Colleagues Who Live In Wisconsin

Dean Health Plan is the medical claims administrator for colleagues who reside in Wisconsin.

You have three Exclusive Provider Organization (EPO) medical options through HSHS:

  • Value option (formerly Basic option)
  • Premier option (formerly High option)
  • High Deductible Health Plan (HDHP) with Health Savings Account (HSA) - see below for more HSA information
  • Waive Coverage


Coverage Options

When you enroll in medical (including prescription drug coverage), you can choose from these coverage levels:

  • Colleague only
  • Colleague + Spouse/LDA
  • Colleague + Child(ren)
  • Colleague + Spouse and Child(ren)

Network

Depending on the zip code of your primary home residence, your provider network is: 
  • HSHS/Prevea 360
  • HSHS/Prevea 360/First Health
Prior Authorization

Out-of-network services will not be covered unless you first obtain a referral from your network provider and prior authorization from Dean Health Plan. Your network provider will need to submit a referral request to Dean Health Plan. If you have questions regarding the referral process, please contact Dean Health Plan at 1-888-895-1188. 


Find a Provider

To locate network providers, follow these steps:

2. Determine your network service area. Your network is determined by your home ZIP code.
3. Based on your network service area, select Find a Prevea360 provider or First Health provider.
 



Excluded Providers

The HSHS medical plan will not pay benefits for services received from particular providers. HSHS is proud of our facilities and physicians, and we want to encourage colleagues to use HSHS facilities and physicians for their care. The utilization of our own providers invests in our people and our organization, helping to build a stronger system of care in the communities we serve. Click HERE to see the list of excluded providers and facilities.
 

Traveling Outside Network Service Area

A referral is not required for urgent care when you are traveling outside your network service area and emergency care. For care required to treat an urgent situation while you are traveling outside your network service area or an emergency medical condition, the HSHS medical plan provides the same benefit level regardless of the provider who provides your care. 


Out-of-area Dependents

If you have a dependent that does not live in the Prevea360 service area, such as a child attending college, you can register your dependent with Dean Health Plan after you receive your Dean Health Plan ID card. Call Dean Health Plan to get started. Once your dependent is registered, the First Health network will apply for your dependent’s medical plan coverage.  

Health Savings Account (HSA)

Colleagues enrolled in the High Deductible Health Plan are eligible to utilize a health savings account (HSA) offered through HealthEquity. Money in your HSA is yours to use on qualified medical, dental and vision expenses or save for retirement. After signing up for your HSA you will receive a debit card in the mail from HealthEquity.

Advantages of HSAs include:

  • No "use it or lose it". The money is yours and the HSA rolls over year after year for use in the future or in retirement.
  • HSAs are triple-tax advantaged - contributions are deducted before taxes, investments and interest earned are tax-free, and money is never taxed if you use it to pay qualified medical, dental and vision expenses.
  • HSAs are individually owned accounts that you keep regardless of employer or insurance changes.

HSHS will make a $25 per-pay-period employer contributions to your HSA regardless of whether you are able to contribute anything to the account yourself. You are able to make additional pre-tax contributions up to IRS limits ($4,150 for self-coverage and $8,300 if you cover any dependents). Those 55 and older can contribute an additional $1,000. HSHS employer contributions count towards the IRS limits.

Colleagues who have other non-HDHP coverage are not eligible to contribute to an HSA. This includes those covered by Medicare, Medicaid, TRICARE, or a FSA or HRA that reimburses expenses before the HDHP deductible is met.

Visit learn.healthequity.com/hshs/hsa to learn more about HSAs and review a list of qualifying expenses.


Additional Resources

2024 HSHS Benefit Guide