Open Enrollment Approved for 2027
The Group Insurance Board (GIB) officially approved the 2027 open enrollment period on February 25, 2026. Wisconsin state employees and eligible members will have the window of October 5–30, 2026 to review and update their health insurance selections.
This decision gives members ample time to prepare. Knowing the dates well in advance allows HR administrators and employees alike to plan accordingly. Early awareness also helps members make more informed choices about coverage options.
The Board directed the Department of Employee Trust Funds (ETF) to schedule a special meeting within two weeks to address several items that needed additional review before final decisions.
Plan Design Changes Under Review
Why the Board Deferred
The Board examined several proposed plan design changes and related cost-sharing adjustments during this meeting. However, members chose to defer the final decision to a future session. This approach reflects the Board’s commitment to thorough evaluation before implementing changes that affect thousands of Wisconsin public employees.
Cost-sharing adjustments can significantly impact members’ out-of-pocket expenses. Therefore, the Board wants to ensure all proposals receive careful consideration and data-backed analysis before approval.
Access Guidance Services Decision Deferred
What Is the AGS Program?
The Access Guidance Services (AGS) program targets non-Medicare members currently enrolled in high-cost drug therapies. Specifically, AGS would allow these members to apply manufacturer copay coupons toward their cost sharing and out-of-pocket limits. This can lead to meaningful savings for individuals managing chronic or complex conditions.
Why the Decision Was Delayed
The Board deferred its AGS decision because it needs additional data on cost savings for the Group Health Insurance Program (GHIP). Approving the program without complete cost analysis could create unintended financial consequences for the broader member pool. Consequently, ETF will gather and present this information at the upcoming special meeting.
Key Coverage Highlights for 2027
The Board approved several notable coverage enhancements for plan year 2027. These changes aim to modernize benefits and align with current medical standards.
Compression Garments for Lymphedema
Coverage for compression garments used to treat lymphedema will increase. This update aligns Wisconsin’s program with Centers for Medicare and Medicaid Services (CMS) policy, ensuring members receive care consistent with federal standards.
Therapy Visit Limits Restructured
Currently, physical, speech, and occupational therapy each carry separate visit limits. The Board approved combining these into a single, unified limit across all therapy disciplines. This change gives members greater flexibility in managing their rehabilitation needs.
Expanded Coverage for Chronic Conditions
The Board extended coverage for health benefits related to degenerative eye diseases, sleep apnea, and other chronic conditions. As a result, more members can access necessary care without facing coverage gaps.
Anti-Obesity Medications Update
Where Things Stand
ETF presented a detailed update on the anti-obesity medications (AOMs) marketplace. The update covered current usage trends, health outcomes data, and cost projections. Additionally, the Board reviewed a proposal for a separate formulary tier for AOMs — one that would include manufacturer rebates alongside higher out-of-pocket costs for members.
No Action Taken Yet
Despite the review, the Board took no action on adding AOMs at this meeting. This decision reflects the complexity of integrating new drug categories into a large public benefits program. Further discussion and analysis will inform future decisions on this topic.
Well Wisconsin Program Discussions Begin
A Strategic Conversation Starts
The Board began the first of several planned discussions on the Well Wisconsin Program — specifically addressing its purpose and long-term direction. These conversations signal a thoughtful review of how the wellness initiative serves members.
Next Steps for ETF
As a follow-up, ETF will evaluate the role of incentives within the program. The department will also research best practices and emerging trends in employer-based wellness across both public and private sectors. This research will help shape recommendations for the program’s future.
Other Board Approvals
Beyond the major agenda items, the Board approved several administrative and procedural updates:
- Annual officer elections — Chair Herschel Day, Vice Chair Nathan Houdek, and Secretary Nancy Thompson were officially elected to their roles.
- Primary care designation language — Changes clarify expectations for health plans designating a primary care provider or clinic, ensuring consistency across the program.
- Board governance updates — Non-substantive changes to governance policies and procedures were approved to keep documentation current.
What Comes Next
The Board’s work for 2027 planning continues on two fronts. First, the special March meeting will address the deferred items from this session, including plan design changes and the AGS program. Second, the Board is scheduled to set 2027 rates at its regularly scheduled meeting on May 21, 2026.
Members are encouraged to stay informed through ETF’s official channels as these decisions take shape. Open enrollment in October 2026 will reflect the final outcomes of these ongoing Board deliberations.
