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Wisconsin Department of Employee Trust Funds header image It's Your Choice 2019 Local Health Plan Insurance Program
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2019 It's Your Choice - Local Health Plan Insurance for Employees and Retirees
Wisconsin Department Of Employee Trust Funds It's Your Choice 2019


Local Health Plan
Insurance for Employees
and Retirees
(PO6, PO16)


Group Health Cooperative of Eau Claire

1-888-203-7770 or 715-552-4300
group-health.com

What’s New for 2019

Group Health Cooperative of Eau Claire is pleased to serve counties throughout Northern and Central Wisconsin.

Members of the Cooperative now have access to our care management app, Valera Health. Using Valera’s virtual chat function, Group Health Cooperative’s case management team has the ability to conveniently connect with members to provide support and self-help resources. The chat feature helps individuals manage behavioral health conditions like depression and anxiety as well as medical conditions such as asthma, diabetes and heart failure. Members have the opportunity to set goals, make connections to appropriate services and improve overall wellbeing. To learn more about the program, call 1-888-203-7770 to speak with Member Services.

Provider Directory

Go to group-health.com to access a provider directory. Use www.group-health.com/Directories/Providers.aspx as a direct path or visit www.group-health.com, choose “Members,” then “My Plan” and State of WI Group Health Insurance Program. To request a printed directory be mailed to you, call Member Services at 1-888-203-7770.

Referrals, Prior Authorizations, Out-of-Network Care

Referrals are not needed when receiving care from in-network providers. You must get a prior authorization before receiving care from an out-of-network provider, for all admissions and for select outpatient services. You will receive written notification of the approval or denial for the prior authorization. Members with low back pain are required to participate in a shared decision making tool to review information on options, outcomes and to clarify personal values. For further information regarding authorization guidelines, please visit group-health.com or call 1-888-203-7770 to speak with Member Services.

Service Area

Ashland, Bayfield, Burnett, Clark, Douglas, Iron, Langlade, Lincoln, Marathon, Oneida, Price, Sawyer, Taylor, Vilas and Washburn counties.

Emergency and Urgent Care Outside Service Area

If you require emergency or urgent care while outside the network, seek care at the nearest medical facility. Use the FirstCare Nurseline listed on your ID card if assistance is needed to determine the appropriate level of care. Follow-up care must be received from an in-network provider unless otherwise authorized by the Cooperative.

Mental, Behavioral Health and Substance Abuse Services

No referral is needed to see a provider in the Cooperative’s network. Prior authorization guidelines may apply for certain services; please contact Member Services at 1-888-203-7770 for additional information. Please refer to the provider directory for a listing of mental health providers in the Cooperative’s network.

24-Hour Nurseline

FirstCare Nurseline: 1-800-586-5473

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: 9/7/2018 8:23:42 AM