It's Your Choice 2006
This section includes information provided by each health plan
to assist you in selecting your plan for the coming year. Plans
may provide you with additional information through mailings during
Dual-Choice and as a participant with a specific plan. Read this
section carefully and contact the plan for more information.
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.
- 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
must select PCPs in the same clinic or IPA or if women may select
OB/GYN as their PCP.
Hospitals who are participating with the Leapfrog survey are recognized
on the following pages. Please review Section C, questions 37 and
39, and see the survey results at www.leapfroggroup.org for more
One Frog is awarded when a hospital has recently submitted data
A second Frog is awarded to the hospital based on the results they
achieved in the fourth ‘leap’. The fourth leap is focused
on patient safety, uses the National Quality Forum (NQF) endorsed
measures and applies to ALL hospitals (rural/urban). A hospital
receives a second frog when their results on this leap are either
a full pie or 3/4 pie, meaning full implementation on the measure
or good progress in implementing measure respectively. When you
visit the Leapfrog website and click on the pie for this fourth
measure for a hospital, you are able to see the progress of that
hospital for each of the individual 27 NQF safety measures.
A checkmark is awarded to a hospital when it has provided data
for ALL of the error prevention measures and 2 out of the three
clinical measures (treatment of heart attacks, heart failure and
pneumonia.) More information about CheckPoint appears in Section
C, questions 38 and 39 and on their web side www.checkpoint.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 alternate plans. 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:
Compcare Health Services Insurance Corporation
Dean Health Plan
Group Health Cooperative – Eau Claire
Group Health Cooperative – South Central
Medical Associates HMO
MercyCare Health Plan HMO
Network Health Plan
Physicians Plus Insurance Corporation
WPS Patient Choice Plan 1
WPS Patient Choice Plan 2
2006 Health Plan Features
Comparison of State Plan
Plans With Uniform Benefits
The PBM & Plans Without Uniform Benefits