State Group Health Insurance

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 there is out-of-network coverage. All plan designs automatically include pharmacy benefits for no additional cost. Uniform Dental can be added to your State Group Health Insurance for a minimal cost, if selected.

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.

 

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 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), and your spouse enrolls in coverage through their employer, your dependents may only be covered under one plan, your plan OR your spouse’s plan.

For detailed information on who you can cover on this plan, see the Dependent Eligibility Chart (UWS 25) pdf .

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 How to Choose Your Health Insurance Plan web page 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 online at my.wisconsin.edu. If you are unable to enroll online, you must complete a Health Insurance Application/Change Form (ET-2301) (available in the Forms & Resources section below) and submit it to your benefits contact during your enrollment period.

If you enroll in the HDHP or Access HDHP, you are required to enroll in a Health Savings Account (HSA). Most employees will be able to enroll in the HSA online at my.wisconsin.edu. If you are unable to enroll online, complete the HSA Enrollment Form (available in the Forms & Resources section below) and submit it to your benefits contact during your 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 benefits contact during their enrollment period.

**Employees that elect coverage to begin when the employer contributes to the premium must enroll through the my.wisconsin.edu.

ID Cards

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.

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.

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 & Resources section below).

Benefit Premiums

For State Group Health Insurance premiums review the Benefit Premiums web page.

Forms & Resources

Plan Administrators

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: 05/29/2024