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). Listed below are a few resources that may help you determine the plan design that may be best for you and your family:
- Comparison of Health and Pharmacy Benefits (available in the Forms & Resources section below)
- Plan Design Options eLearning (available in the Forms & Resources section below)
Additional information on each plan design can be found in the navigation in the left.
Eligibility
You are eligible for the State Group Health Insurance program if you are eligible for the Wisconsin Retirement System (WRS) Benefit Package or the Graduate Assistant/Short-Term Benefit Package.
Dependents: This program allows your eligible dependents to be covered by one group health insurance program only. This means that if you work for UW System and your 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 your spouse enrolls in coverage through their employer, your dependents may only be covered under one plan, the your plan OR your spouse’s plan.
For detailed information on who you can cover on this plan, see the .
If a dependent will be covered but does not have a Social Security Number you must submit an Affidavit (ET-1907) (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 Health Plan
- Access HDHP
Note: Some employees are not eligible for the High Deductible Health Plan (HDHP) or Access HDHP.
Enrollment
You 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 electronically through the MyUW portal. Employees unable to enroll electronically through the MyUW portal must complete a Health Insurance Application/Change Form (ET-2301) (available in the Forms & Resources section below) and submit it to the institution benefits contact 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 it to the institution benefits contact during the enrollment period.
If you do not enroll in the State Group Health Insurance program during your initial 30-day enrollment period, you may enroll during the Annual Benefits Enrollment (ABE) period or if you have a qualifying life event (click Life Events in the left-hand menu for more information).
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.
University Staff Employees
University Staff 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, you may choose your 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; you pay 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). You 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 you do 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 it to their institution benefits contact during their enrollment period.
**Employees that elect coverage to begin when the employer contributes to the premium must enroll through the MyUW portal.
Coordination of Benefits
Coordination of Benefits (COB) provides information about other health insurance coverage you may have, including other coverage your spouse may have.
If you enroll in State Group Health Insurance, you are required to provide Coordination of Benefits (COB) information through the MyUW portal. Follow the instructions in How To Enroll.
For the “Other Health Insurance” question, if you have coverage under your spouse or parent’s insurance, answer “yes” and provide the insurance policy information found on your insurance card. If you are not covered under your spouse or parent’s insurance, and do not have other health insurance coverage, 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 review the Benefit Premiums web page.
Forms & Resources
- Health Benefits Decision Guide
- Health Plan Search
- Automatic Premium Conversion Waiver (ET-2340)
- Glossary of Health Coverage and Medical Terms
- Guide to Office Visit Copays
- Health Insurance Plan Brochure (ET-4112)
- How to Get Care When You Need It eLearning (ETF)
- Patient Rights and Responsibilities
- Plan Design Options eLearning (ETF)
- Preventive Health Services
- State & Federal Notifications
- Summary of Benefits and Coverage
- Terms and Conditions
- Affordable Care Act (ACA)
- Health Insurance Marketplace Notice
- Continuation: Contact UW-Shared Services, Service Operations at serviceoperations@support.wisconsin.edu or (888) 298-0141 (7:45-4:30 p.m. Monday-Friday) to obtain a continuation form upon termination.
Plan Administrators
- State Group Health Insurance: Department of Employee Trust Funds | (877) 533-5020
- Pharmacy Benefits: Navitus Health Solutions | (866) 333-2757
- Uniform Dental Benefits: Delta Dental of Wisconsin | (844) 337-8383
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.
Updated: 03/20/2023