{"id":6352,"date":"2024-09-10T10:29:59","date_gmt":"2024-09-10T15:29:59","guid":{"rendered":"https:\/\/www.wisconsin.edu\/abe\/?page_id=6352"},"modified":"2025-08-25T16:14:36","modified_gmt":"2025-08-25T21:14:36","slug":"welcome-to-2025-annual-benefits-enrollment","status":"publish","type":"page","link":"https:\/\/www.wisconsin.edu\/abe\/","title":{"rendered":"Welcome to 2025 Annual Benefits Enrollment!"},"content":{"rendered":"\n\t\t\t\t\t<div id=\"cfct-build-6352\" class=\"cfct-build grid\">\n\t\t\t\t\t\t<div class=\"row\"><div class=\"col-md-12 cfct-block\">\n\t\t\t<div class=\"cfct-module uwsa-callout\">\n\t\t\t\t<div class=\"cfct-mod-content callout jumbotron grey-bg\">\n    <img loading=\"lazy\" decoding=\"async\" width=\"2500\" height=\"407\" src=\"https:\/\/www.wisconsin.edu\/abe\/wp-content\/uploads\/sites\/220\/2024\/08\/ABE-logo-horizontal-large.png\" class=\"cfct-mod-image \" alt=\"\" srcset=\"https:\/\/www.wisconsin.edu\/abe\/wp-content\/uploads\/sites\/220\/2024\/08\/ABE-logo-horizontal-large.png 2500w, https:\/\/www.wisconsin.edu\/abe\/wp-content\/uploads\/sites\/220\/2024\/08\/ABE-logo-horizontal-large-300x49.png 300w, https:\/\/www.wisconsin.edu\/abe\/wp-content\/uploads\/sites\/220\/2024\/08\/ABE-logo-horizontal-large-2000x326.png 2000w, https:\/\/www.wisconsin.edu\/abe\/wp-content\/uploads\/sites\/220\/2024\/08\/ABE-logo-horizontal-large-768x125.png 768w, https:\/\/www.wisconsin.edu\/abe\/wp-content\/uploads\/sites\/220\/2024\/08\/ABE-logo-horizontal-large-1536x250.png 1536w, https:\/\/www.wisconsin.edu\/abe\/wp-content\/uploads\/sites\/220\/2024\/08\/ABE-logo-horizontal-large-2048x333.png 2048w\" sizes=\"auto, (max-width: 2500px) 100vw, 2500px\" \/><\/div>\n\n\t\t\t<\/div><\/div><\/div><div class=\"row\"><div class=\"col-md-6 cfct-block\">\n\t\t\t<div class=\"cfct-module uwsa-rich-text\">\n\t\t\t\t<div class=\"cfct-mod-content copy\"><h2 class=\"toc-skip\">What is Annual Benefits Enrollment?<\/h2>\n<p>The Annual Benefits Enrollment (ABE) period is <strong>September 30 &#8211; October 25, 2024<\/strong>! ABE is an annual opportunity for benefits eligible employees to enroll in or make changes to most benefit plans for the upcoming calendar year. This is the only time you are eligible to make changes unless you have a qualifying life event, such as a family or employment status change.<\/p>\n<h4><strong>Changes made during ABE will be effective January 1, 2025<\/strong><\/h4>\n<p>The <strong>2025<\/strong> benefits information is summarized below. Find <strong>2024 <\/strong>benefits information on the <a href=\"https:\/\/www.wisconsin.edu\/ohrwd\/benefits\/\" target=\"_blank\" rel=\"noopener\">Universities of Wisconsin Employee Benefits website<\/a>.<\/p>\n<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"cfct-module uwsa-rich-text\">\n\t\t\t\t<div class=\"cfct-mod-content copy\"><h2><strong>Benefits Changes for 2025<\/strong><\/h2>\n<p>Check out the <a href=\"https:\/\/youtu.be\/-BWgVUwySw0\" target=\"_blank\" rel=\"noopener\">Annual Benefits Enrollment Highlights video<\/a> to see what&#8217;s changing for 2025.<\/p>\n<p>Attend an in-person benefits fair (offered at some institutions) or virtual benefit sessions to learn more about your benefits. For dates, times, and to register for the virtual sessions, review the <a href=\"https:\/\/www.wisconsin.edu\/ohrwd\/total-rewards\/events\/fairs\/\" target=\"_blank\" rel=\"noopener\">Benefit &amp; Wellness Fairs web page<\/a>.<\/p>\n<p>Review the information below to understand the benefits changes so you can make informed decisions for you and your family.<\/p>\n<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"cfct-module cfct-lastupdate\">\n\t\t\t\t<div class=\"listing-module\"><p><span class=\"item-date\">Updated: 08\/25\/2025<\/span><\/p><\/div>\n\t\t\t<\/div><\/div><div class=\"col-md-6 cfct-block\">\n\t\t\t<div class=\"cfct-module cfct-shortcode\">\n\t\t\t\t<div class=\"cfct-mod-content\"><div id=\"toc\" class=\"uwsa-toc callout hidden-print\"><\/div><style>@media (min-width: 768px) {#toc { max-width: 100%} <\/style><script>jQuery(document).ready(function() {\n \t\t\t\t\tgenerateTOC(\"Annual Benefits Enrollment\", \"\", \"div.entry-content\" ,2 ,\"true\", \"toc\");\n \t\t\t\t\t });<\/script><\/div>\n\t\t\t<\/div><\/div><\/div><div class=\"row\"><div class=\"col-md-12 cfct-block\">\n\t\t\t<div class=\"cfct-module uwsa-rich-text\">\n\t\t\t\t<div class=\"cfct-mod-content copy\"><h3><strong>State Group Health Insurance<\/strong><\/h3>\n<p><span style=\"float: none;background-color: transparent;cursor: text;font-family: 'Open Sans','Helvetica Neue',Helvetica,Arial,sans-serif;font-size: 14px;font-style: normal;font-variant: normal;font-weight: 400;letter-spacing: normal;text-align: left;text-decoration: none;text-indent: 0px\">The health plan designs (health plan and high deductible health plan) will remain the same. The copayments and coinsurance levels within the plan designs will also remain the same.<\/span><\/p>\n<h4>For 2025, the following changes will be made:<\/h4>\n<p><strong>Employee Premiums (see chart below)<\/strong><\/p>\n<p>Employee premiums for all plan designs will increase effective January 1, 2025.<\/p>\n<p><strong>High Deductible Health Plan (HDHP) &#8211; <\/strong><strong>Deductible<\/strong><\/p>\n<p>To remain compliant with the federal minimum deductible requirement for HDHPs, the annual deductibles will increase to $1,650 for individual coverage and $3,300 for family coverage.<\/p>\n<p><strong>Health Insurance Plan Carriers<\/strong><\/p>\n<p>Dean Health Plan Prevea360 West &amp; Mayo Clinic will be renamed Dean Health Plan Medica West &amp; Mayo Clinic starting January 1, 2025.<\/p>\n<p>If you are currently enrolled with Dean Health Plan Prevea360 West &amp; Mayo Clinic, you will automatically be enrolled with <strong>Dean Health Plan Medica West &amp; Mayo Clinic<\/strong> with the same plan design and dependents for 2025 unless you make a change during ABE.<\/p>\n<p>All other health insurance plan carriers will remain in the program for 2025.<\/p>\n<p>Important: Contact your health insurance carrier to make sure that your preferred doctors, clinics, and hospitals will remain in-network. Carrier contact information can be found in the Health Plan Decision Guide (available in the Resources section below).<\/p>\n<p><strong>Covered Services<\/strong><\/p>\n<ul>\n<li>Expand the lifetime limit for orthoptic eye training<\/li>\n<li>Clarify coverage for nutritional counseling services related to weight management<\/li>\n<\/ul>\n<p><span style=\"float: none;background-color: transparent;cursor: text;font-family: 'Open Sans', 'Helvetica Neue', Helvetica, Arial, sans-serif;font-size: 14px;font-variant: normal;font-weight: 400;letter-spacing: normal;text-align: left;text-decoration: none;text-indent: 0px\">The following resources can be found in the Forms &amp; Resources section below.<\/span><\/p>\n<ul>\n<li><span style=\"float: none;background-color: transparent;cursor: text;font-family: 'Open Sans', 'Helvetica Neue', Helvetica, Arial, sans-serif;font-size: 14px;font-variant: normal;font-weight: 400;letter-spacing: normal;text-align: left;text-decoration: none;text-indent: 0px\"><strong>Health &amp; Pharmacy Comparison<\/strong>\u00a0will help you choose a <strong>plan design<\/strong><\/span><\/li>\n<li><span style=\"float: none;background-color: transparent;cursor: text;font-family: 'Open Sans', 'Helvetica Neue', Helvetica, Arial, sans-serif;font-size: 14px;font-variant: normal;font-weight: 400;letter-spacing: normal;text-align: left;text-decoration: none;text-indent: 0px\"><strong>Health Plan Search<\/strong> and <strong>Health Plan Decision Guide<\/strong> will show you which counties are covered by each insurance carrier<\/span><\/li>\n<li><strong>How To Choose Your Health Insurance Plan web page<\/strong> provides steps to help you select a health plan design that fits your needs and a health insurance carrier that will provide services in the county you would like to receive services in<\/li>\n<\/ul>\n<p>Review the <a href=\"https:\/\/www.wisconsin.edu\/ohrwd\/benefits\/health\/\" target=\"_blank\" rel=\"noopener\">State Group Health Insurance web page<\/a> for additional information.<\/p>\n<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"cfct-module uwsa-rich-text\">\n\t\t\t\t<div class=\"cfct-mod-content copy\"><h4>State Group Health Insurance &#8211; 2025 monthly Premiums (active employees)*<\/h4>\n<table class=\"table-bordered\" style=\"width: 1086px\">\n<tbody>\n<tr style=\"height: 12.9375px\">\n<th style=\"width: 307px;height: 12.9375px;text-align: center;vertical-align: middle\" scope=\"col\"><strong>2025 Monthly Employee Premiums<\/strong><br \/>\n(without Uniform Dental)<\/th>\n<th style=\"width: 401px;height: 12.9375px;text-align: center;vertical-align: middle\" colspan=\"2\" scope=\"col\"><strong>Health Plan<\/strong><br \/>\n(WRS benefit package)<\/th>\n<th style=\"width: 424px;height: 12.9375px;text-align: center;vertical-align: middle\" colspan=\"2\" scope=\"col\"><strong>High Deductible Health Plan (HDHP)<\/strong><br \/>\n(WRS benefit package)<\/th>\n<th style=\"width: 482px;height: 12.9375px;text-align: center;vertical-align: middle\" colspan=\"2\" scope=\"col\"><strong>Health Plan<\/strong><br \/>\n(non-WRS Graduate Assistant \/ Short-Term Academic Staff benefit package)<\/th>\n<\/tr>\n<tr style=\"height: 13px\">\n<th style=\"width: 307px;height: 13px;text-align: center;vertical-align: middle\" scope=\"col\"><\/th>\n<td class=\"table-light-gray\" style=\"width: 192px;height: 13px;text-align: center\"><strong>Individual<\/strong><\/td>\n<td class=\"table-light-gray\" style=\"width: 209px;height: 13px;text-align: center\"><strong>Family<\/strong><\/td>\n<td style=\"width: 228px;height: 13px;text-align: center\"><strong>Individual<\/strong><\/td>\n<td style=\"width: 196px;height: 13px;text-align: center\"><strong>Family<\/strong><\/td>\n<td class=\"table-light-gray\" style=\"width: 211px;height: 13px;text-align: center\"><strong>Individual<\/strong><\/td>\n<td class=\"table-light-gray\" style=\"width: 271px;height: 13px;text-align: center\"><strong>Family<\/strong><\/td>\n<\/tr>\n<tr style=\"height: 39px\">\n<td style=\"width: 307px;height: 39px\" scope=\"col\"><strong>Health Plan &amp; HDHP <\/strong>(excludes Access Plans)<\/td>\n<td class=\"table-light-gray\" style=\"width: 192px;height: 39px;text-align: center\">$120.00<\/td>\n<td class=\"table-light-gray\" style=\"width: 209px;height: 39px;text-align: center\">$297.00<\/td>\n<td style=\"width: 228px;height: 39px;text-align: center\">$42.00<\/td>\n<td style=\"width: 196px;height: 39px;text-align: center\">$104.00<\/td>\n<td class=\"table-light-gray\" style=\"width: 211px;height: 39px;text-align: center\">$60.00<\/td>\n<td class=\"table-light-gray\" style=\"width: 271px;height: 39px;text-align: center\">$148.50<\/td>\n<\/tr>\n<tr style=\"height: 83px\">\n<td style=\"width: 307px;height: 83px\" scope=\"col\"><strong>Access Health Plan &amp; Access HDHP<\/strong><\/td>\n<td class=\"table-light-gray\" style=\"width: 192px;height: 83px;text-align: center\">$292.00<\/td>\n<td class=\"table-light-gray\" style=\"width: 209px;height: 83px;text-align: center\">$724.00<\/td>\n<td style=\"width: 228px;height: 83px;text-align: center\">$214.00<\/td>\n<td style=\"width: 196px;height: 83px;text-align: center\">$531.00<\/td>\n<td class=\"table-light-gray\" style=\"width: 211px;height: 83px;text-align: center\">$146.00<\/td>\n<td class=\"table-light-gray\" style=\"width: 271px;height: 83px;text-align: center\">$362.00<\/td>\n<\/tr>\n<tr style=\"height: 61px\">\n<td style=\"width: 307px;height: 61px\" scope=\"col\"><strong>Access Health Plan &amp; Access HDHP<br \/>\n<\/strong>(if <strong>required<\/strong> to work outside of Wisconsin)<\/td>\n<td class=\"table-light-gray\" style=\"width: 192px;height: 61px;text-align: center\">$183.00<\/td>\n<td class=\"table-light-gray\" style=\"width: 209px;height: 61px;text-align: center\">$460.00<\/td>\n<td style=\"width: 228px;height: 61px;text-align: center\">$105.00<\/td>\n<td style=\"width: 196px;height: 61px;text-align: center\">$267.00<\/td>\n<td class=\"table-light-gray\" style=\"width: 211px;height: 61px;text-align: center\">$91.50<\/td>\n<td class=\"table-light-gray\" style=\"width: 271px;height: 61px;text-align: center\">$230.00<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><em>*All employee premiums in the above chart are <strong>without Uniform Dental<\/strong>. Review the chart in the dental section below for the employee dental premiums for 2025.<\/em><\/p>\n<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"cfct-module cfct-notice\">\n\t\t\t\t<div class=\"alert alert-warning cfct-mod-content\"><p>Note: The health plan and HDHP only provide out-of-network coverage for emergencies and urgent care situations. <\/p>\n<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"cfct-module uwsa-rich-text\">\n\t\t\t\t<div class=\"cfct-mod-content copy\"><h3>Health Insurance Opt-Out Incentive<\/h3>\n<p>If you <strong>do not need<\/strong> health insurance coverage through the Universities of Wisconsin, you may be eligible for the Health Opt-Out Incentive. The Opt-Out Incentive is taxable and the $2,000 is paid evenly over 24 pay periods (two paychecks each month).<\/p>\n<p>Enrollment is required <strong>each year<\/strong> to receive the Opt-Out Incentive.<\/p>\n<p><em>Note: Enroll by selecting the <strong>health opt-out<\/strong> option in the MyWisconsin portal. If you select the waive option, you <strong>will not<\/strong> receive the health opt-out incentive in 2025.<\/em><\/p>\n<p>See the How to Enroll section below for enrollment information. Or review the\u00a0<a href=\"https:\/\/www.wisconsin.edu\/ohrwd\/benefits\/opt-out\/\" target=\"_blank\" rel=\"noopener\">Health Insurance Opt-Out Incentive web page<\/a> for additional information.<\/p>\n<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"cfct-module uwsa-rich-text\">\n\t\t\t\t<div class=\"cfct-mod-content copy\"><h3>Pharmacy Benefits<\/h3>\n<p>The employee premium for pharmacy benefits is included in the State Group Health Insurance premium. Find in-network pharmacies and formulary lists on the <a href=\"https:\/\/www.navitus.com\/\" target=\"_blank\" rel=\"noopener\">Navitus website<\/a>, or call Navitus at (866) 333-2757 with questions.<\/p>\n<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"cfct-module uwsa-rich-text\">\n\t\t\t\t<div class=\"cfct-mod-content copy\"><h3>Uniform, Preventive &amp; Supplemental Dental Insurance<\/h3>\n<p>Uniform and Preventive Dental Insurance plans provide the same coverage for diagnostic, preventive, basic, and orthodontic services. Review the following to determine which plan (Uniform Dental or Preventive Dental) you are eligible for:<\/p>\n<ul>\n<li>If you\u00a0<strong>enroll\u00a0<\/strong>in State Group Health Insurance, you are eligible for the <strong>Uniform<\/strong> Dental Insurance plan.<\/li>\n<li>If you <strong>waive<\/strong> State Group Health Insurance OR elect the <strong>Health Opt-Out Incentive,\u00a0<\/strong>you are eligible for the <strong>Preventive<\/strong> Dental Insurance plan.<\/li>\n<\/ul>\n<p>You may enroll in <strong>either<\/strong> the Uniform or the Preventive plan\u00a0<strong>and<\/strong> <strong>one<\/strong> Supplemental Dental Insurance plan (Select <strong>or<\/strong> Select Plus plan).<\/p>\n<p>Your enrollment, coverage level, and dependents will remain the same from 2024 to 2025 if you do not make a change.<\/p>\n<h4>For 2025, the following changes will be made:<\/h4>\n<ul>\n<li><strong>Employee Premiums (see chart below)<\/strong>\n<ul>\n<li>Uniform Dental (individual coverage): employee premium will increase<\/li>\n<li>Uniform Dental (family coverage) and Supplemental Dental: employee premiums will remain the same<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>For additional information, review the plan comparison and premium chart provided below.<\/p>\n<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"cfct-module uwsa-rich-text\">\n\t\t\t\t<div class=\"cfct-mod-content copy\"><h4>Dental Insurance Comparison<\/h4>\n<table class=\"table-bordered\">\n<thead>\n<tr>\n<th><\/th>\n<th style=\"text-align: center;vertical-align: middle\"><strong>Uniform Dental Insurance and Preventive Dental Insurance<\/strong><\/th>\n<th style=\"text-align: center;vertical-align: middle\"><strong>Supplemental Dental &#8211; Select Plan<\/strong><\/th>\n<th style=\"text-align: center;vertical-align: middle\"><strong>Supplemental Dental &#8211; Select Plus Plan<\/strong><\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<th><strong>Provider Network<\/strong><\/th>\n<td style=\"text-align: center;width: 25%\">Delta Dental PPO &amp; Delta Dental Premier<\/td>\n<td style=\"text-align: center;width: 25.4723%\">Delta Dental PPO<\/td>\n<td style=\"text-align: center;width: 26.5277%\">Delta Dental PPO &amp; Delta Dental Premier<\/td>\n<\/tr>\n<tr>\n<th><strong>Benefit Maximum<\/strong><\/th>\n<td style=\"text-align: center;width: 25%\">$1,000 \/ person<\/td>\n<td style=\"text-align: center;width: 25.4723%\">$1,000 \/ person<\/td>\n<td style=\"text-align: center;width: 26.5277%\">$2,500 \/ person<\/td>\n<\/tr>\n<tr>\n<th><strong>Deductible<\/strong><\/th>\n<td style=\"text-align: center;width: 25%\">None<\/td>\n<td style=\"text-align: center;width: 25.4723%\">$100 \/ person<\/td>\n<td style=\"text-align: center;width: 26.5277%\">$25 \/ person<\/td>\n<\/tr>\n<tr>\n<th><strong>Preventive Services<\/strong><\/th>\n<td style=\"text-align: center;width: 25%\">100%<\/td>\n<td style=\"text-align: center;width: 25.4723%\">No coverage<\/td>\n<td style=\"text-align: center;width: 26.5277%\">No coverage<\/td>\n<\/tr>\n<tr>\n<th><strong>Basic Services<\/strong><\/th>\n<td style=\"text-align: center;width: 25%\">100%: fillings, p<span style=\"font-family: inherit;font-size: inherit;background-color: transparent\">eriodontal maintenance <\/span>80%: anesthesia, emergency pain relief<\/td>\n<td style=\"text-align: center;width: 25.4723%\">No coverage<br \/>\n(except anesthesia at 50%)<\/td>\n<td style=\"text-align: center;width: 26.5277%\">No coverage<br \/>\n(except anesthesia at 80%)<\/td>\n<\/tr>\n<tr>\n<th><strong>Major Services<\/strong><\/th>\n<td style=\"text-align: center;width: 25%\">No coverage<\/td>\n<td style=\"text-align: center;width: 25.4723%\">50%<\/td>\n<td style=\"text-align: center;width: 26.5277%\">60% or 80% (varies by service)<\/td>\n<\/tr>\n<tr>\n<th><strong>Orthodontia<\/strong><br \/>\n(lifetime maximum)<\/th>\n<td style=\"text-align: center;width: 25%\">50% up to $1,500<br \/>\n<em>(to age 19)<\/em><\/td>\n<td style=\"text-align: center;width: 25.4723%\">No coverage<\/td>\n<td style=\"text-align: center;width: 26.5277%\">50% up to $1,500<br \/>\n(in addition to Uniform or Preventive Dental)<br \/>\n<em>(includes adult ortho)<\/em><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"cfct-module uwsa-rich-text\">\n\t\t\t\t<div class=\"cfct-mod-content copy\"><h4>Dental Insurance &#8211; 2025 monthly Premiums (active employees)<\/h4>\n<table class=\"table-bordered\">\n<thead>\n<tr>\n<th style=\"text-align: center;vertical-align: middle\"><strong>2025 Monthly Employee Premiums<\/strong><\/th>\n<th style=\"width: 10%;height: 9px;text-align: center;vertical-align: middle\"><strong>Uniform Dental<\/strong><\/th>\n<th style=\"width: 10%;height: 9px;text-align: center;vertical-align: middle\"><strong>Preventive Dental<\/strong><\/th>\n<th style=\"width: 16.3506%;height: 9px;text-align: center;vertical-align: middle\"><strong>Supplemental Dental &#8211; Select Plan<\/strong><\/th>\n<th style=\"width: 19.6494%;height: 9px;text-align: center;vertical-align: middle\"><strong>Supplemental Dental &#8211; Select Plus Plan<\/strong><\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<th style=\"width: 15%;height: 39px\"><strong>Individual<\/strong><\/th>\n<td style=\"width: 10%;height: 39px;text-align: center\">$4.00<\/td>\n<td style=\"width: 10%;height: 39px;text-align: center\">$36.10<\/td>\n<td style=\"width: 16.3506%;height: 39px;text-align: center\">$9.08<\/td>\n<td style=\"width: 19.6494%;height: 39px;text-align: center\">$21.60<\/td>\n<\/tr>\n<tr>\n<th style=\"width: 15%;height: 39px\"><strong>Individual + Spouse<\/strong><\/th>\n<td style=\"width: 10%;height: 39px;text-align: center\">$10.00<\/td>\n<td style=\"width: 10%;height: 39px;text-align: center\">$90.28<\/td>\n<td style=\"width: 16.3506%;height: 39px;text-align: center\">$18.16<\/td>\n<td style=\"width: 19.6494%;height: 39px;text-align: center\">$43.22<\/td>\n<\/tr>\n<tr>\n<th style=\"width: 15%;height: 39px\"><strong>Individual + Child(ren)<\/strong><\/th>\n<td style=\"width: 10%;height: 39px;text-align: center\">$10.00<\/td>\n<td style=\"width: 10%;height: 39px;text-align: center\">$90.28<\/td>\n<td style=\"width: 16.3506%;height: 39px;text-align: center\">$12.24<\/td>\n<td style=\"width: 19.6494%;height: 39px;text-align: center\">$40.12<\/td>\n<\/tr>\n<tr>\n<th style=\"width: 15%;height: 39px\"><strong>Family<\/strong><\/th>\n<td style=\"width: 10%;height: 39px;text-align: center;vertical-align: middle\">$10.00<\/td>\n<td style=\"width: 10%;height: 39px;text-align: center;vertical-align: middle\">$90.28<\/td>\n<td style=\"width: 16.3506%;height: 39px;text-align: center;vertical-align: middle\">$21.76<\/td>\n<td style=\"width: 19.6494%;height: 39px;text-align: center;vertical-align: middle\">$66.20<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"cfct-module uwsa-rich-text\">\n\t\t\t\t<div class=\"cfct-mod-content copy\"><h3>Vision Insurance<\/h3>\n<p>This plan provides coverage for an annual eye exam and materials (contacts\/glasses). Employee premiums for 2025 will remain the same.<\/p>\n<p>Your enrollment, coverage level, and dependents will remain the same from 2024 to 2025 unless you make a change during ABE.<\/p>\n<table style=\"width: 310px\">\n<thead>\n<tr>\n<th style=\"width: 274px;text-align: center\" colspan=\"2\"><strong>2025 Monthly Employee Premiums<\/strong><\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"width: 274px\"><strong>Individual<\/strong><\/td>\n<td style=\"width: 87px\">$5.72<\/td>\n<\/tr>\n<tr class=\"table-light-gray\">\n<td style=\"width: 274px\"><strong>Individual + Spouse<\/strong><\/td>\n<td style=\"width: 87px\">$11.42<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 274px\"><strong>Individual + Child(ren)<\/strong><\/td>\n<td style=\"width: 87px\">$12.88<\/td>\n<\/tr>\n<tr class=\"table-light-gray\">\n<td style=\"width: 274px\"><strong>Family<\/strong><\/td>\n<td style=\"width: 87px\">$20.58<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>Review the documents provided in the Forms &amp; Resources section for additional information.<\/p>\n<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"cfct-module uwsa-rich-text\">\n\t\t\t\t<div class=\"cfct-mod-content copy\"><h3>Individual &amp; Family Life Insurance<\/h3>\n<h4>DURING THIS ENROLLMENT PERIOD ONLY: ENHANCED ENROLLMENT OPPORTUNITY<\/h4>\n<p>During this enrollment period only, there will be an enhanced enrollment opportunity offered for the Individual &amp; Family (I&amp;F) Life Insurance Plan.<\/p>\n<ul>\n<li>If you are currently enrolled, you may increase employee coverage by up to $100,000 (in $5,000 increments, up to plan maximum, without proof of good health), or decrease or cancel coverage. You may also increase your spouse\/domestic partner coverage by up to $10,000, and\/or child coverage by $2,500 (up to plan maximums).<\/li>\n<li>If you are not currently enrolled, you may enroll in up to $100,000 employee coverage (in $5,000 increments, without proof of good health).<\/li>\n<\/ul>\n<p>Also, effective January 1, 2025:<\/p>\n<ul>\n<li>Premium rates for spouse\/domestic partner coverage will decrease. Premium rates for employee and child coverage will remain the same.<\/li>\n<li>A new Accidental Death &amp; Dismemberment benefit equal to your employee, spouse\/domestic partner, and child coverage will automatically be included, at no additional cost.<\/li>\n<li>The disability premium waiver will no longer be available. If you were approved for disability premium waiver prior to January 1, 2025, you are not affected by this change.<\/li>\n<\/ul>\n<p>Review the <a href=\"https:\/\/www.wisconsin.edu\/ohrwd\/benefits\/life\/if\/\" target=\"_blank\" rel=\"noopener\">Individual &amp; Family Life Insurance web page<\/a> for additional information.<\/p>\n<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"cfct-module uwsa-rich-text\">\n\t\t\t\t<div class=\"cfct-mod-content copy\"><h3>Accidental Death &amp; Dismemberment (AD&amp;D) Insurance<\/h3>\n<p>You may enroll, change, or cancel your AD&amp;D coverage at any time. C<span style=\"float: none;background-color: transparent;cursor: text;font-family: 'Open Sans','Helvetica Neue',Helvetica,Arial,sans-serif;font-size: 14px;font-style: normal;font-variant: normal;font-weight: 400;letter-spacing: normal;text-align: left;text-decoration: none;text-indent: 0px;text-transform: none\">hanges made during ABE to your AD&amp;D coverage will be effective January 1, 2025. <\/span>If you would like to change your coverage prior to January 1, submit the AD&amp;D Application available in the Forms &amp; Resources section below to your benefits contact.<\/p>\n<p>Your enrollment and coverage level will remain the same from 2024 to 2025 if you do not make a change.<\/p>\n<p><span style=\"float: none;background-color: transparent;font-family: 'Open Sans','Helvetica Neue',Helvetica,Arial,sans-serif;font-size: 14px;font-style: normal;font-variant: normal;font-weight: 400;letter-spacing: normal;text-align: left;text-decoration: none;text-indent: 0px\">Review the <a href=\"https:\/\/www.wisconsin.edu\/ohrwd\/benefits\/accident\/add\/\" target=\"_blank\" rel=\"noopener\">AD&amp;D Insurance web page<\/a> for details on the plan.<\/span><\/p>\n<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"cfct-module uwsa-rich-text\">\n\t\t\t\t<div class=\"cfct-mod-content copy\"><h3>Accident Insurance<\/h3>\n<p>This plan provides a lump sum payment to you for specific injuries due to an accident (for example: fractures, stitches, hospitalization). Additional features of the plan include:<\/p>\n<ul>\n<li>Accidental death &amp; dismemberment coverage<\/li>\n<li>Identity Theft coverage from Generali Global Assistance<\/li>\n<\/ul>\n<p>Your enrollment, coverage level, and dependents will remain the same from 2024 to 2025 if you do not make a change. Employee premiums will remain the same.<\/p>\n<table style=\"width: 335px\">\n<thead>\n<tr>\n<th style=\"width: 632px;text-align: center\" colspan=\"2\"><strong>2025 Monthly Employee Premiums<\/strong><\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"width: 632px\"><strong>Individual<\/strong><\/td>\n<td style=\"width: 220px\">$3.72<\/td>\n<\/tr>\n<tr class=\"table-light-gray\">\n<td style=\"width: 632px\"><strong>Individual + Spouse<\/strong><\/td>\n<td style=\"width: 220px\">$5.32<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 632px\"><strong>Individual + Child(ren)<\/strong><\/td>\n<td style=\"width: 220px\">$7.16<\/td>\n<\/tr>\n<tr class=\"table-light-gray\">\n<td style=\"width: 632px\"><strong>Family<\/strong><\/td>\n<td style=\"width: 220px\">$10.46<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>Review the <a href=\"https:\/\/www.wisconsin.edu\/ohrwd\/benefits\/life-accident\/accident\/\" target=\"_blank\" rel=\"noopener\">Accident Insurance web page<\/a> for additional information.<\/p>\n<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"cfct-module uwsa-rich-text\">\n\t\t\t\t<div class=\"cfct-mod-content copy\"><h3>Spending and Savings Accounts<\/h3>\n<h5>Flexible Spending Account (FSA)<\/h5>\n<h4>For 2025, the contribution and carryover amounts are as follows:<\/h4>\n<table class=\"table-striped\" style=\"width: 899px\">\n<thead>\n<tr>\n<th style=\"width: 206.312px;text-align: center\"><strong>Account Type<\/strong><\/th>\n<th style=\"width: 103.688px;text-align: center\"><strong>Minimum<\/strong><\/th>\n<th style=\"width: 239px;text-align: center\"><strong>Maximum<\/strong><\/th>\n<th style=\"width: 95px;text-align: center\"><strong>Carryover<\/strong><\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"width: 206.312px\">Health Care and Limited Purpose FSA<\/td>\n<td style=\"width: 103.688px;text-align: center;vertical-align: middle\">$50<\/td>\n<td style=\"width: 239px;text-align: center;vertical-align: middle\">$3,200 per year (increase)<\/td>\n<td style=\"width: 95px;text-align: center;vertical-align: middle\"><strong>$50* <\/strong>&#8211; $640 (increase)<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 206.312px\">Dependent Day Care Account<\/td>\n<td style=\"width: 103.688px;text-align: center;vertical-align: middle\">NA<\/td>\n<td style=\"width: 239px;text-align: center;vertical-align: middle\">$2,500 or $5,000 (depending on tax filing status)<\/td>\n<td style=\"width: 95px;text-align: center;vertical-align: middle\">NA<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 206.312px\">Parking &amp; Transit Accounts<\/td>\n<td style=\"width: 103.688px;text-align: center;vertical-align: middle\">$50<\/td>\n<td style=\"width: 239px;text-align: center;vertical-align: middle\">$315 per month (increase)<\/td>\n<td style=\"width: 95px;text-align: center;vertical-align: middle\"><strong>$50* <\/strong>&#8211; Unlimited<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong>*REMINDER:<\/strong> To be eligible for carryover from 2024 to 2025, you must:<\/p>\n<ul>\n<li>have a minimum balance of $50 in your FSA at the end of the run-out period (March 31, 2025) OR<\/li>\n<li>re-enroll for the 2025 plan year during ABE<\/li>\n<\/ul>\n<p>Note: If you are eligible for carryover, it will be applied to your FSA around April 15, 2025.<\/p>\n<p>Re-enrollment is required each year to participate in the FSA. See the <a href=\"https:\/\/www.wisconsin.edu\/ohrwd\/benefits\/spending-savings-accts\/fsa\/\" target=\"_blank\" rel=\"noopener\">FSA web page<\/a> for additional information.<\/p>\n<h5><strong>Health Savings Account (HSA)<\/strong><\/h5>\n<h4>For 2025, the following changes will be made:<\/h4>\n<p>The employer contribution to your HSA, if eligible, will increase to $828 for individual coverage and $1,650 for family coverage. The below maximum contribution amounts include the employer contribution.<\/p>\n<ul>\n<li>Individual HDHP: $4,300* (increase)<\/li>\n<li>Family HDHP: $8,550* (increase)<\/li>\n<\/ul>\n<p><em>*If you are or will attain age 55+ in 2025, you may contribute an additional $1,000 to your HSA.<\/em><\/p>\n<p>If you are paid on an annual basis (over 12 months), the employer and employee contributions are processed on 24 paychecks per calendar year (first two paycheck dates a month).<\/p>\n<p>If you are paid on an academic year basis (over 9 months), the employer and employee contributions are processed on 18 paychecks during the academic year. You will receive the full employer contribution (if eligible) and meet your annual employee contribution amount over 18 paychecks.<\/p>\n<p>Re-enrollment is required each year to participate in the HSA. See the <a href=\"https:\/\/www.wisconsin.edu\/ohrwd\/benefits\/spending-savings-accts\/hsa\/\" target=\"_blank\" rel=\"noopener\">HSA web page<\/a> for additional information.<\/p>\n<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"cfct-module cfct-notice\">\n\t\t\t\t<div class=\"alert alert-warning cfct-mod-content\"><p>ACTION REQUIRED: You must re-enroll in the Spending &amp; Savings Accounts each year you want to participate. <\/p>\n<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"cfct-module uwsa-rich-text\">\n\t\t\t\t<div class=\"cfct-mod-content copy\"><h2>Changes Allowed During ABE<\/h2>\n<table class=\"table-bordered\">\n<thead>\n<tr style=\"height: 39px\">\n<th style=\"width: 366px;height: 39px\" scope=\"col\"><strong>Benefit Plan<\/strong><\/th>\n<th style=\"width: 353px;height: 39px\" scope=\"col\"><strong>What Changes are Allowed during ABE?<\/strong><\/th>\n<th style=\"width: 249.833px;height: 39px\" scope=\"col\"><strong>Add or Remove Dependents*<\/strong><\/th>\n<th style=\"width: 331.167px;height: 39px\" scope=\"col\"><strong>Cancel<\/strong><\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"height: 39px\">\n<th style=\"width: 366px;height: 39px\" scope=\"row\"><strong>State Group Health Insurance<\/strong><\/th>\n<td style=\"width: 353px;text-align: left;vertical-align: middle;height: 39px\">Enroll, Change Plan Design and\/or Carrier<\/td>\n<td style=\"width: 249.833px;text-align: left;vertical-align: middle;height: 39px\">Yes<\/td>\n<td style=\"width: 331.167px;text-align: left;vertical-align: middle;height: 39px\">Yes<\/td>\n<\/tr>\n<tr style=\"height: 61px\">\n<th style=\"width: 366px;vertical-align: middle;height: 61px\" scope=\"row\"><strong>State Group Health Insurance<\/strong><br \/>\n<strong>Opt-Out Incentive<\/strong><\/th>\n<td style=\"width: 353px;text-align: left;vertical-align: middle;height: 61px\"><strong>MUST<\/strong> re-enroll each year<\/td>\n<td style=\"width: 249.833px;text-align: left;vertical-align: middle;height: 61px\">N\/A<\/td>\n<td style=\"width: 331.167px;text-align: left;vertical-align: middle;height: 61px\">N\/A (automatically ends December 31st)<\/td>\n<\/tr>\n<tr style=\"height: 83px\">\n<th style=\"width: 366px;vertical-align: middle;height: 83px\" scope=\"row\"><strong>Uniform Dental Insurance<\/strong><\/th>\n<td style=\"width: 353px;text-align: left;vertical-align: middle;height: 83px\">Enroll<br \/>\n(if <strong>enrolled<\/strong> in State Group Health)<\/td>\n<td style=\"width: 249.833px;text-align: left;vertical-align: middle;height: 83px\">Yes<\/td>\n<td style=\"width: 331.167px;text-align: left;vertical-align: middle;height: 83px\">Yes<\/td>\n<\/tr>\n<tr style=\"height: 30px\">\n<th style=\"width: 366px;vertical-align: middle;height: 30px\" scope=\"row\"><strong>Preventive Dental Insurance<\/strong><\/th>\n<td style=\"width: 353px;text-align: left;vertical-align: middle;height: 30px\">Enroll<br \/>\n(if <strong>not enrolled<\/strong> in State Group Health)<\/td>\n<td style=\"width: 249.833px;text-align: left;vertical-align: middle;height: 30px\">Yes<\/td>\n<td style=\"width: 331.167px;text-align: left;vertical-align: middle;height: 30px\">Yes<\/td>\n<\/tr>\n<tr style=\"height: 61px\">\n<th style=\"width: 366px;vertical-align: middle;height: 61px\" scope=\"row\"><strong>Supplemental Dental Insurance<\/strong><\/th>\n<td style=\"width: 353px;text-align: left;vertical-align: middle;height: 61px\">Enroll, Change Plans (Select OR Select Plus)<\/td>\n<td style=\"width: 249.833px;text-align: left;vertical-align: middle;height: 61px\">Yes<\/td>\n<td style=\"width: 331.167px;text-align: left;vertical-align: middle;height: 61px\">Yes<\/td>\n<\/tr>\n<tr style=\"height: 45px\">\n<th style=\"width: 366px;vertical-align: middle;height: 45px\" scope=\"row\"><strong>Vision Insurance<\/strong><\/th>\n<td style=\"width: 353px;text-align: left;vertical-align: middle;height: 45px\">Enroll<\/td>\n<td style=\"width: 249.833px;text-align: left;vertical-align: middle;height: 45px\">Yes<\/td>\n<td style=\"width: 331.167px;text-align: left;vertical-align: middle;height: 45px\">Yes<\/td>\n<\/tr>\n<tr style=\"height: 83px\">\n<th style=\"width: 366px;vertical-align: middle;height: 83px\" scope=\"row\"><strong>Individual &amp; Family Life Insurance<\/strong><\/th>\n<td style=\"width: 353px;text-align: left;vertical-align: middle;height: 83px\">If enrolled, you may increase coverage.<\/p>\n<p>If not enrolled, you have a one-time enrollment opportunity for employee only coverage.<\/td>\n<td style=\"width: 249.833px;text-align: left;vertical-align: middle;height: 83px\">If enrolled, you may not add dependents, but you may remove dependents anytime<\/p>\n<p>If not enrolled: N\/A<\/td>\n<td style=\"width: 331.167px;text-align: left;vertical-align: middle;height: 83px\">If enrolled: Yes (anytime)<\/p>\n<p>If not enrolled: N\/A<\/td>\n<\/tr>\n<tr style=\"height: 61px\">\n<th style=\"width: 366px;vertical-align: middle;height: 61px\" scope=\"row\"><strong>Accidental Death &amp; Dismemberment Insurance<\/strong><\/th>\n<td style=\"width: 353px;text-align: left;vertical-align: middle;height: 61px\">Enroll, Change Volume of Coverage<\/td>\n<td style=\"width: 249.833px;text-align: left;vertical-align: middle;height: 61px\">Yes<\/td>\n<td style=\"width: 331.167px;text-align: left;vertical-align: middle;height: 61px\">Yes (anytime)<\/td>\n<\/tr>\n<tr style=\"height: 83px\">\n<th style=\"width: 366px;vertical-align: middle;height: 83px\" scope=\"row\"><strong>Accident Insurance\u00a0<\/strong><\/th>\n<td style=\"width: 353px;text-align: left;vertical-align: middle;height: 83px\">Enroll<\/td>\n<td style=\"width: 249.833px;text-align: left;vertical-align: middle;height: 83px\">Yes<\/td>\n<td style=\"width: 331.167px;text-align: left;vertical-align: middle;height: 83px\">Yes<\/td>\n<\/tr>\n<tr style=\"height: 39px\">\n<th style=\"width: 366px;vertical-align: middle;height: 39px\" scope=\"row\"><strong>Flexible Spending Accounts<\/strong><\/th>\n<td style=\"width: 353px;text-align: left;vertical-align: middle;height: 39px\"><strong>MUST<\/strong> re-enroll each year<\/td>\n<td style=\"width: 249.833px;text-align: left;vertical-align: middle;height: 39px\">N\/A<\/td>\n<td style=\"width: 331.167px;text-align: left;vertical-align: middle;height: 39px\">N\/A (automatically ends December 31st)<\/td>\n<\/tr>\n<tr style=\"height: 83px\">\n<th style=\"width: 366px;vertical-align: middle;height: 83px\" scope=\"row\"><strong>Health Savings Account<br \/>\n(must have High Deductible Health Plan)<br \/>\n<\/strong><\/th>\n<td style=\"width: 353px;text-align: left;vertical-align: middle;height: 83px\"><strong>MUST<\/strong> re-enroll each year<\/td>\n<td style=\"width: 249.833px;text-align: left;vertical-align: middle;height: 83px\">N\/A<\/td>\n<td style=\"width: 331.167px;text-align: left;vertical-align: middle;height: 83px\">N\/A (automatically ends December 31st)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>* To determine if you can cover your spouse and\/or dependent children, see the Dependent Eligibility Chart available in the Forms &amp; Resources section below.<\/p>\n<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"cfct-module uwsa-rich-text\">\n\t\t\t\t<div class=\"cfct-mod-content copy\"><h2>How To Enroll<\/h2>\n<p>Once you have made your decisions, enroll by logging into <a href=\"http:\/\/my.wisconsin.edu\" target=\"_blank\" rel=\"noopener\">my.wisconsin.edu<\/a> then navigate to the Benefits Enrollment tile (September 30 &#8211; October 25, 2024).<\/p>\n<p>You will be required to provide the below dependent information when you enroll.<\/p>\n<ul>\n<li>Dependent Names, Social Security Numbers, Date of Birth, and Gender<\/li>\n<li>Health insurance coverage information (if you have <strong>other<\/strong> health insurance coverage)<\/li>\n<\/ul>\n<p>Within 48 hours from when you enroll at my.wisconsin.edu, you will receive an e-mail with instructions about how to review your benefits elections. Review your benefits elections to ensure your elections and dependents are accurate. If you do not receive the email within 48 hours, reach out to your <a style=\"background-color: #ffffff\" href=\"https:\/\/www.wisconsin.edu\/ohrwd\/benefits\/contact\/\">benefits contact<\/a>.<\/p>\n<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"cfct-module uwsa-rich-text\">\n\t\t\t\t<div class=\"cfct-mod-content copy\"><h2>Other Considerations for 2025<\/h2>\n<ul>\n<li>Wisconsin Retirement System (WRS): Employee and employer contributions to the WRS will increase to 6.95% for most employees effective January 1, 2025.<\/li>\n<li>The below life insurance plans will no longer be available effective January 1, 2025:\n<ul>\n<li>UW Employees, Inc. (UWEI) Life Insurance<\/li>\n<li>University Insurance Association (UIA) Life Insurance<\/li>\n<\/ul>\n<\/li>\n<li>State Group Life Insurance: Employee coverage premium will increase 5% for most age groups effective April 1, 2025. Spouse &amp; Dependent coverage premium will remain the same.<\/li>\n<li>Income Continuation Insurance (ICI): Effective April 1, 2025, premium rates will decrease.<\/li>\n<li>Reminder: Contributions for the 403(b) Supplemental Retirement Program (SRP) and Wisconsin Deferred Compensation (WDC) 457 Program are processed the first two paychecks of the month (24 paychecks per calendar year).<\/li>\n<\/ul>\n<\/div>\n\t\t\t<\/div><\/div><\/div><div class=\"row\"><div class=\"col-md-6 cfct-block\">\n\t\t\t<div class=\"cfct-module uwsa-rich-text\">\n\t\t\t\t<div class=\"cfct-mod-content copy\"><h5>No open enrollment opportunity for the below plans (proof of good health available).<\/h5>\n<ul>\n<li>State Group Life Insurance<\/li>\n<li>Income Continuation Insurance<\/li>\n<\/ul>\n<\/div>\n\t\t\t<\/div><\/div><div class=\"col-md-6 cfct-block\">\n\t\t\t<div class=\"cfct-module uwsa-rich-text\">\n\t\t\t\t<div class=\"cfct-mod-content copy\"><h5>Enroll in the below plans at any time during the year.<\/h5>\n<ul>\n<li>Accidental Death &amp; Dismemberment (AD&amp;D) Insurance<\/li>\n<li>UW 403(b) Supplemental Retirement Program (SRP)<\/li>\n<li>Wisconsin Deferred Compensation (457) Program<\/li>\n<li>Parking &amp; Transit Accounts<\/li>\n<li>Long-Term Care Insurance<\/li>\n<\/ul>\n<\/div>\n\t\t\t<\/div><\/div><\/div><div class=\"row\"><div class=\"col-md-12 cfct-block\">\n\t\t\t<div class=\"cfct-module uwsa-rich-text\">\n\t\t\t\t<div class=\"cfct-mod-content copy\"><h5>Well-being Resources<\/h5>\n<p>The $150 Well Wisconsin incentive is available to you and your spouse in 2025 if you enroll in State Group Health Insurance. To earn the incentive, complete a health assessment questionnaire, health check, and a WebMD well-being activity by mid-October.<\/p>\n<p>Review the <a href=\"https:\/\/www.wisconsin.edu\/ohrwd\/well-being\/\" target=\"_blank\" rel=\"noopener\">Well-Being Resources web page<\/a> for information on the Employee Assistance Program (EAP), flu vaccine clinics, mental health resources, and well-being webinars.<\/p>\n<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"cfct-module cfct-notice\">\n\t\t\t\t<div class=\"alert alert-warning cfct-mod-content\"><p>You may make changes beginning September 30, 2024. All benefit elections must be submitted by Friday, October 25, 2024 (4:30 pm). Paper applications must be received by your benefits contact by Friday, October 25, 2024 (4:30 pm). Changes are effective January 1, 2025.<\/p>\n<\/div>\n\t\t\t<\/div><\/div><\/div><div class=\"row\"><div class=\"col-md-12 cfct-block\">\n\t\t\t<div class=\"cfct-module cfct-heading\">\n\t\t\t\t<h2 class=\"cfct-mod-title\">Forms &amp; Resources<\/h2>\n\t\t\t<\/div><\/div><\/div><div class=\"row\"><div class=\"col-md-4 cfct-block\">\n\t\t\t<div class=\"cfct-module uwsa-rich-text\">\n\t\t\t\t<div class=\"cfct-mod-content copy\"><h3 class=\"toc-skip\">State Group Health Insurance<\/h3>\n<ul>\n<li><a href=\"https:\/\/www.wisconsin.edu\/ohrwd\/benefits\/health\/select-a-plan\/\" target=\"_blank\" rel=\"noopener\">How To Choose Your Health Insurance Plan<\/a><\/li>\n<li><span class=\"doc-icon\"><a class=\"doc-type pdf\" href=\"https:\/\/www.wisconsin.edu\/abe\/download\/Comparison-Health-and-PharmacyABE(3).pdf\" target=\"_blank\">Health &amp; Pharmacy Benefits Comparison<span class=\"sr-only\"> pdf<\/span><\/a><\/span>\r\n<\/li>\n<li><a href=\"https:\/\/etf.wi.gov\/its-your-choice\/2025\/health-plan-search\/state\" target=\"_blank\" rel=\"noopener\">Health Plan Search<\/a><\/li>\n<li><a href=\"https:\/\/etf.wi.gov\/video\/transitioning-care-new-health-plan\" target=\"_blank\" rel=\"noopener\">Video: Transition Care to Different Health Plan<\/a><\/li>\n<li><a href=\"https:\/\/www.wisconsin.edu\/ohrwd\/benefits\/download\/Health-Insurance-Application-Change-Form1.pdf\" target=\"_blank\" rel=\"noopener\">Health Insurance Application\/Change Form (ET-2301)<\/a><\/li>\n<li><a href=\"https:\/\/etf.wi.gov\/health-benefits\/state-and-federal-notifications\" target=\"_blank\" rel=\"noopener\">State and Federal Notifications<\/a><\/li>\n<\/ul>\n<\/div>\n\t\t\t<\/div><\/div><div class=\"col-md-4 cfct-block\">\n\t\t\t<div class=\"cfct-module uwsa-rich-text\">\n\t\t\t\t<div class=\"cfct-mod-content copy\"><h3 class=\"toc-skip\">Dental Insurance<\/h3>\n<ul>\n<li><span class=\"doc-icon\"><a class=\"doc-type pdf\" href=\"https:\/\/www.wisconsin.edu\/abe\/download\/dentalcomparison.pdf\" target=\"_blank\">Dental Insurance Plan Comparison<span class=\"sr-only\"> pdf<\/span><\/a><\/span>\r\n<\/li>\n<li><span class=\"doc-icon\"><a class=\"doc-type pdf\" href=\"https:\/\/www.wisconsin.edu\/abe\/download\/dentalbrochure.pdf\" target=\"_blank\">Dental Insurance Brochure<span class=\"sr-only\"> pdf<\/span><\/a><\/span>\r\n<\/li>\n<li><span class=\"doc-icon\"><a class=\"doc-type pdf\" href=\"https:\/\/www.wisconsin.edu\/abe\/download\/dentalapp.pdf\" target=\"_blank\">Dental Enrollment Form<span class=\"sr-only\"> pdf<\/span><\/a><\/span>\r\n<\/li>\n<li><a href=\"https:\/\/www.deltadentalwi.com\/s\/find-a-provider\" target=\"_blank\" rel=\"noopener\">Find a Provider: Dental Insurance<\/a><\/li>\n<\/ul>\n<\/div>\n\t\t\t<\/div><\/div><div class=\"col-md-4 cfct-block\">\n\t\t\t<div class=\"cfct-module uwsa-rich-text\">\n\t\t\t\t<div class=\"cfct-mod-content copy\"><h3 class=\"toc-skip\">Vision Insurance<\/h3>\n<ul>\n<li><span class=\"doc-icon\"><a class=\"doc-type pdf\" href=\"https:\/\/www.wisconsin.edu\/abe\/download\/visionsummary.pdf\" target=\"_blank\">Vision Insurance Summary<span class=\"sr-only\"> pdf<\/span><\/a><\/span>\r\n<\/li>\n<li><span class=\"doc-icon\"><a class=\"doc-type pdf\" href=\"https:\/\/www.wisconsin.edu\/abe\/download\/visionbrochure.pdf\" target=\"_blank\">Vision Insurance Brochure<span class=\"sr-only\"> pdf<\/span><\/a><\/span>\r\n<\/li>\n<li><span class=\"doc-icon\"><a class=\"doc-type pdf\" href=\"https:\/\/www.wisconsin.edu\/abe\/download\/visionenrollment.pdf\" target=\"_blank\">Vision Enrollment Form<span class=\"sr-only\"> pdf<\/span><\/a><\/span>\r\n<\/li>\n<li><a href=\"https:\/\/eyedoclocator.eyemedvisioncare.com\/#\/member\/en?networkSetId=1166&amp;networkDDDisabled=true\" target=\"_blank\" rel=\"noopener\">Find a Provider: Vision Insurance<\/a><\/li>\n<\/ul>\n<\/div>\n\t\t\t<\/div><\/div><\/div><div class=\"row\"><div class=\"col-md-4 cfct-block\">\n\t\t\t<div class=\"cfct-module uwsa-rich-text\">\n\t\t\t\t<div class=\"cfct-mod-content copy\"><h3 class=\"toc-skip\">I&amp;F Life Insurance<\/h3>\n<ul>\n<li><span class=\"doc-icon\"><a class=\"doc-type pdf\" href=\"https:\/\/www.wisconsin.edu\/abe\/download\/I&amp;Fenhancedenrollmentsummary.pdf\" target=\"_blank\">I&amp;F Enhanced Enrollment Summary<span class=\"sr-only\"> pdf<\/span><\/a><\/span>\r\n<\/li>\n<li><a href=\"https:\/\/www.wisconsin.edu\/ohrwd\/benefits\/download\/i&amp;fcalc(3).xlsx\" target=\"_blank\" rel=\"noopener\">I&amp;F Premium Calculator<\/a><\/li>\n<li><span class=\"doc-icon\"><a class=\"doc-type pdf\" href=\"https:\/\/www.wisconsin.edu\/abe\/download\/i&amp;f(2)\/aio.pdf\" target=\"_blank\">I&F Annual Increase Option Form<span class=\"sr-only\"> pdf<\/span><\/a><\/span>\r\n<br \/>\n<em>(use to increase coverage)<\/em><\/li>\n<li><a href=\"https:\/\/www.wisconsin.edu\/ohrwd\/benefits\/download\/life\/if\/app.pdf\" target=\"_blank\" rel=\"noopener\">I&amp;F Application<\/a><br \/>\n<em>(use to decrease or cancel coverage)<\/em><\/li>\n<\/ul>\n<\/div>\n\t\t\t<\/div><\/div><div class=\"col-md-4 cfct-block\">\n\t\t\t<div class=\"cfct-module uwsa-rich-text\">\n\t\t\t\t<div class=\"cfct-mod-content copy\"><h3 class=\"toc-skip\">AD&amp;D and Accident Insurance<\/h3>\n<ul>\n<li><a href=\"https:\/\/www.wisconsin.edu\/ohrwd\/benefits\/download\/life\/add\/fact.pdf\" target=\"_blank\" rel=\"noopener\">AD&amp;D Insurance Fact Sheet<\/a><\/li>\n<li><a href=\"https:\/\/www.wisconsin.edu\/ohrwd\/benefits\/download\/life\/add\/app.pdf\" target=\"_blank\" rel=\"noopener\">AD&amp;D Insurance Application<\/a><\/li>\n<li><span class=\"doc-icon\"><a class=\"doc-type pdf\" href=\"https:\/\/www.wisconsin.edu\/abe\/download\/AccidentBrochureABE.pdf\" target=\"_blank\">Accident Insurance Brochure<span class=\"sr-only\"> pdf<\/span><\/a><\/span>\r\n<\/li>\n<li><a href=\"https:\/\/www.wisconsin.edu\/ohrwd\/benefits\/download\/accidentapp.pdf\" target=\"_blank\" rel=\"noopener\">Accident Insurance Enrollment Form<\/a><\/li>\n<\/ul>\n<\/div>\n\t\t\t<\/div><\/div><div class=\"col-md-4 cfct-block\">\n\t\t\t<div class=\"cfct-module uwsa-rich-text\">\n\t\t\t\t<div class=\"cfct-mod-content copy\"><h3 class=\"toc-skip\">Spending &amp; Savings Accounts<\/h3>\n<ul>\n<li><span class=\"doc-icon\"><a class=\"doc-type pdf\" href=\"https:\/\/www.wisconsin.edu\/abe\/download\/fsahandbookABE.pdf\" target=\"_blank\">FSA Enrollment Handbook<span class=\"sr-only\"> pdf<\/span><\/a><\/span>\r\n<\/li>\n<li><span class=\"doc-icon\"><a class=\"doc-type pdf\" href=\"https:\/\/www.wisconsin.edu\/abe\/download\/fsa\/fsaenrollmentABE.pdf\" target=\"_blank\">FSA Enrollment Form (healthcare, dependent day care, parking & transit)<span class=\"sr-only\"> pdf<\/span><\/a><\/span>\r\n<\/li>\n<li><span class=\"doc-icon\"><a class=\"doc-type pdf\" href=\"https:\/\/www.wisconsin.edu\/abe\/download\/hsahandbookABE.pdf\" target=\"_blank\">HSA Enrollment Handbook<span class=\"sr-only\"> pdf<\/span><\/a><\/span>\r\n<\/li>\n<li><span class=\"doc-icon\"><a class=\"doc-type pdf\" href=\"https:\/\/www.wisconsin.edu\/abe\/download\/hsa\/hsaenrollmentABE.pdf\" target=\"_blank\">HSA Enrollment Form<span class=\"sr-only\"> pdf<\/span><\/a><\/span>\r\n<\/li>\n<\/ul>\n<\/div>\n\t\t\t<\/div><\/div><\/div><div class=\"row\"><div class=\"col-md-4 cfct-block\">\n\t\t\t<div class=\"cfct-module uwsa-rich-text\">\n\t\t\t\t<div class=\"cfct-mod-content copy\"><h3 class=\"toc-skip\">Additional Information<\/h3>\n<ul>\n<li><a href=\"https:\/\/youtu.be\/-BWgVUwySw0\" target=\"_blank\" rel=\"noopener\">2025 Benefits Highlights Video<\/a><\/li>\n<li><a href=\"https:\/\/etf.wi.gov\/publications\/25et-2107\/download?inline=\" target=\"_blank\" rel=\"noopener\">Health Benefits Decision Guide<\/a><\/li>\n<li><span class=\"doc-icon\"><a class=\"doc-type pdf\" href=\"https:\/\/www.wisconsin.edu\/abe\/download\/abereferenceguide.pdf\" target=\"_blank\">Reference Guide<span class=\"sr-only\"> pdf<\/span><\/a><\/span>\r\n<\/li>\n<li><span class=\"doc-icon\"><a class=\"doc-type pdf\" href=\"https:\/\/www.wisconsin.edu\/abe\/download\/aberetireeguide.pdf\" target=\"_blank\">Retiree Reference Guide<span class=\"sr-only\"> pdf<\/span><\/a><\/span>\r\n<\/li>\n<li><a href=\"https:\/\/www.wisconsin.edu\/ohrwd\/benefits\/download\/Dependent-Eligibility-Chart-UWS-25.pdf\" target=\"_blank\" rel=\"noopener\">Dependent Eligibility Chart (UWS 25)<\/a><\/li>\n<li><a href=\"https:\/\/www.wisconsin.edu\/abe\/presentations\/\" target=\"_blank\" rel=\"noopener\">Employee Presentations web page<\/a><\/li>\n<li><a href=\"https:\/\/uwsystemadmin.qualtrics.com\/jfe\/form\/SV_d7gr9e2LnEKqEei\" target=\"_blank\" rel=\"noopener\">Employee Survey<\/a><\/li>\n<\/ul>\n<\/div>\n\t\t\t<\/div><\/div><div class=\"col-md-4 cfct-block\">\n\t\t\t<div class=\"cfct-module uwsa-rich-text\">\n\t\t\t\t<div class=\"cfct-mod-content copy\"><h3 class=\"toc-skip\">MyWisconsin Portal<\/h3>\n<ul>\n<li><a href=\"https:\/\/my.wisconsin.edu\" target=\"_blank\" rel=\"noopener\">MyWisconsin Portal (Universities of Wisconsin employees)<\/a><\/li>\n<li><a href=\"https:\/\/my.wisc.edu\" target=\"_blank\" rel=\"noopener\">MyWisconsin Portal (UW-Madison employees)<\/a><\/li>\n<li><a href=\"https:\/\/uwservice.wisconsin.edu\/docs\/publications\/abe-quick-start.pdf\" target=\"_blank\" rel=\"noopener\">Self-Enrollment Guide (through MyWisconsin Portal)<\/a><\/li>\n<\/ul>\n<\/div>\n\t\t\t<\/div><\/div><div class=\"col-md-4 cfct-block\"><\/div><\/div><div class=\"row\"><div class=\"col-md-12 cfct-block\">\n\t\t\t<div class=\"cfct-module uwsa-rich-text\">\n\t\t\t\t<div class=\"cfct-mod-content copy\"><p><em>Every effort has been made to ensure this information is current and correct. Information on this page does not guarantee enrollment, benefits and\/or the ability to make changes to your benefits.<\/em><\/p>\n<\/div>\n\t\t\t<\/div><\/div><\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t","protected":false},"excerpt":{"rendered":"","protected":false},"author":2271,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-6352","page","type-page","status-publish","hentry","cfct-can-haz-build"],"_links":{"self":[{"href":"https:\/\/www.wisconsin.edu\/abe\/wp-json\/wp\/v2\/pages\/6352","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.wisconsin.edu\/abe\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.wisconsin.edu\/abe\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.wisconsin.edu\/abe\/wp-json\/wp\/v2\/users\/2271"}],"replies":[{"embeddable":true,"href":"https:\/\/www.wisconsin.edu\/abe\/wp-json\/wp\/v2\/comments?post=6352"}],"version-history":[{"count":40,"href":"https:\/\/www.wisconsin.edu\/abe\/wp-json\/wp\/v2\/pages\/6352\/revisions"}],"predecessor-version":[{"id":6542,"href":"https:\/\/www.wisconsin.edu\/abe\/wp-json\/wp\/v2\/pages\/6352\/revisions\/6542"}],"wp:attachment":[{"href":"https:\/\/www.wisconsin.edu\/abe\/wp-json\/wp\/v2\/media?parent=6352"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}