State Group Health Insurance Summary
State Group Health Insurance provides comprehensive medical and prescription coverage. Dental coverage is available for an additional minimal cost. All plans offers offer the same benefits (Uniform Benefits) but your choice of health plan determines the provider network and your selected plan design determines your out-of-pocket costs.
You are eligible for the State Group Health Insurance program if you are eligible for the Wisconsin Retirement System (WRS).
Before selecting a specific health plan, you need to pick a health plan design. The following options are available:
- Enroll in health insurance with or without uniform dental coverage
- Enroll in either a low deductible (IYC Plan) or High-Deductible Health Plan (HDHP)
- Enroll in a health plan with a specific provider network or enroll in a plan with a nationwide network (Access)
To compare the plan designs and see the breakdown of your costs, see either the In-Network or Out-of-Network (Access Plan) cost comparison pages.
Available Health Plans
You can use the Health Plan Search Tool to find health plans available in your area. For each health plan you can quickly see the top health systems and their covered providers.
Prescription drug coverage is included in your health insurance. You can see prescription drug information on the Pharmacy Cost Chart.
Prescription benefits are administered by
Navitus. Navitus has a nationwide network so prescriptions can be filled both locally and across the country.
Mail-order pharmacy is available through
Navitus has a member website called Navi-Gate where you can review your prescription history, view the formulary and use tools to help you reduce your out-of-pocket prescription costs.
When enrolling in health insurance, employees have the option to choose Uniform Dental coverage for an additional minimal cost.
Delta Dental is the administrator of the plan.
Health Savings Account
If you enroll in a High-Deductible Health Plan (HDHP), you must also be eligible for and enroll in a Health Savings Account (HSA). An HSA is used to set aside money on a pre-tax basis to pay for HSA-eligible expenses for employees enrolled in a HDHP.
2020 HSA Annual Employer Contribution*
- Single = $31.25 bi-weekly ($750 if enrolled all year)
- Family = $62.50 bi-weekly ($1,500 if enrolled all year)
* If required to pay half of total health premium, receive half of total HSA employer contribution. Craftsworkers are not eligible for an HSA employer contribution.
2020 HSA Total Annual Contribution Limit (employee + employer)
- Single = $3,550
- Family = $7,100
- Age 55 or older = $1,000 catch-up contribution limit
Employees must re-enroll in the HSA every year.
If not enrolling in health insurance, you may be eligible for up to a $2,000 Opt-Out Stipend. The stipend is considered taxable earnings.
Must re-apply for the stipend every year during Open Enrollment.