The It’s Your Choice Open Enrollment Period is October 17 – November 11, 2016. All changes made during this period are effective January 1, 2017. NEW FOR 2017 – eBenefits All benefit elections will be made through STAR eBenefits. You no longer submit paper applications or use multiple websites to enroll in coverage. Go to https://ess.wi.gov and click on the Benefits Enrollment link in the Wisconsin Benefits section of the page. See the eBenefits Quick guide for details. ACTIONS THAT CAN BE TAKEN DURING OPEN ENROLLMENT Review the chart below to see what actions can be taken during Open Enrollment. Click on the plan name to learn more about the plan.

Enroll Add or Remove

Dependents Change Plans Cancel Coverage

Health X X X X

EPIC Benefits+ X X Add or remove vision

coverage X

Dental Wisconsin X X X X

Anthem DentalBlue X X X X

VSP Vision X X N/A X

AD&D X Change coverage level X X

Flexible Spending Accounts (FSA) (healthcare, limited purpose, dependent care, parking, transit)

Must re-enroll every year Coverage will automatically end if no 2017 enrollment

Health Savings Account (HSA) Must re-enroll every year

Enrollment will end if employee doesn’t elect High Deductible Health Plan (HDHP) but employee’s HSA account remains active

PLANS NOT INCLUDED IN OPEN ENROLLMENT You cannot enroll in Income Continuation Insurance or State Group Life Insurance during the open enrollment period. You can enroll in or make changes to Wisconsin Deferred Compensation at any time. HOW DO I KNOW IF I NEED TO DO ANYTHING DURING OPEN ENROLLMENT? You must re-enroll in the Flexible Spending Account (FSA) and Health Savings Account (HSA) programs every year. With

the exception of these two programs, if you do nothing, your current benefits will continue in 2017. Review your

current benefits summary online at https://ess.wi.gov (available in the Wisconsin Benefits section of the page).

Health plans may make changes to their provider network so you should confirm that the doctors, clinics, and hospitals you currently use will still be available in 2017. See the Health Plans by County map to see which health plans are available in each county.

Three health plans will no longer be available in 2017 – Arise – Aspirus, WEA Trust South Central and Anthem Blue Southeast. If you are currently in one of these plans, you will need to select a new health plan for 2017.

Significant Provider Network Change – Network Health Plan will no longer include the ThedaCare provider network. A new health plan for 2017, Security – Valley, includes the ThedaCare provider network.

HEALTHCARE AND DEPENDENT CARE FLEXIBLE SPENDING ACCOUNT REMINDERS FOR 2016 ENROLLEES The last day to incur claims for the 2016 plan year is December 31, 2016. All claims must be submitted to TASC by March 31, 2017. Healthcare and Limited Purpose FSA Carryover Limit = $500. Any amounts left in your account over $500 will be forfeit. Dependent Care = No carryover allowed. Any amount left in your account will be forfeit.

WHAT SHOULD I CONSIDER WHEN MAKING MY ELECTIONS FOR 2017?

Health Insurance o Is my health plan available for 2017?

o Can I still see my current providers if I keep my current health plan?

o Do I want uniform dental coverage?

You can elect health insurance with or without dental coverage. For a few dollars per month, you will have

uniform dental benefits (administered by Delta Dental)

Summary of Uniform Dental Benefits

Benefit In-Network Coverage Examples & Limitations of Coverage

Deductible $0

Annual Benefit Maximum $1,000 per member

Diagnostic, Preventive, Basic Services 100% Exams, cleanings, X-rays, fluoride, sealants, fillings

Orthodontics 50% Lifetime max of $1,500 per member, children under 19 only

o Do I want a low deductible or high deductible heath plan (HDHP)?

The low deductible health plan (IYC Health Plan) has a higher premium but lower out-of-pocket costs. The

HDHP offers lower premiums but the annual deductible must be met before claims are paid ($1,500

single/$3,000 family). See the Health Plan Comparison chart for details about the difference between the

two plan types.

Are you eligible for a High Deductible Health plan? If you enroll in an HDHP, you are required to enroll in a

Health Savings Account (HSA). You are NOT eligible for an HSA (or HDHP) if you are covered by any other

health insurance, including Medicare Part A, or if you can be claimed as a dependent on another person’s

tax return (unless it’s your spouse).

o Do I need a nationwide provider network?

If yes, should consider the Access Health Plan

o Are there specific plan features that are important to you (performance ratings, web portals, 24-hour nurse line

or telehealth)? See the Health Plan Features comparison page for plan-specific information.

o Do you plan to opt-out of health insurance and apply for the annual $2,000 health insurance opt-out stipend?

If yes, you must re-apply for the stipend on an annual basis. Complete a health insurance application

(sections 1, 14 and 15) and submit it to your agency by November 11, 2016 to apply for the stipend. You

must also “Waive” your health insurance in eBenefits.

Opt-Out Stipend Eligibility Requirements:

Must not be covered by state health insurance in 2017 as a subscriber OR a dependent; and

Must NOT be a craftsworker; and

If employed by the state in 2015 and were eligible for the employer contribution towards health

insurance, did NOT opt out of coverage in 2015.

Dental and Vision Coverage

o Do you anticipate any high cost dental procedures within the next year?

EPIC Benefits+, Dental Wisconsin and Anthem DentalBlue all provide dental coverage beyond what is

provided for by Uniform Dental Benefits. See the Dental Plan Comparison chart to determine what

plan(s) may be right for you.

A Healthcare FSA or Limited Purpose FSA allows you to set aside money on a pre-tax basis for out-of-

pocket dental costs.

o Do you usually have out-of-pocket vision costs (glasses, contacts, LASIK)?

VSP Vision and EPIC Benefits+ offer vision insurance benefits above what is provided by State Group

Health Insurance (coverage for an annual eye exam)

A Healthcare FSA or Limited Purpose FSA allows you to set aside money on a pre-tax basis for out-of-

pocket vision costs.

Healthcare Flexible Spending Account (FSA)

o Do you tend to have out-of-pocket medical, dental, vision or prescription expenses every year?

If yes, you can contribute up to $2,550 to a Healthcare FSA (or Limited Purpose FSA if enrolling in a High

Deductible Health Plan). This allows you to reduce your taxable income and set aside money for out-of-

pocket medical-related expenses.

Estimate your expenses wisely – you cannot change your election mid-year unless you have a qualifying

life event.

Dependent Care Flexible Spending Account (FSA)

o Do you have child or adult daycare expenses?

If yes, you can contribute up to $5,000 in a Dependent Care Account. This allows you to reduce your

taxable income and set aside money for dependent day care expenses.

Estimate your expenses wisely – you cannot change your election mid-year unless you have a qualifying

event.

Health Savings Account

o Are you enrolling a High Deductible Health Plan (HDHP) for 2017?

If yes, you are required to enroll in a Health Savings Account (HSA) every year EVEN IF you do not plan to

contribute anything to your account.

Accidental Death & Dismemberment Life Insurance (AD&D)

o Starting in 2017, you can no longer enroll in, make changes to or cancel your AD&D coverage at any time. You

will only be able to make changes during the Open Enrollment period or if you have a qualifying life event.

o If already enrolled, do you want to make any changes to your coverage for 2017?

o If you aren’t enrolled, do you need to add more life insurance for very minimal cost?

Do you have parking or transit expenses?

o If yes, you may want to enroll in a Parking or Transit Flexible Spending Account. You must re-enroll every year.

o Do you have deductions already coming out of your check pre-tax to pay for a state parking lot/garage or

Vanpool? If yes, those expenses do not qualify for the Parking or Transit FSA program.

2017 Premiums

Non-High Deductible Health Plans Single

(monthly) Single

(biweekly) Family

(monthly) Family

(biweekly)

IYC Plan with Dental $88.00 $44.00 $219.00 $109.50

IYC Plan without Dental $85.00 $42.50 $211.00 $105.50

Access with Dental (required to work out of state)

$138.00 $69.00 $347.00 $173.50

Access without Dental (required to work out of state)

$135.00 $67.50 $339.00 $169.50

Access with Dental $266.00 $133.00 $664.00 $332.00

Access without Dental $263.00 $131.50 $656.00 $328.00

High Deductible Health Plans Single

(monthly) Single

(biweekly) Family

(monthly) Family

(biweekly)

HDHP IYC Plan with Dental $33.00 $16.50 $82.00 $41.00

HDHP IYC Plan without Dental $30.00 $15.00 $74.00 $37.00

HDHP Access with Dental (required to work out of state)

$83.00 $41.50 $210.00 $105.00

HDHP Access without Dental (required to work out of state)

$80.00 $40.00 $202.00 $101.00

HDHP Access with Dental $211.00 $105.50 $527.00 $263.50

HDHP Access without Dental $208.00 $104.00 $519.00 $259.50

2017 Monthly Premiums Employee Employee + Spouse/DP

Employee + Child(ren)

Family

EPIC Benefits+ Without Vision $21.56 $43.12 $43.12 $64.68

EPIC Benefits+ With Vision $25.60 $50.24 $50.24 $75.16

Dental Wisconsin Select $20.52 $42.18 $48.68 $71.58

Dental Wisconsin PPO $24.60 $52.08 $58.22 $88.02

Anthem DentalBlue Supplemental Plan $19.56 $39.14 $39.14* $58.73**

Anthem DentalBlue PPO $19.15 $38.29 $38.29* $63.18**

Anthem DentalBlue Dentacare HMO $18.47 $36.94 $36.94* $59.09**

VSP $6.54 $13.08 $14.73 $23.54

* Premium for Employee + 1 ** Premium for Employee + 2 or more