Health Insurance Plan Changes Effective July 1, 2019
Due to the increase in premiums by the health insurance carriers, two plan design changes were needed to ensure the health plans stayed within budgetary allowances. As of July 1, 2019, there will be changes to the employee premium contributions for Point of Service (POS) plans, and there will be an increase in the co-pay for Emergency Room visits. The information below includes these changes. Additional information is provided in this 2019 Health Insurance Changes video.
Who is Eligible?
Health insurance is available to regular employees who are scheduled to work 19 or more hours per week, or have a contract of at least 50%. The District offers comprehensive health insurance from two different providers for eligible employees. You may enroll in health insurance through either Group Health Cooperative of South Central Wisconsin (GHC) or Dean Health Plan. These carriers provide you with a diverse range of networks and providers, yet have the exact same type of coverage (co-pays, etc.), but with slightly different employee premiums (what you pay per period for your coverage).
For either carrier (GHC or Dean Health Plan), you can enroll in the Health Maintenance Plan (HMO), the Point-of-Service Plan (POS) or the Preferred Provider Organization Plan (PPO). The PPO plan is only available to employees who do not live in South Central Wisconsin. The POS and PPO plans provide greater access to non-network services when referrals are not available. The POS and PPO plans have higher employee premiums and all out-of-network services are subject to an annual deductible and insurance co-pay.
How Much Does it Cost?
Health insurance premiums are based on the carrier you select (GHC or Dean Health Plan), the plan type you choose (HMO or POS), the coverage tier (single/family) and your payroll frequency. Your premium contribution rate is based on a sliding scale and varies by type of employee and plan type. Contributions for HMO plans are between 1.25% and 10% of the total monthly cost of the insurance. Contributions for POS plans are between 2.50% and 20%. As a benefit to its employees, the District pays the remaining percentage. Premiums are paid by pre-tax payroll deductions. See the Resources box on this page to determine what your cost will be.
Listed below are some of the programs in place to help you utilize all of the benefits available through the health insurance plans:
- Wellness incentives are provided for specific healthy behaviors.
- Complementary medicine provides discounts for specific healthy activities.
- Nurse Line provides highly trained, registered nurses who can answer your medical questions and provide advice without an appointment or cost.
- GHC Nurse Line: 608-661–7350
- Dean Nurse Line: 800-576-8773
- MyChart online and mobile applications are provided so that you can access your benefit and claim information virtually anywhere.
Have Questions? Contact the Benefits Helpdesk at email@example.com or at (608) 663-1692
Nurse on Call: 608-661–7350
Nurse on Call: 800-576-8773
Select "Commercial HMO/POS"