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Wisconsin Department of Employee Trust Funds header image It's Your Choice 2018 Local Deductible Health Plan Insurance Program
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2018 It's Your Choice - Local Deductible Health Plan Insurance for Employees and Retirees
Wisconsin Department Of Employee Trust Funds It's Your Choice 2018


Local Deductible Plan
Insurance for Employees
and Retirees
(PO4, PO14)


Network Health

844-625-2208
networkhealth.com

Open Enrollment October 2 – 27, 2017

If you are currently enrolled in Network Health Northeast or Network Health Southeast and do not wish to change health plans during open enrollment, you will automatically be enrolled in the new combined Network Health offering.

You do not need to take action during open enrollment unless you would like to select a health plan other than Network Health for 2018.

What’s New for 2018

Network Health will no longer be separated by northeast and southeast. We'll offer a comprehensive plan offering and provider network. Network Health members will have access to more than 1,845 primary care doctors, 11,045 specialists and 50 hospitals.

Menominee, Marinette and Kenosha counties are included in Network Health's service area for 2018. See below for a full list of counties in our 2018 service area.

A dedicated customer service line has been created for the State of Wisconsin and Wisconsin Public Employer Group Health Insurance Program enrollees. By calling 844-625-2208 or 920-720-1811, you'll be connected with Network Health representatives who are specially trained to answer State of Wisconsin and Wisconsin Public Employer Group Health Insurance Program questions. Representatives can be reached Monday-Thursday from 7:30 a.m. to 6 p.m. and Friday from 7:30 a.m. to 5 p.m.

Network Health is enhancing its member portal experience. In 2018, the landing page you see when you sign in to the portal will look different. You may be prompted to update your credentials, including, but not limited to, creating a new password. The member portal will also become mobile responsive, making it easier for you to view and keep track of your health, benefit information and claims from a mobile device.

The member portal can be accessed at networkhealth.com/MyAccount. If you're a new member, you'll have access to the portal on the date your coverage is effective. You can also connect with Network Health on Facebook, Twitter, LinkedIn and YouTube. At NetworkHealthConnections.com and CoPilotWI.com, you can find inspirational stories, videos, education and tips about life, health and wellness.

Provider Directory

Go to networkhealth.com to access a provider directory. Click Find a Doctor and choose "2018 State of Wisconsin employees/members" 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 844-625-2208.

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 844-625-2208 prior to the appointment.

Service Area

Brown, Calumet, Dodge, Door, Fond du Lac, Green Lake, Kenosha, Kewaunee, Manitowoc, Marinette, Menominee, Milwaukee, Oconto, Outagamie, Ozaukee, Portage, Racine, Sheboygan, Washington, Waukesha, and Winnebago counties.
Limited provider availability in: Marquette, Shawano, Waupaca and Waushara 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 844-625-2208 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. For non-emergent care, use MDLIVE®
virtual visits to access board-certified doctors by phone, secure video or the MDLIVE App. To access MDLIVE, visit MDLIVE.com/networkhealth.

Mental, Behavioral Health and Substance Abuse Services

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. You may also access BreakThrough, a teletherapy program offered by MDLIVE behavioral services. This service is offered by phone or secure video and is HIPAA-compliant. To access this service, visit MDLIVE.com/networkhealth.

24-Hour Nurseline

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

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: 9/27/2017 3:25:52 PM