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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)


2017 Health Plan Report Card

Grievance Rating

The 2016 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 2016 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
Dean Health Insurance (all plans) 1 33
GHC of Eau Claire 44
GHC of South Central Wisconsin  44
HealthPartners Health Plan 33
Medical Associates Health Plans 55
MercyCare Health Plans 22
Network Health 11
Quartz (all plans) 2 33
Security Health Plan (all plans) 3 22
WEA Trust (all plans) 4 33

TABLE KEY

Sort columns by clicking on the header.

5

Best rating

4

 

3

 

2

 

1

Worst rating

RESOURCES

List of MeasuresList of measures that make up ratings and the health plans’ results in each.

Meathods UsedReview our methods used for developing these ratings.

List of MeasuresAvailable Health Plans and links to plan description pages.

notes:

1.Participating Dean plans include Dean Health Insurance and Dean Prevea360.
2Participating Quartz plans include Community and UW Health. Result is the average of Gundersen, Physicians Plus and Unity ratings that is weighted based on the number of ETF members enrolled in each plan for 2016.
3Participating Security Health plans include Central and Valley.
4.Participating WEA Trust plans include East, Northwest Chippewa Valley, Northwest Mayo Clinic Health System, IYC Access Health 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: 9/11/2017 4:59:40 PM