Unsure of how to choose your health insurance plan? Here’s a guide to help you make your decision.

Step 1 – Choose a Plan Design

Below provides a brief summary of the plan designs that the State Group Health Insurance program offers. The plan designs differ in monthly premiums, cost-sharing and whether or not there is out-of-network coverage. Take a moment to click on each plan design in the left hand menu or review the Comparison of Health and Pharmacy Benefits pdf to determine which plan design may be best for you.

Health Plan

The Health Plan has a lower deductible and lower out-of-pocket limits but a higher monthly premiumThis plan design only covers out-of-network benefits for emergency and urgent care services.

High Deductible Health Plan (HDHP)

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 to save for your out-of-pocket health, dental and/or vision expenses. The UW System contributes to your HSA (if you meet the eligibility requirements). You will indicate how much you would like to contribute on an annual basis; however, employee contributions are optional and changes are allowed at any time.

Not everyone is eligible to enroll in the HDHP. Click on the HDHP to learn more.

Access HEALTH Plan

The Access Health Plan provides freedom of choice for doctors and hospitals across the country (nationwide coverage); 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 cost is more than for the Health Plan and the HDHP.

Access High Deductible health plan (hDHP)

The Access HDHP provides freedom of choice for doctors and hospitals across the country (nationwide coverage); 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 cost than the Access Health Plan.

The Access HDHP is paired with a Health Savings Account (HSA) to help you save for your out-of-pocket health, dental and/or vision expenses. The UW System contributes to your HSA (if you meet the eligibility requirements). You will indicate how much you would like to contribute on an annual basis; however, employee contributions are optional and changes are allowed at any time.

Not everyone is eligible to enroll in the Access HDHP. Click on the Access HDHP to learn more.

Note: The Access Health Plan and Access HDHP are administered by WEA Trust only. If you choose either of these plan designs, you may go to Step 4. If you have chosen the Health Plan or the HDHP, go to Step 2.

Step 2 – Choose a Geographic Coverage Area

Now that you know which plan design you would like, review the Health Plan Search. This interactive map will show you which insurance carriers are available by county and will help you select a carrier that includes the providers and hospitals in the preferred county that you would like to receive services in. You do not have to choose a health insurance carrier in your county; however, keep in mind that the Health Plan and HDHP only cover out-of-network benefits for emergency and urgent care services.

Step 3 – Choose a Health Insurance Carrier

Now that you know which insurance carriers you have to choose from in the county where you would like to receive services, you should review the health insurance carrier quality ratings:

  • Access to specific physicians or other health care providers,
  • Referral and prior authorization requirements,
  • Plan features, (i.e. if they offer a member web portal or a 24-hour nurse line),
  • Quality and member satisfaction (see Health Plan Report Card)

Step 4 – Review Uniform Dental Benefits (UDB)

All health insurance plans provide medical and prescription drug coverage (no additional charge). Uniform Dental Benefits provide preventive dental services and may be added to any health insurance plan (for a minimal cost). Review the Uniform Dental Benefits and determine if you would like to add this to your Health Insurance plan.

Step 5 – Enroll or Make a Change

Now that you have chosen a plan design and health insurance carrier, you will need to either enroll or make a change to your current enrollment. Make changes or enroll online using Self Service.

 

last updated: 12/02/2019

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.