Date: October 12, 2006
For more information contact: Eileen Mallow, Assistant Deputy Commissioner, (608) 266-7843 or eileen.mallow@wisconsin.gov

Open Enrollment Raises Health Insurance Questions

Madison, WI—October brings an open enrollment period for health insurance for many persons. During open enrollment, employers who offer more than one health insurance plan give their employees a chance to choose a new insurer. This is the time for employees to think carefully about health insurance options they may have available to them.

"Here is the chance for consumers to pick the best health plan to meet their needs for the upcoming year," said Wisconsin Insurance Commissioner Jorge Gomez. "Employees should take a few minutes now to review any materials provided by their employer and compare them to their health and financial needs."

The Office of the Commissioner of Insurance offers the following tips for those who have an open enrollment option:

• Take time to evaluate the health care coverage you and your family are likely to need for the next year. Providers associated with health plans can change at any time, so make sure providers you want to see will continue to be available in your health plan.
• Make sure you understand any requirements your health plan has for referrals or prior authorization for services - they can vary among different plans.
• Consider your total cost for health care during the year. Higher deductibles can mean a lower cost for monthly premiums, but you will likely have higher out-of-pocket expenses at the time health care is provided.
• Compare benefits that may be available under the different options. There may be differences in benefits such as pharmacy, physical and occupational therapy or preventive care.
• Pay close attention to any dates for change documents to be filed with your employer.
• Do not be afraid to request information in writing from either the insurer or your employer.

There is also publicly available information on quality for some health plans that consumers may want to consider. Many HMOs participate in national quality studies and make available their quality scores. OCI publishes selected quality information in its brochure, Consumers Guide to Managed Care Plans in Wisconsin, available from the agency Web site at oci.wi.gov or by calling 1-800-236-8517.

Created by the Legislature in 1871, Wisconsin's Office of the Commissioner of Insurance (OCI) was vested with broad powers to ensure that the insurance industry responsibly and adequately met the insurance needs of Wisconsin citizens. Today, OCI's mission is to lead the way in informing and protecting the public and responding to its insurance needs.