What's Changing

On March 23, 2020, The Board of Education voted to stay with GHC and Dean Health Plan for the next fiscal year (7/1/20 - 6/30/21).

In order to balance the budget, the Board implemented changes in three areas:

  • Add a deductible to the in-network HMO and POS plans: $100 per individual with a $200 family maximum
  • Update Prescription Drug Copay (GHC plans only)
  • Adjust Employee Premium Contributions

What is a Deductible?

A deductible is the "first dollar" amount you pay for certain health care services before your health insurance begins to pay.  Services that generally apply to the deductible are:

  • Diagnostic Services (labs, x-rays, scans or MRI, for example)
  • Inpatient Hospital Services (hospital stays, surgery, labor and delivery, skilled nursing services, for example)
  • Outpatient Hospital Services (day surgery, oral surgery, ambulance services, mental health day treatment, for example)
  • Outpatient Services (Hospice, home health services, for example)
  • Therapy Services (speech therapy, physical therapy, occupational therapy, autism therapy, for example)
  • Durable Medical Equipment/Medical Supplies (hearing aids, crutches, soft casts, for example)

The initial deductible period will start on 7-1-20 and will run through 12-31-20.  The deductible will reset on 1-1-21 and will run through the entire calendar year (resetting annually after that).  The deductible is set up to run on a calendar year to run concurrently with your medical flexible spending account.  Don't forget to set aside money in your flexible spending account during open enrollment (Oct 15 - Nov 15) to help with any copay or deductible expenses!

Something New! Similar to dental insurance, you will receive Explanation of Benefits (EOBs) for the services that apply to the deductible, until the deductible is met.  The EOB is provided for transparency to show the cost of these services - it is not a bill. Please do not pay for these services until you receive a bill from your provider.  

Prescription Drug Copay Updates (GHC Only)

GHC's prescription drug tiers are being updated to match Dean's tiers.  There are no changes to the Dean tiers.

GHC's Formulary

                  Current      New (7/1/20)

     Tier 1:       $6               $6

     Tier 2:       $15             $15

     Tier 3/4:    $15             $30

Dean's Formulary

     Tier 1: $6

     Tier 2: $15

     Tier 3/4: $30

Employee Premium Contributions

The Employee Premium Contributions (EPC) will be changing on 7/1/2020 due to the EPC structure changes and changes in premiums.  You will see the premiums automatically adjusted on your 7/1 paychecks if you receive checks over the summer months.  If you do not receive checks over the summer, you will see an adjustment on your last paycheck in June to cover the premium adjustments.  You can view a chart of the new premiums here.  

Additional Benefits

Listed below are some of the programs in place to help you utilize all of the benefits available through the health insurance plans:

Have Questions? Contact the Benefits Helpdesk at benefits@madison.k12.wi.us or at (608) 663-1692

Insurance Header Picture

GHC Information

GHC Website

GHC's LGBTQ Primary Care Doctor List

Telephone: 608-828-4853 

Nurse on Call: 608-661–7350

Find A GHC Doctor

DEAN INFORMATION

Dean Website

Telephone: 800-279-1301

Nurse on Call: 800-576-8773

Multilingual Provider List

Find A Dean Doctor 

     Select "Commercial HMO/POS"