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  • InsideTrack
  • December 02, 2020

    It's Open Enrollment Season: Is Your Firm Eligible for State Bar Group Health Plan?

    Now is the time to make health care coverage decisions for 2021. The State Bar's Group Health Plan may help you gain coverage and save money. Here's where to find out more.
    health insurance family

    Dec. 2, 2020 – Now is the time to review whether your current health coverage is the best fit for your firm. For coverage effective Jan. 1, 2021, all paperwork must be submitted by Dec. 15, 2020.

    First available in 2020, the State Bar of Wisconsin Group Health Plan is another health care insurance option for members in firms of two or more employees.

    The Group Health Plan allows law firms to be underwritten outside of “community rating.” This means rather than being rated as an entire pool, health underwriting allows your firm to be rated accordingly, unlike ACA plans which do not allow this type of underwriting.

    How Does the Group Health Plan Work?

    The plan is a group plan option for employer firms to offer for employees (attorneys and staff) and their eligible dependents. While the open enrollment period beginning Nov. 1 is the most common timeframe for reviewing health insurance, firms can change health care coverage at any time throughout the year without disrupting deductibles paid on existing plans.

    Firms of two or more employees may qualify for the plan if they have at least one non-family member employed in your office that works 26 hours or more per week.

    Under current Federal and State association group health plan law, the plan cannot provide coverage to individual attorneys either working as solo practitioners without nonfamily employees, or as individual participants outside their firm’s employee group health plan.

    The Group Health Plan offers large-group coverage for small groups that band together, resulting in large group pricing and potential cost-savings for smaller firms. In fact, groups of 2-9 people are seeing a 15% premium reduction in rates for coverage effective Jan. 1, 2021.

    While there is an obvious benefit to small firms as a result of pooling together and sharing the risk, large firms can benefit as well by joining an even larger group to absorb the risks and help the plan operate more cost-effectively. Benefits of participating in the group health plan are that:

    • cost savings is greater by pooling risks with others;

    • premiums are based on the size of the pool, not the size of your office;

    • you can choose from multiple plan options;

    • employer contributions are recommended, but not required;

    • each employee does not need to accept coverage – it just needs to be offered; and

    • you can combine your group health care coverage with tax-advantaged medical benefits accounts to save even more.

    If you suspect that you could be saving more on your health care coverage, the State Bar of Wisconsin Group Health Plan could be the right fit.

    Plan Details

    Coverage statewide is provided through WPS Health Insurance – and allows access to out-of-state care with renowned Mayo Clinic.

    Recognizing the increased need for mental health coverage as a result of the pandemic, the comprehensive plan was recently expanded to include coverage for the most commonly prescribed antidepressants with no cost-sharing.

    In Dane County, coverage is provided by Quartz, granting you access to UW-Health Hospital and Clinics for all your medical and health care needs.

    How Your Firm Benefits – By Firm Size

    For solo/small firms: Pool risks with others for greater cost-savings. Premiums are based on the size of the pool, not the size of your office. The larger the pool, the more you’ll save.

    For medium-sized firms: Save time by enlisting the support of the benefits specialists at Professional Insurance Programs to administer your health plan. Use a comprehensive health plan as a valuable recruitment and retention tool.

    For large firms: Recognize greater savings by taking your already sizeable group and adding it to an even larger pool to absorb risks and help the plan operate more cost-effectively. See less fluctuation in your premiums.

    All firms: Combine group health care coverage with medical benefits accounts from TASC and get pre-tax savings through Health Savings Accounts (HSAs), Health Reimbursement Arrangements (HRAs), and Flexible Savings Accounts (FSAs).

    Please note that, under current federal and state association group health plan regulations, the plan is not available to State Bar members living outside Wisconsin, individuals whose firm chose not to adopt the plan, and solo practitioners without nonfamily member employees.

    Who Do I Call to Get a Quote?

    While there is no denying that premium is an important consideration, the true cost of any health plan is more complicated than just the outlay for premiums. The process of reviewing health coverage may be daunting, but it’s worth taking some time to look at how your current plan is performing.

    For more information on the State Bar Group Health Plan, contact:

    Professional Insurance Programs (PIP)
    (800) 637-4676

    Visit PIP’s website for information on the State Bar of Wisconsin Group Health Plan.

    What Additional Health Care Programs Are Available?

    For additional cost-savings measures, including the Group Dental Plan through Delta Dental, the EyeMed Vision plan, and supplemental Critical Illness and Accident Coverage, contact:

    Bultman Financial Services, Inc.
    (800) 344-7040 or (262) 782-9949


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