How To Choose Your Health Insurance Plan

Steps are listed below to help you select a health insurance plan design that fits your needs and select a health insurance plan carrier that will provide services in the county you would like to receive services in.

Step 1: Choose a Health Insurance Plan Design

Below are resources to help you choose a plan design and brief descriptions of each plan design offered in the State Group Health Insurance Program. The plan designs offered in the State Group Health Insurance Program differ in monthly premiums, cost-sharing, and whether there is out-of-network coverage.

Resources:

• Review each plan design listed in the left hand menu
• Use the Comparison of Health & Pharmacy Benefits pdf to help you compare plan designs
• Use Benefits Mentor (an interactive virtual benefits counselor)
• Watch ETF’s Choosing a Plan Design video

Brief Descriptions:

• Health Plan Design
  The Health Plan has a lower deductible and lower out-of-pocket limits but a higher monthly premium. This plan design only covers out-of-network benefits for emergency and urgent care services.
• High Deductible Health Plan (HDHP) Design
  The HDHP has a higher deductible and higher out-of-pocket limits but the lowest monthly premium. This plan design only covers out-of-network benefits for emergency and urgent care services.
  The HDHP is paired with a Health Savings Account (HSA) to help you save for out-of-pocket health, dental, and vision expenses. The Universities of Wisconsin contributes to your HSA (if eligible). You may also contribute to your HSA on a pre-tax basis from your paycheck. Changes to your contributions are allowed at any time.
  All employees are not eligible for the HDHP/HSA. Review the Health Savings Account web page linked above to learn more.
• Access Health Plan Design
  The Access Health Plan provides freedom of choice for doctors and hospitals across the country; however, there are lower costs when you use in-network providers (available nationwide). In exchange for the increased flexibility in doctors, hospitals, and providers, the monthly premium is more than it is for the Health Plan and the HDHP.
• Access High Deductible Health Plan (HDHP) Design
  The Access HDHP provides freedom of choice for doctors and hospitals across the country; however, there are lower costs when you use in-network providers (available nationwide). This plan design has a higher deductible and higher out-of-pocket limits than the Access Health Plan. In exchange for the increased cost sharing, this plan design offers a lower monthly premium than the Access Health Plan.
  The Access HDHP is paired with a Health Savings Account (HSA) to help you save for out-of-pocket health, dental, and vision expenses. The Universities of Wisconsin contributes to your HSA (if eligible). You may also contribute to your HSA on a pre-tax basis from your paycheck. Changes to your contributions are allowed at any time.
  All employees are not eligible for the HDHP/HSA. Review the Health Savings Account web page linked above to learn more.

Step 2: Choose a Health Insurance Plan Carrier

Use the Health Plan Search Tool to help you choose a health insurance plan carrier that includes the providers and hospitals in the county that you would like to receive services in.

• Health Plan Search

This is an important step since the Health Plan and HDHP only cover out-of-network benefits for emergency and urgent care services.

When using the Health Plan Search Tool click on the link to each of the insurance carrier websites to review a summary about the carrier that includes information about access to specific physicians, referral and prior authorization requirements and other plan features (for example: member portal, 24-hour nurse line, telehealth app).

Also, as part of your health insurance plan carrier decision review the health insurance plan carriers’ quality ratings.

• Quality Ratings

Note: This step is not necessary if you select the Access Health Plan or Access HDHP since those plans are administered by Dean Health Plan.

Step 3: Decide if you need Uniform Dental Benefits

All health insurance plan designs provide medical and pharmacy benefits.

Uniform Dental Benefits provide preventive dental services and may be added to your health insurance plan design for a minimal cost. Review the Uniform Dental Benefits to determine if you would like to add this to your health insurance plan design.

Step 4: Enroll

Enroll using the MyUW portal.

You will receive a confirmation statement via email 24-48 hours after making your elections in the MyUW portal. Review your confirmation statement carefully and reach out to your benefits contact within your enrollment period if you need to change your elections.