Overview

UW System offers comprehensive medical and prescription drug coverage to eligible employees and their family members through the State Group Health Insurance program. This program is administered by the Department of Employee Trust Funds (ETF) and offers different plan designs. The plan designs differ in monthly premiums, cost-sharing and whether there is out-of-network coverage. All plan designs include pharmacy benefits (no additional cost) and may be elected with or without Uniform Dental (minimal additional cost).

Use ALEX, review the Comparison of Health and Pharmacy Benefits pdf , watch ETF’s “Plan Design Options eLearning” (available in the Forms & Resources section below) or click each plan design in the menu to the left to determine which plan best fits your needs.

Eligibility

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: This program allows an employee’s eligible dependents to be covered by one group health insurance program only. This means that if an employee works for UW System and the employee’s spouse works for a state or local employer that also offers the State Group Health Insurance program (state program) or the Wisconsin Public Employers (WPE) Group Health Insurance program (local program) and the employee’s spouse enrolls in coverage through their employer, their dependents may only be covered under one plan, the employee’s plan OR the spouse’s plan.

For information regarding who can be covered, see the Dependent Eligibility Chart (UWS 25) in the Forms & Resources section below.

If a dependent will be covered but does not have a Social Security Number (not a United States citizen), the employee must submit an Affidavit for Insurance Purposes (available in the Forms & Resources section below) at the time of enrollment.

Plan Designs

Click each plan (in the left-hand menu) or use the Comparison of Health & Pharmacy Benefits (available in the Forms & Resources section below) for additional information.

  • Health Plan
  • High Deductible Health Plan (HDHP)
  • Access Plan
  • Access HDHP

Note: Some employees are not eligible for the High Deductible Health Plan (HDHP) or Access HDHP.

Enrollment

Employees have 30 days from the date of employment or the date of obtaining a benefits-eligible job to enroll in the State Group Health Insurance program. Most employees will be able to enroll through Self Service. Employees unable to enroll through Self Service should complete a Health Insurance Application/Change Form (ET-2301) (available in the Forms & Resources section below) and submit it to the human resources office during their enrollment period.

Employees enrolling in the HDHP or Access HDHP are required to enroll in the Health Savings Account (HSA). Complete the HSA Enrollment Form (available in the Forms & Resources section below) and submit to the human resources office during the enrollment period.

If the employee does not enroll in the State Group Health Insurance program during their initial 30-day enrollment period, they may enroll during the Annual Benefits Enrollment (ABE) period or if they have a qualifying life event (click Life Events in the left-hand menu for more information).

University Staff Employees

Employees have two opportunities to enroll in the State Group Health Insurance program:

1. Within 30 days from date of employment or the date of obtaining a benefits-eligible job. In this situation, employees may choose their coverage effective date:

  • As soon as possible* (first of the month on/after start date). No employer contribution for the first two months of coverage; employee pays the total premium cost for the first two months of coverage; or
  • When the employer contributes to the premium** (first of the month on/following the completion of two (2) months of state WRS service). Employee will receive the employer contribution with the first month of coverage after completion of two months of state WRS service.

2. Enroll prior to becoming eligible for the employer contribution towards the premium** (if employee does not already have two months of state WRS service).

  • Coverage is effective on the first day of the month on/following the completion of two months of state WRS service (when you become eligible for the employer contribution).

*Employees that elect coverage to begin as soon as possible will need to complete a Health Insurance Application/Change Form (available in the Forms & Resources section below) and submit to their human resources office during their enrollment period.

**Employees that elect coverage to begin when the employer contributes to the premium should enroll through Self Service.

Faculty, Academic Staff and Limited Appointees, Student Assistants and Employees-in-Training

Coverage is effective the first day of the month on or following date of employment or date of obtaining a benefits-eligible job.

Coordination of Benefits

Employees who enroll in State Group Health Insurance are required to provide Coordination of Benefits (COB) information in Self Service. Follow the instructions in Self Service to provide this information. (See How To Enroll).

For the “Other Health Insurance” question, employees covered under their spouse or parent’s insurance should answer “Yes” and provide the insurance policy information found on their insurance card. Employees not covered under their spouse or parent’s insurance and do not have other health insurance coverage should answer “No.”

Employees that elect a HDHP that do not provide the required COB information during enrollment will default to a non-HDHP.

Benefit Premiums

For State Group Health Insurance premiums, click here.

Forms & Resources

Plan Administrators

last updated: 11/05/2019

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.