Oct. 18, 2023 – With increased wages, inflation, and medical utilization combined with sky-rocketing pharmaceutical costs, health care coverage premiums continue to rise. While it does not directly impact Wisconsin, the largest health care worker strike in U.S. history is a sign of the turmoil within the medical industry, resulting in higher health care coverage costs.

According to the Kaiser Family Foundation, small employers (defined as 3-49 workers) continue exploring alternative health care options and the percentage of workers covered by these alternative arrangements has increased from 21% in 2019 to 41% in 2022.

Before reducing coverage, decreasing employer contributions, or eliminating coverage completely for attorneys and law firm staff when you receive your premium increase, consider exploring the State Bar’s group health plan for law firms as a cost-saving option.

About The State Bar Group Health Plan for Law Firms

The State Bar of Wisconsin Group Health Plan for Law Firms provides an option to consider in offering health care options to attorneys and staff. While it may not be the answer for every firm, now is the time to submit details for a price quote to determine whether it reduces your costs.

November’s open-enrollment timeframe brings this topic to the forefront, but law firms can enroll in the group health plan at any time throughout the year, not just during the open enrollment period. Coverage is provided by Wisconsin Physicians Service Insurance Corporation (WPS, WPS Health Insurance).

The process is painless. Hear from Jennifer Stuber of Stuber Law, LLC, in Three Lakes, about her experience:

If you’ve heard about the State Bar’s group health plan for law firms and wondered if it would save your firm health care costs, take it from me, it’s worth checking out! I took the time to request a rate quote and I was pleasantly surprised to find out the plan saved me $1,000/month. That’s no typo! The process to request a quote was quick and easy, and the plan administrators were very helpful. I was very happy with the plan options and the comprehensive coverage provided. I encourage you to check into the plan. It’s time well spent!

If you haven’t looked into the group health plan for law firms to see if it’s an option for you, here’s some information to consider surrounding common myths that may be holding you back.

Myth: Only lawyers in my law firm qualify for coverage under the group plan.

Fact: The group health plan is open to lawyers and nonlawyer staff, and their spouses and dependents, in law firms with two or more nonfamily employees in Wisconsin that are considered employers under current association health plan law.

Under current federal and state association health plan law, the State Bar’s plan cannot provide coverage to individual attorneys either working as solo practitioners without at least one nonfamily employee, or as individual participants outside their firm’s employee group health plan. In other words, this plan is not an option if you are unhappy with the health care plan currently being offered by your law firm or employer.

Myth: All members in my law firm must accept coverage for us to be eligible to participate.

Fact: There is no requirement that everyone in your law firm accept the coverage. There is a requirement that you offer coverage to every nonfamily employee who works 26 hours or more per week unless your law firm employee handbook defines full-time as 30 hours or more. Anyone covered under another plan may decline coverage.

Myth: The plan only covers employees who are full-time.

Fact: For plan purposes, full-time is defined as anyone working 26 or more hours per week, unless your law firm employee handbook defines full-time as 30 hours or more. Anyone covered under another plan may decline coverage. Once you have qualified that you are a “group,” you’re set to check into further plan options and details.

Myth: The federal subsidies for the open market plans make health care more cost-effective than the group health plan.

Fact: Federal subsidies are available for individuals and families with net incomes within a certain range of the federal poverty level to purchase health care coverage in the federal or state Marketplace. The subsidies catch the attention of newer attorneys who have no dependents and who are looking for low-cost, bare-bones coverage. But a closer look at the benefits provided under the ACA plans compared with the group health plan for law firms shows there’s a big difference.

If the group health plan offers attractive coverage at a more affordable price to most in your firm, but newer attorneys prefer using the federal subsidy toward their coverage, you might want to provide the new attorneys with your own incentive by matching the federal subsidy, or a contribution of some kind toward their health care coverage costs. Depending on the math, building a long-term, loyal employee may be worth the investment.

Unfortunately, you’re not eligible for a subsidy in the federal or state Marketplace if your employer offers coverage that’s considered affordable and provides minimum value.

Myth: The plan requires the employer to contribute to the cost of the employee’s health care coverage.

Fact: Employers can select up to four plan options within one carrier from a menu of six Copay Plans and six HSA-Qualified High Deductible Health Plans. This gives your employees flexibility when selecting a plan that meets their needs as an individual or for a family.

The employer has the option to select the contribution level for the employees, if any. This gives the employer the freedom to attract and retain law firm talent in a challenging employment environment. Plan administrators suggest employers contribute 50% of the single premium, but there are no legal or plan requirements in place.

Myth: The plan is low cost because it offers a small provider network and limited benefits.

Fact: The group health plan offers a statewide network of providers and a variety of benefits in several different options. Those covered under a qualifying WPS statewide network can enjoy access to in-network benefits when they visit First Health Network providers in 49 states outside Wisconsin. The First Health Network includes access to Mayo Clinic for second opinions and treatment. This is ideal for those who travel or have children attending college or living out of state.

The Plan affords preventive services without cost-sharing when care is received from in-network providers for routine immunizations, routine medical exams including routine diagnostic services, well-child care, mammograms, and preventive screenings.

The Plan provides for a $0 copay on select preventive drugs aimed at managing chronic conditions more effectively. It also covers a comprehensive list of common medications used to treat asthma, depression, diabetes, high cholesterol, and high blood pressure (available in both generic and brand names).

Additionally, several value-added benefits are provided at no additional cost. These include:

• Telehealth services from Teladoc;
• EyeMed Vision Discount Program;
• Hearing Care Solutions;
• Pulmonary Care Program (to manage Asthma/COPD);
• Diabetes Care Program (welldoc);
• Tobacco Cessation Assistance; and
• Active & Fit Direct Program.

There is convenient access to online tools and resources for even more health and wellness information.

Where to Find Out More about the State Bar Group Health Plan for Law Firms

Visit the Professional Insurance Program’s website on the State Bar Group Health Plan for Law Firms.

Information and rate quotes can be obtained from the following representatives at Professional Insurance Programs:

Christine Nadolski
Benefits Manager
cnadolski@profinsprog.com
Phone: (414) 755-4172

​Wendy Block
Senior Account Manager
wblock@profinsprog.com
Phone: (414) 755-4185​

Law firms can enroll in the group health plan at any time throughout the year, not just during open enrollment time in November. For coverage effective Jan. 1, 2024, paperwork must be submitted by Dec. 15.