{"id":371,"date":"2019-08-26T08:27:42","date_gmt":"2019-08-26T13:27:42","guid":{"rendered":"https:\/\/www.wisconsin.edu\/ohrwd\/benefits\/?page_id=371"},"modified":"2026-03-30T14:04:38","modified_gmt":"2026-03-30T19:04:38","slug":"health","status":"publish","type":"page","link":"https:\/\/www.wisconsin.edu\/ohrwd\/benefits\/health\/","title":{"rendered":"State Group Health Insurance"},"content":{"rendered":"<div id=\"toc\" class=\"uwsa-toc callout hidden-print\"><\/div><style>@media (min-width: 768px) {#toc { max-width: 40%} <\/style><script>jQuery(document).ready(function() {\n \t\t\t\t\tgenerateTOC(\"State Group Health Insurance\", \"\", \"div.entry-content\" ,2 ,\"true\", \"toc\");\n \t\t\t\t\t });<\/script>\n<h2><strong>Overview<\/strong><\/h2>\n<p>Universities of Wisconsin offers comprehensive medical and pharmacy benefits 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.<\/p>\n<p>There are several plan designs that differ in monthly premiums, cost-sharing and whether there is out-of-network coverage. All plan designs include pharmacy benefits. Uniform Dental can be added to your State Group Health Insurance for a minimal cost, if selected.<\/p>\n<p>For resources to help you determine the plan design and health insurance carrier that may be best for you and your family, go to the How to Choose Your Health Insurance Plan web page or click on each of the different plan designs in the menu to the left.<\/p>\n<p>&nbsp;<\/p>\n<h2><a id=\"eligibility\"><\/a>Eligibility<\/h2>\n<p>You are eligible for the State Group Health Insurance program if you are eligible for the <a href=\"https:\/\/www.wisconsin.edu\/ohrwd\/benefits\/general-employee-info\/#eligibility\" target=\"_blank\" rel=\"noopener noreferrer\">Wisconsin Retirement System (WRS) Benefit Package or the Graduate Assistant\/Short-Term Benefit Package<\/a>.<\/p>\n<p><strong>Dependents: <\/strong>This program allows your eligible dependents to be covered by <strong>one<\/strong> group health insurance plan only. This means that if you work for the Universities of Wisconsin 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), you and your spouse may each enroll in an individual plan with your employer (covering just you as their employee), OR you or your spouse may enroll in one family plan with your employer (covering all eligible family members); meaning the other would decline coverage.<\/p>\n<p><span style=\"float: none;background-color: transparent;color: #333333;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\">For information on who you can cover on this plan, review the <span class=\"doc-icon\"><a class=\"doc-type pdf\" href=\"https:\/\/www.wisconsin.edu\/ohrwd\/benefits\/download\/Dependent-Eligibility-Chart-UWS-25.pdf\" target=\"_blank\">Dependent Eligibility Chart (UWS 25)<span class=\"sr-only\"> pdf<\/span><\/a><\/span>\r\n.<\/span><\/p>\n<p>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 &amp; Resources section below) at the time of enrollment.<\/p>\n<h2><a id=\"plan-designs\"><\/a>Plan Designs<\/h2>\n<p>Click each plan (in the left-hand menu) or use the How to Choose Your Health Insurance Plan web page for additional information.<\/p>\n<ul>\n<li>Health Plan<\/li>\n<li>High Deductible Health Plan (HDHP)<\/li>\n<li>Access Health Plan<\/li>\n<li>Access HDHP<\/li>\n<\/ul>\n<p><em><strong>Note: Some employees are not eligible for the High Deductible Health Plan (HDHP) or Access HDHP.<\/strong><\/em><\/p>\n<h2>Enrollment<\/h2>\n<p>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.<\/p>\n<p>If you enroll in the HDHP or Access HDHP, you are required to enroll in a Health Savings Account (HSA).<\/p>\n<p>If you do not enroll in the State Group Health Insurance program during your initial 30-day enrollment period, you may enroll in the fall with coverage effective for the upcoming calendar year or if you have a qualifying life event. See\u00a0<a href=\"https:\/\/www.wisconsin.edu\/ohrwd\/benefits\/life-events\/\" target=\"_blank\" rel=\"noopener noreferrer\">Life Events<\/a>\u00a0for more information.<\/p>\n<h4><strong>Faculty, Academic Staff and Limited Appointees, Student Assistants and Employees-in-Training<\/strong><\/h4>\n<p>Coverage is effective the first day of the month on or following date of employment or date of obtaining a benefits-eligible job.<\/p>\n<h4><strong>University Staff Employees<\/strong><\/h4>\n<p>University Staff employees have two opportunities to enroll in the State Group Health Insurance program:<\/p>\n<p><strong>1. Within 30 days from date of employment or the date of obtaining a benefits-eligible job. <\/strong>In this situation, you may choose your coverage effective date:<\/p>\n<ul>\n<li>As soon as possible (first of the month on\/after start date). <em>No employer contribution for the first two months of coverage; you pay the total premium cost for the first two months of coverage; or<\/em><\/li>\n<li>When the employer contributes to the premium (first of the month on\/following the completion of two (2) months of state WRS service). <em>You will receive the employer contribution with the first month of coverage after completion of two months of state WRS service.<\/em><\/li>\n<\/ul>\n<p><strong>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).<\/strong><\/p>\n<ul>\n<li>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).<\/li>\n<\/ul>\n<h2>ID Cards<\/h2>\n<p>If you enroll in State Group Health Insurance, you will receive an ID card for healthcare services and a separate ID card for pharmacy benefits.<\/p>\n<p>Present your health insurance ID card at telehealth visits, office visits, urgent care visits, emergency room visits, and any other appointment that involves healthcare services. Present your pharmacy benefits ID card at the pharmacy.<\/p>\n<p>To request a new health insurance ID card, contact your health insurance carrier. The phone numbers for the health insurance carriers are listed on the last page of the Health Benefits Decision Guide (available in the Forms &amp; Resources section below).<\/p>\n<h2>Benefit Premiums<\/h2>\n<p>For State Group Health Insurance premiums review the <a href=\"https:\/\/www.wisconsin.edu\/ohrwd\/benefits\/premiums\/\" target=\"_blank\" rel=\"noopener\">Benefit Premiums web page<\/a>.<\/p>\n<h2>Forms &amp; Resources<\/h2>\n<ul>\n<li><a href=\"https:\/\/etf.wi.gov\/publications\/et2301\/download?inline=\" target=\"_blank\" rel=\"noopener\">2026 Health Insurance Application\/Change Form (ET-2301)<\/a><\/li>\n<li><span class=\"doc-icon\"><a class=\"doc-type pdf\" href=\"https:\/\/www.wisconsin.edu\/ohrwd\/benefits\/download\/certificatehphdhpaccess.pdf\" target=\"_blank\">Certificate of Coverage for Health Plan, HDHP, Access Plan<span class=\"sr-only\"> pdf<\/span><\/a><\/span>\r\n<\/li>\n<li><a href=\"https:\/\/etf.wi.gov\/its-your-choice\/2026\/health-benefits\/guide-office-visit-copays\" target=\"_blank\" rel=\"noopener noreferrer\">Guide to Office Visit Copays<\/a><\/li>\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\/ohrwd\/benefits\/download\/hsaenrollment.pdf\" target=\"_blank\">HSA Enrollment Form<span class=\"sr-only\"> pdf<\/span><\/a><\/span>\r\n<\/li>\n<li><a href=\"https:\/\/etf.wi.gov\/publications\/26et-2107\/download?inline=\" target=\"_blank\" rel=\"noopener\">Insurance Benefits Decision Guide<\/a><\/li>\n<li><a href=\"https:\/\/etf.wi.gov\/its-your-choice\/2026\/state-employee-and-retiree-health-plan-supplemental-benefits\/health-insurance-employees-cobra-and-retirees-without-medicare\/summary-benefits-and-coverage\" target=\"_blank\" rel=\"noopener\">Summary of Benefits and Coverage<\/a><\/li>\n<li><a href=\"https:\/\/etf.wi.gov\/publications\/et2340\/download?inline=\" target=\"_blank\" rel=\"noopener\">Automatic Premium Conversion Waiver (ET-2340)<\/a><\/li>\n<li><span class=\"doc-icon\"><a class=\"doc-type pdf\" href=\"https:\/\/www.wisconsin.edu\/ohrwd\/benefits\/download\/uws93.pdf\" target=\"_blank\">Employee Affidavit (UWS 93)<span class=\"sr-only\"> pdf<\/span><\/a><\/span>\r\n<\/li>\n<li><a href=\"https:\/\/www.dol.gov\/sites\/dolgov\/files\/EBSA\/laws-and-regulations\/laws\/affordable-care-act\/for-employers-and-advisers\/sbc-uniform-glossary-of-coverage-and-medical-terms-final.pdf\" target=\"_blank\" rel=\"noopener\">Glossary of Health Coverage and Medical Terms<\/a><\/li>\n<li><a href=\"https:\/\/etf.wi.gov\/publications\/et4112\/direct\" target=\"_blank\" rel=\"noopener\">Health Insurance Plan Brochure (ET-4112)<\/a><\/li>\n<li><a href=\"https:\/\/etf.wi.gov\/video\/get-medical-care-when-you-need-it-fast\" target=\"_blank\" rel=\"noopener noreferrer\">How to Get Care When You Need It eLearning (ETF)<\/a><\/li>\n<li><a href=\"https:\/\/etf.wi.gov\/health-benefits\/patient-rights-and-responsibilities\" target=\"_blank\" rel=\"noopener noreferrer\">Patient Rights and Responsibilities<\/a><\/li>\n<li><a href=\"https:\/\/etf.wi.gov\/insurance\/health-pharmacy\/preventive-care-services-covered-100\" target=\"_blank\" rel=\"noopener\">Preventive Care Services Covered<\/a><\/li>\n<li><a href=\"https:\/\/etf.wi.gov\/health-benefits\/state-and-federal-notifications\" target=\"_blank\" rel=\"noopener noreferrer\">State &amp; Federal Notifications<\/a><\/li>\n<li><a href=\"https:\/\/www.wisconsin.edu\/ohrwd\/benefits\/terms-conditions\/\" target=\"_blank\" rel=\"noopener noreferrer\">Terms and Conditions<\/a><\/li>\n<li><a href=\"https:\/\/www.wisconsin.edu\/ohrwd\/aca\/\" target=\"_blank\" rel=\"noopener noreferrer\">Affordable Care Act (ACA)<\/a><\/li>\n<li><a href=\"https:\/\/www.wisconsin.edu\/ohrwd\/download\/aca(3)\/notice.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Health Insurance Marketplace Notice<\/a><\/li>\n<li>Continuation: Contact UW-Shared Services, Service Operations at <a href=\"mailto:GetHelpUW@support.wisconsin.edu\" target=\"_blank\" rel=\"noopener\">GetHelpUW@support.wisconsin.edu<\/a>\u00a0or (888) 298-0141 (7:45-4:30 p.m. Monday-Friday)\u00a0to obtain a continuation form upon termination.<\/li>\n<\/ul>\n<h2>Plan Administrators<\/h2>\n<ul>\n<li>State Group Health Insurance: <a href=\"https:\/\/etf.wi.gov\/\" target=\"_blank\" rel=\"noopener noreferrer\">Department of Employee Trust Funds<\/a> | (<span style=\"float: none;background-color: transparent;color: #333333;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;line-height: 22px;text-align: left;text-decoration: none;text-indent: 0px;text-transform: none\">877) 533-5020<\/span><\/li>\n<li>Pharmacy Benefits: <a href=\"https:\/\/www.navitus.com\/\" target=\"_blank\" rel=\"noopener noreferrer\">Navitus Health Solutions<\/a> | (866) 333-2757<\/li>\n<li>Uniform Dental Benefits: <a href=\"https:\/\/www.deltadentalwi.com\/state-of-wi\" target=\"_blank\" rel=\"noopener noreferrer\">Delta Dental of Wisconsin<\/a> | (844) 337-8383<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Overview Universities of Wisconsin offers comprehensive medical and pharmacy benefits 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. There are several plan designs that differ in monthly premiums, cost-sharing and whether [&#8230;]<\/p>\n","protected":false},"author":20,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"page-templates\/42.7563.php","meta":{"footnotes":""},"class_list":["post-371","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.wisconsin.edu\/ohrwd\/benefits\/wp-json\/wp\/v2\/pages\/371","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.wisconsin.edu\/ohrwd\/benefits\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.wisconsin.edu\/ohrwd\/benefits\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.wisconsin.edu\/ohrwd\/benefits\/wp-json\/wp\/v2\/users\/20"}],"replies":[{"embeddable":true,"href":"https:\/\/www.wisconsin.edu\/ohrwd\/benefits\/wp-json\/wp\/v2\/comments?post=371"}],"version-history":[{"count":19,"href":"https:\/\/www.wisconsin.edu\/ohrwd\/benefits\/wp-json\/wp\/v2\/pages\/371\/revisions"}],"predecessor-version":[{"id":36988,"href":"https:\/\/www.wisconsin.edu\/ohrwd\/benefits\/wp-json\/wp\/v2\/pages\/371\/revisions\/36988"}],"wp:attachment":[{"href":"https:\/\/www.wisconsin.edu\/ohrwd\/benefits\/wp-json\/wp\/v2\/media?parent=371"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}