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Wisconsin Department of Employee Trust Funds header image It's Your Choice 2017 Local Traditional Health Plan Insurance Program
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2017 It's Your Choice - Local Traditional Health Plan Insurance for Employees and Retirees
Wisconsin Department Of Employee Trust Funds 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

RESOURCES

Meathods UsedReview our methods used for developing these ratings.

Quality resource linksOther Quality Resource links for ratings.

List of MeasuresHealth Plan Features and links to plan description pages.

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