Wisconsin Marketplace Health Insurance Plans
Qualified Plans on Health Insurance Marketplace
Beginning October 1, 2013, each state was required by law to have a new online marketplace where residents can buy health insurance. In these marketplaces, most states will offer five tiers of Obamacare Health Exchange Plans: platinum, gold, silver, bronze and catastrophic. Platinum plans will offer the highest level of coverage but tend to cost more in monthly premiums. Bronze plans will cover only a bare minimum of health care expenses but tend to have low premiums. If you are relatively healthy and want to pay less up front, consider a lower-tier plan such as bronze or silver.
You should also look at a Health Insurance Marketplace plan if you are lower-income, because the government will give financial help on a sliding scale to pay for premiums, and better benefits if you select a silver-tier plan. If you have not already done so, we can tell you if a Health Insurance Marketplace plan makes sense given your income on the State Overview tab, under the heading, "Do I Qualify For a Tax Break?"
Read ACA and Health Insurance: Which "Metal" Tier is Right for You? for more advice on choosing between metal tiers.
Ninety-seven exchange plans are available in Wisconsin, though many are offered only in certain counties, reports The Wisconsin State Journal. According to the Post-Crescent, residents of 59 of Wisconsin’s 72 counties can choose from at least two insurance carriers. In Dodge, Jefferson, Shawano and Walworth, residents have a choice of six insurers. In Milwaukee and Dane counties, there are four competing insurers. No insurer offers plans for residents living in Florence, Green Lake, Lafayette, Marquette and Menominee counties, according to the Post-Crescent.
Arise (formerly WPS Health Plan). In 2006, WPS rebranded itself as Arise Health Plan. It's one of the largest health insurance companies in Wisconsin and the only nonprofit to offer statewide coverage to both the public and private sectors, according to the company. Arise offers HMO and PoS exchange plans in every tier.
Common Ground Healthcare Cooperative (CGHC). With a $56.4 million federal loan, this new, nonprofit, member-governed co-op offers exchange plans in the following 19 counties of eastern Wisconsin: Marinette, Oconto, Door, Shawano, Kewaunee, Brown, Outagamie, Manitowoc, Calumet, Winnebago, Fond du Lac, Sheboygan, Washington, Ozaukee, Waukesha, Milwaukee, Racine, Walworth and Kenosha. CGHC offers PPO exchange plans in Catastrophic through Gold tiers.
CompCare Health Services Insurance Corporation (Anthem). Established in 1969 as Comprehensive Care Corporation, CompCare is the health maintenance organization (HMO) subsidiary of Blue Cross and Blue Shield of Wisconsin (BCBSWi), according to Anthem. CompCare is affiliated with the Blue Cross and Blue Shield Association, the oldest U.S. health insurance system. The Blue Cross and Blue Shield Association offers coverage in all 50 states, Washington, D.C., and Puerto Rico and has 37 Blue Cross and Blue Shield companies that serve over 100 million members (one third of all Americans), according to the company. Nationally, Blue Cross and Blue Shield companies have contracts with over 96 percent of hospitals and 91 percent of providers. Wisconsin residents who buy a CompCare exchange plan may not have access to the entire Anthem Blue Cross and Blue Shield network of doctors and hospitals. Anthem offers PoS exchange plans in Catastrophic through Gold tiers.
Dean Health Plan. Established in 1904, Dean Health system is a for-profit company and claims to be one of the largest U.S. integrated healthcare systems, serving over 300,000 people. In 2013, DHP joined SSM Health Care system, which owns St. Mary’s Hospital and St. Clare Hospital in Wisconsin. DHP offers HMO exchange plans in Catastrophic through Gold tiers as well as a Bronze-tier EPO exchange plan.
Group Health Cooperative of South Central Wisconsin. Established in the mid-1970s, GHC-SCW is one of the oldest nonprofit, member-governed co-ops in the United States, serving more than 72,000 people. Group Health offers HMO exchange plans in every tier.
Gundersen Health Plan. Gundersen Health is a nonprofit health care system providing health services to residents in 19 counties in Iowa, Minnesota and Wisconsin. Gundersen offers coverage to residents living in the following 10 counties in Wisconsin: Buffalo, Crawford, Grant, Jackson, Juneau, La Crosse, Monroe, Richland, Trempealeau and Vernon. Gundersen is affiliated with the following hospitals: Palmer Lutheran Health Center, Gundersen Tri-County Hospital and Clinics, and St. Joseph’s Health Services–Gundersen Lutheran. Gundersen offers PoS exchange plans in every tier.
Health Tradition Health Plan. Established in 1986 as Greater La Crosse Health Plans, Health Tradition has over 40,000 members, according to the company. Health Tradition offers HMO exchange plans in Catastrophic through Gold tiers.
Medica Health Plans of Wisconsin. Established in 1975 as Physicians Health Plan, Medica became an independent health plan in 2001. Medica has over 1.5 million members in Minnesota and parts of Wisconsin, North Dakota and South Dakota. Its network includes 27,000 doctors at over 4,000 medical facilities. Medica offers PPO exchange plans in Catastrophic through Gold tiers.
MercyCare Health Plans. Established in 1994 as a subsidiary of Mercy Health System Corporation, MercyCare has more than 40,000 members in southern Wisconsin and northern Illinois, according to the company. Its service area includes the following counties: Jefferson, Green, Rock, Walworth and McHenry. MercyCare offers HMO exchange plans in Bronze through Gold tiers.
Molina Healthcare of Wisconsin. Established in 1980 in California, Molina Healthcare is a multi-state health care organization with a focus on providing government-sponsored health services to over 5 million Americans in 15 states, according to the company. In Wisconsin, Molina offers HMO exchange plans in Silver and Gold tiers.
Physicians Plus Insurance Corporation. Established in 1986 and owned by Meriter Health Services, Physicians Plus serves more than 105,000 residents of south-central Wisconsin. Its network includes more than 3,000 providers in 20 Wisconsin counties, according to the company. Physicians Plus offers HMO exchange plans in Catastrophic through Gold tiers.
Security Health Plan of Wisconsin. This nonprofit health maintenance organization (HMO) has several networks offering coverage in different regions of Wisconsin. A complete listing of each network’s service area is available. Security Health offers HMO and EPO exchange plans in Catastrophic through Gold tiers.
Unity Health Insurance. Tracing its history back to 1983, Unity Health became a subsidiary of University Health Care (UHC) and affiliated with the University of Wisconsin Hospitals and Clinics Authority (UWHC) as well as the University of Wisconsin Medical Foundation (UWMF) in 2005, according to the company. Unity Health offers HMO exchange plans in every tier.
Last updated by Heilbrunn, Evi | December 5, 2013