Reviewing the Health Opt-Out Incentive Business Process in HRS

Overview

This procedure describes the business process for employees wanting to elect the Health Opt-Out incentive. Effective January 1, 2016, UW employees who are covered under the State Group Health Insurance program may be eligible to receive $2,000 by opting out of the program.

Process Considerations:

UW-Shared Services (UWSS) and Employee Trust Funds (ETF) determine if an employee is eligible for the Health Opt-Out Incentive.
Full and part-time employees and Craftworkers under the Wisconsin Retirement System (WRS) are eligible for the Health Opt-Out Incentive.
Grad/Short-term Academic Staff employees are not eligible for the Health Opt-Out Incentive.
An employee is NEVER eligible for the Health Opt-Out Incentive if they were eligible for State Group Health insurance but declined health benefits in 2015.
- If a Grad employee declined health coverage in 2015, and now is in an eligible WRS position, this does NOT negate their eligibility for the Health Opt-Out Incentive.
An employee is not eligible for the Health Opt-Out Incentive if they are currently a dependent under the State Group Health Insurance program.
If an employee receives State Group Health insurance at any point during the year under a WRS contract, they are not eligible to enroll in the Health Opt-Out Incentive. The next eligible enrollment opportunity will be the Annual Benefits Enrollment (ABE) period.
If an employee is on a LOA, Health Opt-Out Incentive follows the same guidelines as if they were enrolled in health insurance
- If paid LOA, the employee is eligible for the Health Opt-Out Incentive the whole time.
- If unpaid LOA, the employee is eligible for the Health Opt-Out Incentive for the first three months of LOA. After the third month, Health Opt-Out Incentive will cease and be removed from HRS.
If the employee is University Staff, the Health Opt-Out Incentives will begin when employer contributions begins.
If the employee is overpaid for the Health Opt-Out Incentive, UWSS will recoup incentive premiums by payroll or Benefits Billing.

You may click on the links below to navigate directly to a section:

Employee & Employer Share Incentive Payroll Schedule:

01A January
01B January
02A February
02B February
03A March
03B March
04A April
04B April
05A May
05B May
06A June
06B June
07A July
07B July
08A August
08B August
09A September
09B September
10A October
10B October
11A November
11B November
12A December
12B December

*Health Opt-Out incentive payments will never take on C payrolls.

Instructions

Institution Process:

Verify the employee completes the following sections of the State Group Health insurance application:
- Section 1: Applicant Information
- Section 2: Spouse Information
- Section 12: Decline Health Insurance and Elect the Opt Out Incentive marked YES
- Section 13: Employee signature and dated
Complete the Employer Information section.
Enter information in Section 11 into HRS - Benefits Personal Data page.
Enroll the employee into the Health Opt-Out plan in HRS - On-Demand page.
If the employee rescinds their Health Opt-Out enrollment, update HRS to remove/change the Health Opt-Out enrollment.

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UWSS Service Operations Process:

Complete initial verification.
Send to ETF to verify eligibility.
Create a ticket with Empl_ID, Employee Name, and Health Opt-Out verification.
Notify the employee of approval or denial.
- If Health Opt-Out is denied, remove enrollment from HRS.

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Additional Resources

Related KBs:

[Link for document 17882 is unavailable at this time.]

Related Links:

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