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Resource Center
2016 Flexplan Decision Guide
Eastern Wisconsin Resources
Plan Summaries
Summary of Benefits and Coverage




You have three medical options through the HSHS Healthy Plan:

All of the options:

  • Are administered for HSHS by Blue Cross Blue Shield of Illinois.
  • Cover the same basic medical services.
  • Include prescription drug coverage - with separate deductibles and out-of-pocket maximums.
  • Feature preventive care and wellness benefits designed to help you stay healthier.
  • Offer a network of doctors, hospitals and healthcare specialists who deliver quality care according to network standards and have agreed to low, preferred rates for covered services. Network providers include:
    • HSHS Facilities, HSHS Medical Group providers, HSHS Preferred Specialists, and HSHS Preferred Primary Care Physicians. Click here to locate HSHS Preferred Providers and HSHS Medical Group Providers.
    • Other network providers that participate in the Blue Cross Blue Shield PPO provider network. Click here to locate a Blue Cross Blue Shield PPO provider.

Your share of the cost of the medical services you receive will differ based on:

  • The option you select. In general, as you increase the plan level (move from Basic to Intermediate or from Intermediate to High) your biweekly payroll cost for coverage increases, while your cost of care (deductible amounts and coinsurance levels) decreases.
  • Use of HSHS services. The medical plan options offer preferred benefits when you or your dependents choose care at an HSHS hospital or receive care from an HSHS Primary Care Physician or HSHS Preferred Specialist. The plan provides an incentive to use HSHS Facilities and HSHS Preferred Primary Care Physicians whenever you can - in the form of lower deductibles, coinsurance and out-of-pocket maximums.
  • Your choice of providers. You have the flexibility to go outside the network, but if your out-of-network provider's charge exceeds the reasonable and customary (R&C) rate, you will be responsible for paying the amount above R&C as well as the deductible and/or coinsurance amount that applies to the medical option you select.

Compare Your Options

Review the Medical Plan Options Comparison Chart in the Flexplan Decision Guide and use the HSHS Healthy Plan Cost Estimator to help you determine which option is best for you.