Group Insurance Board Approves Open Enrollment Period for 2027

In a significant meeting, the Group Insurance Board has officially approved the open enrollment period for the plan year 2027, which will take place from October 5 to October 30, 2026. This timeframe will enable members to review their options and select the best health plans to suit their needs.

During the meeting, the Board also considered various proposed options regarding plan design changes and potential cost-sharing adjustments. However, a final decision on these matters will be deferred until a future gathering, ensuring thorough evaluation and discussion.

One notable topic on the agenda was the Access Guidance Services (AGS) program, which aims to assist non-Medicare members who require high-cost medications. The program would enable these members to apply manufacturer copay coupons towards their cost-sharing and out-of-pocket limits. The Board decided to delay a decision on AGS pending further insights into the potential cost savings for the Group Health Insurance Program (GHIP).

Upcoming Special Meeting

To expediently address the deferred items, the Board has instructed the Department of Employee Trust Funds (ETF) to schedule a special meeting within the next two weeks. This meeting is crucial for ensuring that members have clear and accurate information regarding available plans and services.

Approved Changes for 2027

Several important changes have been approved for the 2027 health plans. Notably, coverage will now include:

• Enhanced coverage for compression garments utilized in the treatment of lymphedema, aligning with the Centers for Medicare and Medicaid Services (CMS) policy.
• An adjustment to the maximum number of physical, speech, and occupational therapy visits, consolidating these into a single, comprehensive limit across all therapy disciplines.
• Expanded health benefits to address degenerative eye diseases, sleep apnea, and other chronic conditions.

Additionally, ETF provided an update on the marketplace for anti-obesity medications (AOMs), highlighting trends in usage, health outcomes, and costs. The Board examined the potential for a separate formulary tier specifically for AOMs, which could involve rebates and increased out-of-pocket costs for members. However, there was no action taken on this proposal during the meeting.

Wellness Program Initiatives

The Board also initiated discussions about the Well Wisconsin Program, focusing on its objectives and future direction. ETF plans to review the role of incentives within the program and investigate best practices across employer-based wellness programs in both public and private sectors.

Other Board Decisions

In addition to the above, the Board approved the annual election of officers, confirming Chair Herschel Day, Vice Chair Nathan Houdek, and Secretary Nancy Thompson. Furthermore, they have made necessary adjustments to ensure consistency in coverage language, enhancing clarity regarding the designation of primary care providers or clinics.

As the Board prepares for the upcoming special meeting in March, they are also set to establish rates for 2027 at their scheduled meeting on May 21, 2026. This proactive approach demonstrates the Board’s commitment to delivering comprehensive and equitable health insurance options to its members.