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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 Health Plan
Insurance for Employees
and Retirees

Network Health Northeast


What’s New for 2016

Froedtert Hospital, Medical College of Wisconsin, Children’s Hospital of Wisconsin and Children’s Hospital Fox Valley are available for specialty care. University Healthcare, Inc., Hospital and Physician Clinics (UW Health) will no longer be participating in our provider network effective January 1, 2016.

Network Health offers a nurse line 24 hours a day, seven days a week, for those need-it-right-now situations. It’s a great resource for:

  • help figuring out where to go for care if it’s not an emergency,
  • advice on general health issues,
  • instructions for current medications or newly prescribed ones.

Provider Directory

Go to to access a provider directory. Click “Find a Doctor,” choose “State of Wisconsin Northeast” as your plan, enter your location and search for a provider. Or, click on Printable Directory on the right. To request a printed directory be mailed to you, call 1-800-826-0940.

Referrals, Prior Authorizations, Out-of-Network Care

Referrals are not needed when receiving care from in-network providers. Prior authorization (or prior approval) is required for certain services, procedures and for out-of-network providers before you receive care. You will receive written notification of the approval or denial for the prior authorization. If you are unsure if a service, test or procedure requires prior authorization or a referral, call 1-800-826-0940 prior to the appointment.

Service Area

Qualified: Brown, Calumet, Dodge, Door, Fond du Lac, Green Lake, Manitowoc, Oconto, Outagamie, Shawano, Sheboygan, Waupaca, Waushara and Winnebago counties.
Non-qualified: Kewaunee and Marquette counties.

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 Network Health at 1-800-826-0940 or your primary care physician if assistance is needed to determine the appropriate level of care. Follow-up care must be received from an in-network provider unless otherwise approved by Network Health.

Mental, Behavioral Health and Substance Abuse

Prior authorization (or prior approval) is required for autism treatment and any inpatient service for mental health, behavioral health or substance abuse services. Contact 1-800-555-3616 for assistance. After hours, please call your provider.

24-Hour Nurseline

Network Health's Nurse Line: 1-888-879-8960

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: 9/23/2015 5:02:41 PM