Group Insurance Board Delays Action on Self-Insurance

December 14, 2016 10:09 AM | Sally Winkelman (Administrator)

December 14, Wisconsin Health  News

The Group Insurance Board delayed a decision Tuesday on changes to the health plan for state employees, including whether to shift to a regional or self-insurance model. 

Chair Michael Farrell said the board has directed Department of Employee Trust Funds staff and Segal Consulting to gather more information and data about the proposals. The board will reconvene in January.  

"There is much complexity and volumes of information that relate to our consideration," he said. "We're not taking these decisions lightly." 

During closed session Tuesday, members weighed seven scenarios offered by ETF staff, according to a memo.  

One proposal could continue the current fully insured model with minimal changes. That model would have up to 16 different vendors participating.  

Other scenarios under consideration would have between six and 11 participating vendors. Those proposals could be fully insured, self-insured or a hybrid. Some of them would divide the state into regions.  

A seventh proposal, which is not recommended by ETF or Segal, would have one or two vendors under a self-insured model.  

The board has been considering self-insurance off and on for five years according to the memo. It's also considering other changes like three-year contracts with health plans.  

Phil Dougherty, spokesman for the Wisconsin Association of Health Plans, said his members "recognize that more can be done in the current competitive model to achieve the state's financial and quality goals." 

"Moving to Segal's regionalization strategy would create the risk of reducing competition and choice, eliminating high quality healthcare networks and separating plan participants from their doctors and medical homes," Dougherty said in a statement. "The right answer for the state is to use the current competitive structure and Wisconsin health plans to build on what works." 

Read a summary memo on the proposals and discussion.