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Wisconsin Department of Employee Trust Funds header image It's Your Choice 2016 State of Wisconsin Group Health Insurance Program
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Wisconsin Department Of Employee Trust Funds It's Your Choice 2016


Local Deductible Plan
Insurance for Employees
and Retirees
(PO4)


WEA Trust – South Central

1-800-279-4000 or 608-276-4000
weatruststatehealthplan.com

What’s New for 2016

We are increasing our commitment to health and wellness in 2016! In addition to the $150 Well Wisconsin incentive, the WEA Trust is offering the following healthy enhancements:

  • Healthy Balance Rebate:  Members may receive a $100 per person, $200 per family rebate for a health club membership, Weight Watchers® classes, or community supported agriculture (CSA) share.
  • Amwell E-visits:  You can have a face-to-face online visit with a doctor any time, any day of the year. These video visits are a great solution for strep throat, sinusitis, urinary tract infections, or other minor, short-term conditions - anywhere you have a web-enabled device. Amwell e-visits are subject to the $15 office visit copayment.

Provider Directory

Go to weatruststatehealthplan.com/providers to search for providers or to access a directory. To request a printed directory be mailed to you, call 1-800-279-4000.

Referrals, Prior Authorizations, Out-of-Network Care

Referrals are not required for this plan. Prior authorization is required for certain services and procedures before you receive care. A list of services requiring preauthorization can be found at weatruststatehealthplan.com. You will receive notification of the approval or denial for the prior authorization.

Out-of-Network Care

WEA Trust will reimburse for covered services at 70% of our maximum allowable fee, subject to a $1,000 individual, $2,000 family deductible. For those enrolled in the High Deductible Health Plan, covered services are reimbursed at 70% of our maximum allowable fee, subject to a $5,000 single, $10,000 family deductible.

Service Area

Dane County

Emergency and Urgent Care Outside Service Area

If you require emergency or urgent care when outside of the network, seek care at the nearest medical facility. Contact 1-800-279-4000 or your primary care physician if assistance is needed to determine the appropriate level of care. Follow-up care must be performed by a network provider to receive network benefits.

Mental, Behavioral Health and Substance Abuse

No prior authorization is required for outpatient services from a network provider, except for psychiatric and neuro-psychiatric testing. Prior authorization is required for in-patient and transitional care. For other services, contact 1-800-279-4000.

24-Hour Nurseline

Not available.

Disclaimer:
Every effort has been made to ensure that this information is accurate, but may be subject to change. Please note revision dates located at the bottom of each page. In the event of conflicting information, federal law, state statute, state health contracts and/or policies and provisions established by the State of Wisconsin Group Insurance Board shall be followed.

This page was last modified on: 10/23/2015 2:37:15 PM