It's Your Choice 2017
Local Traditional Plan
Insurance for Employees
and Retirees
(PO2, PO12)
2016 Health Plan Report Card
Grievance Rating
The 2015 grievance ratings for each health plan appears below.
The health plan’s grievance process is the first step in resolving member complaints. The most frequent types of grievances filed by ETF members in 2015 were related to:
- Coverage denials based on medical necessity
- Non-covered benefits
- Prior authorizations
- Plan administration
Lower rates may be more desirable when selecting a health plan. So lower grievance rates have higher star ratings. Higher grievance rates have less stars.
Grievance Rating
Health Plan |
Star Rating |
Anthem Blue |
11 |
Arise Health Plan |
22 |
Dean Health Insurance (all plans)1 |
44 |
GHC of Eau Claire |
55 |
GHC of South Central Wisconsin |
44 |
Gundersen Health Plan |
22 |
Health Tradition Health Plan |
33 |
HealthPartners Health Plan |
22 |
Humana (all plans)2 |
11 |
Medical Associates Health Plans |
55 |
MercyCare Health Plans |
22 |
Network Health (all plans)3 |
33 |
Physicians Plus |
44 |
Security Health Plan (all plans)4 |
33 |
UnitedHealthcare of Wisconsin |
33 |
Unity Health Insurance (all plans)5 |
33 |
WEA Trust (all plans)6 |
44 |
WPS (all plans)7 |
33 |
TABLE KEY
Sort columns by clicking on the header. |
5 |
Best rating |
4 |
|
3 |
|
2 |
|
1 |
Worst rating |
notes:
1.Participating Dean plans include Dean Health Insurance and Dean Prevea360
2.Participating Humana plans include Eastern and Western
3.Participating Network Health plans include Northeast and Southeast
4.Participating Security Health plans include Central and Valley
5.Participating Unity Health Insurance plans include Community and UW Health
6.Participating WEA Trust plans include East, Northwest Chippewa Valley and Northwest Mayo Clinic Health System
7.Participating WPS plans include the IYC Access Plan, State Maintenance Plan and IYC Medicare Plus
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: 9/19/2016 5:36:53 PM