Employee Matters

The staff of the Employee Compensation and Benefits Services staff prepares this column. This issue, they look at annual fall enrollments related to Health Insurance Dual Choice, and Employee Reimbursement Accounts.

What is Dual Choice?
Dual Choice is the annual opportunity for insured employees to change from one state health plan to another, or to change from single to family coverage without waiting periods or exclusions for pre-existing medical conditions. To be eligible, employees had to be insured in one of the state’s health plans on or before Oct. 1, 2003.

When is the Dual Choice enrollment period for Plan Year 2004?
Enrollment runs through 4:30 p.m., Friday, Oct. 24. The coverage elected becomes effective Jan. 1. Deductions for the new plan start in November.

Will I receive something in the mail?
Insured employees who had deductions in September will receive a Dual Choice booklet mailed to their campus address the first week of October. Employees with coverage effective on or before Oct. 1 who do not receive booklets should contact their payroll and benefit coordinators.

What information in the booklet should employees review or verify?

• Review the “Notable Plan and Program Changes” section and individual plan descriptions (including dental coverage).
• Verify that the current plan is available in employee’s area for 2004.
• Verify clinic and hospital affiliation.

Significant changes have been made to the program for 2004, making it imperative that employees review this information.

Whom should I call with specific benefit or provider questions?
Call the health plan directly. Be sure to verify that newly selected physicians are accepting new patients.

Then what should I do?
If you elect to change your health plan or change your coverage level from single to family, obtain a health-insurance application from your division or department benefits coordinator. Complete the application and return it to your benefits coordinator no later than 4:30 p.m., Friday, Oct. 24. No action is necessary if you do not elect to make changes.

What if I miss my opportunity?
You will have to wait until the next Dual Choice opportunity next year. You can change to the Standard Plan anytime; however, you will be subject to a 180-day waiting period for pre-existing conditions. If you missed Dual Choice enrollment for reasons outside of your control, contact Employee Compensation and Benefits Services. That office will determine whether you might be eligible to file a “late dual choice” enrollment.

Am I eligible to enroll in ERA?
Yes, if the employee holds a classified or unclassified appointment other than a fellow, scholar, research assistant, limited term employee, or student hourly.

What is the enrollment period?
The enrollment period is Monday, Oct. 6, through 4:30 p.m., on Friday, Nov. 21.

How do I enroll?
ERA booklets, which explain the online enrollment procedures, were mailed to employee’s campus addresses at the end of September. If you did not receive an ERA booklet, contact your payroll and benefit coordinator immediately.

When will coverage be effective?
Enrollment during the fall enrollment opportunity is for plan year 2004.

Will there be open enrollment for EPIC Major Medical or DentalBlue?
There is no open enrollment this year.

What if I want more information?
Visit the EC&BS Web site under “New Information”: http://www.bussvc.wisc.edu/ecbs/ecbs.html or e-mail: employee@bussvc.wisc.edu