Patient Rights and Responsibilities

As a participant in this health insurance program, you have certain rights and responsibilities. By becoming familiar with them, you will be able to make the most of your health care.

Program Option
  • Local Deductible Health Plan (PO14) & Supplemental Benefits
  • Local Deductible Health Plan with Uniform Dental (PO4) & Supplemental Benefits
  • Local Health Plan (PO16) & Supplemental Benefits
  • Local Health Plan with Uniform Dental (PO6) & Supplemental Benefits
  • Local High Deductible Health Plan (PO17) & Supplemental Benefits
  • Local High Deductible Health Plan with Uniform Dental (PO7) & Supplemental Benefits
  • Local Traditional Health Plan (PO12) & Supplemental Benefits
  • Local Traditional Health Plan with Uniform Dental (PO2) & Supplemental Benefits
  • State Employee and Retiree Health Plan & Supplemental Benefits

Quartz - Central

Major Health Systems
  • Aurora Health Care
  • Gundersen Health System
  • ProHealth Medical Group
  • UnityPoint Health - Meriter Hospital & Clinics
  • UW Health Hospitals & Specialty Clinics
Full Service Areas
  • Adams County
  • Columbia County
  • Dodge County
  • Fond Du Lac County
  • Grant County
  • Green County
  • Green Lake County
  • Iowa County
  • Jefferson County
  • Juneau County
  • Lafayette County
  • Marquette County
  • Richland County
  • Rock County
  • Sauk County
  • Walworth County
  • Waukesha County
  • Waushara County
  • Wood County
Limited Service Areas
  • Illinois
  • Iowa
  • Minnesota
ET-2311
Form Active Employee / Local Employer / State Employer

COBRA Continuation - Conversion Notice

Under federal law, known as COBRA, you and your qualified beneficiaries may continue group health insurance coverage, if eligible.

Quartz - West

Major Health Systems
  • Black River Memorial 
  • Crossing Rivers Health 
  • Gundersen Health System 
  • OakLeaf IPA and Surgical Hospital 
  • Tomah Health
  • UW Health Hospital & Specialty Clinics
  • Vernon Memorial Healthcare 
Full Service Areas
  • Chippewa County
  • Crawford County
  • Eau Claire County
  • Jackson County
  • La Crosse County
  • Monroe County
  • Trempealeau County
  • Vernon County
Limited Service Areas
  • Buffalo County
  • Clark County
  • Pepin County
  • Illinois
  • Iowa
  • Minnesota
Flyer Active Employee / Local Employer / State Employer

Well Wisconsin Launch Flyer

The new Well Wisconsin portal is simpler, easier to use, and more customized to your personal experience. Complete a health assessment, health check, well-being activity to earn a gift card.