WPS small group plans are available in a range of coinsurance and copay options that meet your employees' needs and protect your bottom line. Our prescription drug benefit features tiered copayments to maximize cost efficiency and value. You can offer your employees a choice of up to four benefit designs, each with a different combination of deductibles, copays, and coinsurance. You fund the base plan, and your employees can buy up to higher-cost options if they wish.
Complete coverage, flexibility, and Wisconsin-based customer support for your small business:
1Preventive drugs include specific supplements, contraceptives, immunizations, and other preventive drugs ranked A or B by the U.S. Preventive Services Task Force. 2The Active&Fit Direct program are provided by American Specialty Health Fitness, Inc., a subsidiary of American Specialty Incorporated (ASH). Active&Fit Direct are registered trademarks of ASH and used with permission herein. If you think an employee might be unable to meet a standard for a reward under this wellness program, the employee might qualify for an opportunity to earn the same reward by different means.
HMO plans offered by WPS Health Plan deliver value through easy in-network access to health care providers and a primary care practitioner to help employees coordinate their care.
POS plans offered by WPS Health Plan provide versatility that allows employees to use in-network or out-of-network health care providers while still relying on a primary care practitioner to help manage their care.
PPO plans offered by WPS Health Insurance offer the convenience of no primary care practitioners or referrals required. Employees can see any health care provider they choose, in or out of network.
Health Plans Available A high-deductible health plan features a low premium and can be paired with a Health Savings Account (HSA) that lets employees budget and pay for qualified medical expenses using tax-free dollars. An HSA acts like a personal savings account, except the money is used exclusively for medical expenses. Funds roll over from year to year, and the account moves with the employee, providing a sense of security. For more information, view our HSA FAQ
|Health Maintenance Organization (HMO) Plans||Point-of-Service (POS) Plans||Preferred Provider Organization (PPO) Plans|
|Definition||A managed care health plan that covers care provided by in-network health care professionals.||A managed care health plan that covers care provided by in-network and out-of-network health care professionals.||A managed care health plan that covers care provided by in-network and out-of-network health care professionals without referrals.|
|Primary care practitioner (PCP) required||No||No||No|
|Referral required to see a specialist||Yes, you can see a provider outside the network. However, it may cost more unless you get an approved referral.||Yes, but you will need an approved referral to have the same coverage if you see a nonparticipating provider.||No|
|Out-of-network||No, except for emergencies.||Yes, but may cost more.||Yes, but may cost more.|
|Advantages for customers||Lower premium. Lower out-of-pocket costs. Care coordinated by a PCP.||More flexibility. Advantage of HMO pricing with out-of-network coverage.||Broadest choice for care. No referrals required.|
Choosing a health plan for your business is a major decision, and WPS wants you to have the all the information you need to make an informed one. Our Plan Materials page has plenty of resources to help you make an informed decision about plan basics, special features, network options, prescription coverage, plan summaries, and much more. A few examples include:
WPS Health Insurance - PPO
WPS Statewide Network
First Health Network
WPS Health Plan - HMO/POS
WPS Select Plus Network
First Health Network
Small Group Rating and Renewability Disclosure
Small Group Intake Checklist
Have questions about what different types of coverage have to offer your business? Our explainer videos can help you understand the basics of group health plans.