Self-insurance Model Approved for the State Group Health Insurance Program Pending Legislative Approval

On February 8, 2016, the Group Insurance Board (GIB) approved a motion to move to a self-insured funding model for the State Group Health Insurance program effective January, 2018.   This change seeks to maintain benefits, contain costs and improve quality of the State Group Health Insurance program.  The proposed change to the self-insured funding model requires approval by the State Legislature.

Self-insurance is a way to finance employer health insurance programs. Currently in 2017, the state pays health insurance companies a fixed amount for employee health insurance coverage, and they pay all medical claims.  In the proposed model, the state pays medical claims directly to providers through third-party administrators. 

How will this change affect an employees’ choice of doctors?
It is not expected to impact employee provider choice as 98% of current providers will be available under the new program structure. 

Will an employee have to pay more for health insurance in 2018 in a self-insured model?

The employee costs for premiums are unknown at this time as determinations are made available in the fall.  Cost sharing amounts (copay/deductible/coinsurance) are expected to stay the same in 2018.

As more details about this new program become available updates will be provided.  For more information review the news release and Frequently Asked Questions from the Department of Employee Trust Funds.

Source: UW Service Center

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