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

Step 1 – Choose a Plan Design

First, decide which plan design you would like. The following is a summary of the four plan designs that the State Group Health Insurance program offers. Take a moment to review each option to determine which one is best for you. Click on each plan design to learn more. Not everyone is eligible for the HDHP and Access HDHP plan designs.

No matter which plan design you choose, the in-network coverage is the same (Uniform Benefits). The plan designs generally differ in monthly premiums, cost-sharing and whether or not there is out-of-network coverage.

Note: While these plans all offer the same Uniform Benefits package, this does not mean that they will treat all illnesses or injuries in an identical manner. Treatment will vary depending on patient needs, the provider’s preferred practices, and the health plan provider’s managed care policies and procedures.

To compare the four plan designs, see the Comparison of Medical Benefits chart.

Health Plan

The Health Plan design 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 design 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.

This plan design is paired with a Health Savings Account (HSA). You must indicate how much you would like to contribute to the HSA each year with this plan design. The UW System contributes to your HSA if you meet certain eligibility requirements. Employee contributions are optional.

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

Access Plan

The Access plan design 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 designs.

Access HDHP

The Access HDHP design 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 Plan design. In exchange for the increased cost sharing, this plan design offers a lower monthly premium cost than the Access Plan design.

This plan design is paired with a Health Savings Account (HSA). You must indicate how much you would like to contribute to the HSA each year with this plan design. The UW System contributes to your HSA if you meet certain eligibility requirements. Employee contributions are optional.

Not everyone is eligible to enroll in this plan design. Click on the plan design to learn more.

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

Step 2 – Choose a Geographic Coverage Area

Now that you know which plan design you would like, review the Health Plan Provider Map. This interactive map will show you which health plans (insurance carriers) are available by county and will ensure you select the plan 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 plan in your county, but keep in mind how far you are willing to travel for services. Note: The Health Plan and HDHP designs only cover out-of-network benefits for emergency and urgent care services.

Step 3 – Choose a Health Plan (Insurance Carrier)

Now you know which health plans (insurance carriers) you have to choose from in the county where you would like to receive services, you should review the specific health plan features and plan descriptions to learn about their quality ratings and other features, which may include:

  • Referral and prior authorization requirements,
  • Whether they require you to select a primary care provider (PCP),
  • 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 Cards)
  • Access to specific physicians or other health care providers

Note: Most health plans require you to seek services in-network in order to be covered.

Step 4 – Determine if you want Uniform Dental benefits

All offered health plans provide medical and prescription drug coverage (no additional charge). Uniform Dental benefits may be included (for a minimal cost). To learn more about Uniform Dental benefits, click here.

Step 5 – Enroll or Make a Change

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

If you are declining health insurance and electing the Opt-Out Incentive, you must complete the Health Insurance Application/Change Form pdf and submit it to your human resources office.


last updated: 5/31/2018

Every effort has been made to ensure this information is current and correct. This page does not guarantee enrollment or the ability to make changes to your benefits.