Life (SGL) Insurance offers term life insurance to you, your spouse and eligible children. The Benefits Office supports UW employees with a variety of health plan options, generous retirement plans, life insurance and long-term disability coverage, and more. We have a variety of group coverage options for small businesses in Washington. State Group Health Insurance: Department of Employee Trust Funds | 1-877-533-5020. Under age 70 at the time of initial enrollment (if 70 or older when initially eligible, can only apply for coverage through Evidence of Insurability) 3. As long as you meet the enrollment deadline, you’re eligible to continue your health insurance after you retire from UW. Filter plans by county To browse each plan’s network or to find a s… Starting on October 1 2020, GHC-SCW Members can receive their flu shot at a Navitus Pharmacy or during any scheduled UW Specialty Care Appointment. Beginning April 1, 2020, State Group Life Insurance participants will see a 5%, or approximately $1 per month for a typical employee, increase in their premiums. Group Health Cooperative of South Central Wisconsin (GHC-SCW) ghcscw.com MK20-85-0(7.20)O Quick Reference Card in Back Group Health Cooperative of South Central Wisconsin 2021 State of Wisconsin Group Health Insurance Program Offered on the Exchange Wisconsin statutes, administrative code and Group health program... Companies that sell in Washington state and preventive Dental plan ( called Uniform Dental is. Of Group coverage options for small businesses in Washington state students: students needing to purchase health insurance Certificate., insurance and medical care in Washington state Dental ) is available, at extra cost GeoBlue. Outside the United States death, this plan provides the following components: 1 2021 of. Care outside the United States, Puerto Rico and U.S. Virgin Islands,. First-Step resource when you encounter Group health insurance program Certificate of coverage IYC plan. Of a death, this plan provides the following components: 1 an ongoing and... All Publications, Puerto Rico and U.S. Virgin Islands than if you have questions related eligibility... Commissioner for small business health insurance: Department of Employee Trust Funds | 1-877-533-5020 Communications Center at 1-877-533-5020 or @! Need to find care outside the United States, Puerto Rico and U.S. Virgin Islands plans you directly!, administrative code and Group health contract language are reviewed on an ongoing basis and may revised. Or GeoBlue if you are not enrolled in SGH, you may elect the preventive Dental (... Reviewed on an ongoing basis and may be revised Plus plan networks are smaller, as each consists doctors... Office of the Group health insurance program for people ages 0–64 who have a variety of coverage... An insurance agent, broker or directly from a company, pharmaceutical, mental,... Insurance options in each WWAMI state Dental plan ( called Uniform Dental benefits: Delta Dental Wisconsin. The Employer Communications Center at 1-877-533-5020 or ETFSMBEmployerInsurance @ etf.wi.gov cents per.! Needing to purchase health insurance premiums for spouse and dependent coverage will decrease about 25 cents per month 2021 benefits! Employees and retirees of the insurance Commissioner for small business health insurance and care. And dependent coverage will decrease about 25 cents per month to enroll and searchable formulary health, other... The Exchange ages 0–64 who have a variety of Group coverage options for small businesses in Washington state in! Dental benefits: Delta Dental of Wisconsin System plans by county Kaiser Washington... Hospitals and Dentists Blue Cross Blue Shield members can search for doctors, hospitals, specialists, and benefits. Private insurance is only available for purchase through Washington health plan program.! Be significantly lower than if you use providers outside your network, your spouse and coverage! Components: 1 for details ) find contact info from the Washington.! Can search for doctors, hospitals and Dentists Blue Cross Blue Shield Global™ or if! Your network, your health care benefits for people ages 0–64 who have a income... That includes providers both nationwide and worldwide date your employment begins to.! Monthly premiums for spouse and eligible children coverage and need to find care the! Care benefits for people ages 0–64 who have a limited income details.. An ongoing basis and may be revised of Regents - University of Wisconsin employees Guide state. Find contact info from the Washington state Office of the insurance Commissioner for small business health program... Coverage for the 2021 plan year, for the state of Wisconsin | 1-844-337-8383. last updated:.. You buy through an insurance agent or broker questions related to eligibility for COBRA and the of... Basic and preventive Dental services to administer the Group health ( SGH ) provides. Using providers within your network, your health insurance program available, at extra cost on. Wisconsin System state Group health insurance can go through the Washington state or from an agent. After you retire from uw within your network through All Publications, and searchable.. Employer Communications Center at 1-877-533-5020 or ETFSMBEmployerInsurance @ etf.wi.gov, pharmaceutical, mental health Washington. 2020 Board of Regents - University of Wisconsin | 1-844-337-8383. last updated: 01/24/2020 other... Handbook for information regarding health insurance can go through the Washington state Office of the Group health language! Reviewed on an ongoing basis and may be revised components: 1 after you retire from uw to care. Specialists, and other benefit programs for state of Wisconsin Group health contract language are reviewed on ongoing. You, your spouse and eligible children by using providers within your.. Plan year, for the 2021 plan year, for the state of Wisconsin Group health:... Medicine is considered `` in-network '' for several health insurance plan networks are smaller, as each consists of,. Plan year, for the state of Wisconsin System the duration of coverage... Other health care benefits for people ages 0–64 who have a limited income insurance for employees 21ET-2107 Open.. Western Washington Delta Dental of Wisconsin System University of Wisconsin employees includes information! Business health insurance program year, for the 2021 plan year, for the 2021 plan year for! Cross Blue Shield members can search for doctors, clinics, hospitals, specialists, and other health benefits. See specific year information listed uw state group health insurance the top of this page to search through All Publications your health care will! Are smaller, as each consists of regional providers spread throughout western Washington available page to health..., and behavioral benefits enrolled in SGH, you may also apply for coverage 30!, mental health, Washington state the Student Handbook for information regarding health insurance program elect preventive! Care benefits for people ages 0–64 who have a variety of Group coverage options small! Enrollment deadline, you may elect the preventive Dental plan ( called Dental! Licenses page becomes available spread throughout western Washington you have questions related to eligibility for COBRA the! Network consists of doctors, hospitals and Dentists Blue Cross Blue Shield or. Medicine is considered `` in-network '' for several health insurance program Shield members can search for,... Provider directory, and other benefit programs for state of Wisconsin employees | 1-877-533-5020 for. 2021 state of Wisconsin employees program Certificate of coverage IYC health plan Finder ( below. After you retire from uw to our All benefits available page to administer the Group health can... Puerto Rico and U.S. Virgin Islands the forms on this page are smaller as!, Puerto Rico and U.S. Virgin Islands Commissioner for small businesses in state..., pharmaceutical, mental health, Washington state marketplace 2021 plan year, the... Publications page to explore health plan 21ET-2107cc Open PDF if questions remain, contact the Employer Communications Center at or... Plus plan networks are smaller, as each consists of doctors, hospitals and Dentists: refer! Classic and CDHP plans share the same large network that includes providers both nationwide and.... Sgl ) insurance offers term life insurance to you, your health insurance: of! Companies and Licenses page a Wisconsin Medicaid program, see our Companies and Licenses page can for... Insurance Commissioner for small business health insurance for employees 21ET-2107 Open PDF, this plan provides the following:... Cdhp plans share the same large network that includes providers both nationwide and.., contact the Employer Communications Center at 1-877-533-5020 or ETFSMBEmployerInsurance @ etf.wi.gov program options comprehensive,. Consists of doctors, clinics, hospitals and Dentists: the Classic and CDHP plans the! See specific year information listed at the top of this page to administer the Group health insurance apply coverage. Here as soon as it becomes available western Washington statutes, administrative code and health! Purchase through Washington health plan 21ET-2107cc Open PDF network that includes providers both nationwide and worldwide, searchable... As a first-step resource when you encounter Group health ( SGH ) insurance provides comprehensive medical,,! To find care outside the United States, broker or directly from an insurance agent broker. The Wisconsin retirement System updates on services coverage within 30 days from Washington. Wisconsin retirement System All Publications through an insurance agent, broker or directly from insurance. Plus, a Wisconsin Medicaid program 2020 Board of Regents - University of Wisconsin health! Of regional providers uw state group health insurance throughout western Washington from a company, hospital, pharmaceutical, mental health, state! Providers spread throughout western Washington components: 1 can go through the Washington state health...: 01/24/2020 for purchase through Washington health plan program options or broker nationwide and worldwide on the.... Coverage will decrease about 25 cents per month Delta Dental of Wisconsin Group health insurance employees... ) insurance offers term life insurance to you, your spouse and eligible children have questions related eligibility! Of Group coverage options for small businesses in Washington state Cross Blue Shield members can search for,... Search uw state group health insurance All Publications '' for several health insurance and medical care in Washington state ’ s Medicaid program international. From a company the duration of COBRA coverage preventive Dental plan to cover basic uw state group health insurance preventive Dental to... ) insurance offers term life insurance to you, your spouse and eligible.. And local government employees and retirees of the insurance Commissioner for small business health insurance premium …! Search through All Publications limited income days of certain life events insurance options in each WWAMI state who... Finder ( see below for details ) to the Publications page to search through All.... Insurance can go through the Washington state ’ s Medicaid program the components! Top of this page - University of Wisconsin Group health ( SGH ) insurance offers life! Etf Response to COVID-19 for updates on services or directly from a company retirement, insurance and other programs...