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Six Health Plans to Leave State Employee Health Care Program

August 25, 2017

This week the Department of Employee Trust Funds (ETF) announced six health plans have chosen to exit the state employee health care program, leaving 10 plans to offer coverage to state and local government employees in 2018.

The news comes in a year of uncertainty over the state employee plan as the Group Insurance Board voted to move the program from a fully insured program to a self-insured program, with far fewer health plan choices. That proposal was rejected by the Joint Finance Committee in June (see previous Valued Voice article). The Group Insurance Board is expected to meet August 30 to finalize rates and offerings for the program for 2018.

In its announcement ETF does not indicate why the plans have chosen to exit the market, but notes the decisions will affect about 53,000 enrollees. The health plans that have elected not to participate in the program in 2018 are:

  • Anthem Blue Preferred Northeast, which serves Northeast Wisconsin with 4,300 enrollees
  • Arise Health Plan, which serves Northeast Wisconsin with 1,700 enrollees
  • Health Tradition Health Plan, which serves Western Wisconsin with 4,600 enrollees
  • Humana, which serves Eastern and Western Wisconsin, and including Humana’s Medicare Advantage offering, with 18,100 enrollees. 
  • UnitedHealthcare of Wisconsin, which serves Eastern Wisconsin with 14,000 members
  • WPS, which serves all of Wisconsin with 10,600 members

Pending approval by the Group Insurance Board, the health plans available in 2018 will be: 

  • Dean Health Insurance and Dean Health Insurance-Prevea360
  • Group Health Cooperative of Eau Claire
  • Group Health Cooperative of South Central Wisconsin
  • HealthPartners Health Plan
  • Medical Associates Health Plans
  • MercyCare Health Plans
  • Network Health
  • Security Health Plan – Central and Valley
  • Quartz – Community and UW Health (formerly Gundersen, Physicians Plus and Unity)
  • WEA Trust – East, Northwest Chippewa Valley and Mayo Clinic Health System

 

This story originally appeared in the August 25, 2017 edition of WHA Newsletter