Publications

It's Your Choice 2005

State of Wisconsin Employees
Graduate Assistants - University of Wisconsin

Plan Descriptions

This section includes information provided by each health plan to assist you in selecting your plan for the coming year. You should also review the Report Cards section. Plans may provide you with additional information through mailings during Dual-Choice and as a participant with a specific plan. Read all of this information carefully.

While we believe that most of the categories on the following pages are self-explanatory, participants may not be familiar with all of them. For example:

the number of PCPs (primary care physicians) indicated are the total contracted PCPs. It does not reflect PCPs who may be less than full-time with that plan or are affiliated with more than one alternate plan.
the number of board certified speciality care physicians refers to those who have passed a specialty board examination under the American Board of Medical Specialties, an umbrella organization for 24 medical specialty boards in the United States. Physicians eligible to take the exam have: graduated from an approved medical school, completed a specified type and length of training and have been in practice for a specified time.
the 24-hour nurse line refers to a service whereby you can contact nurses to discuss health concerns and receive advice about obtaining emergency or urgent care services.
the PCP restrictions refer to such issues as whether all family members must select PCPs in the same clinic or IPA or if women may select an OB/GYN as their PCP.

If you have questions about the information provided by the plan, contact the plan directly.

Hospitals who have completed the leapfrog survey are noted with frogs preceding their names. For more information on what this signifies, please refer to Section C, Common Questions and Answers, questions 34 and 36 or see the hospital survey results at the leapfrog web site: http://www.leapfroggroup.org.

Hospitals who have shared information with CheckPoint about up to five error prevention measures and 10 clinical interventions to treat heart attacks, heart failure and pneumonia are noted with a check mark. More information about CheckPoint appears in Section C, questions 35 and 36 and on their web site at www.wicheckpoint.org.

Plans Offering Routine Dental Care

The Uniform Benefits package provides health insurance coverage to eligible employees, annuitants, and dependents. The Uniform Benefits package does not include coverage for routine dental care. The Group Insurance Board permits participating plans the option to offer dental coverage to its members. The plans listed below have elected to provide some level of dental benefits. The benefits vary from plan to plan. There are no requirements regarding the minimum levels of coverage offered.

Please refer to Plan Description pages found in this Section for a more detailed explanation of dental benefits offered by the plan you are interested in. Contact the plan directly if you have specific questions regarding the dental coverage or dental providers.

Remember that there will be restrictions on dental providers that you may use, just as there are restrictions on providers you may access for medical care under the plan you select. It is possible that the plan does not have a participating dentist in your county. In that case, the plan will not be "qualified" in that county and you may have to travel to see a plan dentist.

Plans Offering Dental Benefits:

Atrium Health Plan
Compcare Health Services Insurance Corporation
Dean Health Plan
Group Health Cooperative – Eau Claire
Group Health Cooperative – South Central
Health Tradition
Humana
Medical Associates HMO
MercyCare Health Plan HMO
Network Health Plan
Physicians Plus Insurance Corporation
Unity-Community
Unity-UW Health

Note that effective January 1, 2005 the State Maintenance Plan (SMP) is changing its benefits to match those of Uniform Benefits. SMP will no longer offer preventative dental benefits for children.

Comparison of Uniform Benefits to SMP from 2004