It's Your Choice 2019
State Maintenance Plan (SMP)Administered by WEA Trust
Open Enrollment October 1 – 26, 2018
If you are currently enrolled in SMP and do not wish to change plans during open enrollment, you will remain enrolled. Note however, the service area has changed.
What’s New for 2019
State members: SMP will only be offered in Forest County for 2019. It will no longer be offered in Florence County.
Local members: SMP will be offered in Buffalo, Florence, Forest, Marinette, Pepin, Pierce, Polk, Rusk, Shawano, St. Croix, Waupaca, Waushara and Wood counties. It will no longer be offered in Iron and Price counties.
The State Maintenance Plan, or SMP, is a health plan that offers Uniform Benefits. SMP offers in-network providers in some Michigan (for State and Local members) counties.
Go to weatruststatehealthplan.com/providers to search for providers or to access a SMP directory. To request a printed directory be mailed to you, call 1-866-485-0630.
Referrals, Prior Authorizations
You must get a referral approved by WEA Trust before getting care outside the WEA Trust SMP network. Your provider must request the referral. It is ultimately the member’s responsibility to make sure the referral is submitted and approved prior to receiving services.
Prior authorization is required for certain services and procedures before you receive care. Without an approved prior authorization, WEA Trust may deny payment. A list of services requiring preauthorization can be found at https://weatrust.com/preauthorization. You will receive notification of the approval or denial for the prior authorization.
SMP, offered by WEA Trust, will reimburse for covered services at 50% of our maximum allowable fee, subject to a $5,000 individual, $10,000 family deductible.
State employees and State retirees only: Forest County
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 1-866-485-0630 or your primary care physician if assistance is needed to determine the appropriate level of care. Follow-up care must be performed by a network provider to receive network benefits.
Mental, Behavioral Health and Substance Abuse Services
No prior authorization is required for outpatient services from a network provider, except for psychiatric and neuropsychiatric testing. Prior authorization is required for in-patient and transitional care. For other services, contact 1-866-485-0630. Review the Uniform Benefits certificate for details.
WEA Trust contracts with a variety of health care provider systems that offer their own nurselines. A list of those nurselines can be found at weatruststatehealthplan.com/nurseline.
This page was last modified on: 9/7/2018 10:59:51 AM