State Employees Frequently Asked Questions
 

General Questions
Why should I choose Group Health Cooperative of Eau Claire for my health insurance?
Choosing a health plan is an important decision.  When you choose GHC, you can expect great service from real people in your own backyard. Best of all, GHC is a Tier 1 plan, so you get a great price.
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Health Plan Application
I'm completing the health insurance application and it's asking me for a Provider Number. Where do I find this information?
Neither the State of Wisconsin nor GHC requires the Provider Number to be filled in. You may leave it blank. It is located on the application as an optional field.
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I'm unsure which physician I will be using for care, but I know which clinic I will be using. What physician should I list under "Selected Physician"?
Group Health Cooperative only tracks your clinic choice; you are not bound to a physician. Listing the physician along with the clinic where he/she practices will be helpful to ensure that the correct primary clinic is recorded in your file. If you prefer not to choose a physician, it is acceptable to only list the clinic.
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Dependent
How long will my dependent be covered?
Group Health Cooperative will provide coverage to eligible adult child dependents up to age 26. Orthodontia benefits cover unmarried dependent children through age 18. For more information on dependency mandates, please see our Health Care Reform Frequently Asked Questions page.
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Providers and Benefits
I would like to see a list of your providers.
Our provider directory is available right at your fingertips.
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Can I see a physician at Mayo Clinic in Rochester?
You may see a physician at the Mayo Clinic in Rochester only with prior authorization from GHC. Please read our Authorization Guidelines for more information.
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I don't see any psychiatrists listed in your directory. How do I receive mental health services?
We list behavioral health clinics in our directory, we do not list individual psychiatrists. This is because, while behavioral health services are usually a covered benefit, you will need authorization for these services after 6 visits.

Providers in the GHC network have been educated that authorization is required for services after 6 visits; however, it is ultimately your responsibility as a member to ensure this authorization has been obtained. If you have benefit questions related to behavioral health or chemical dependency, please call a GHC Member Services Advocate at (715) 552-4300 or (888) 203-7770.

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Will our health care still be covered if we live outside the GHC service area?
Only emergency and urgent care visits are covered outside of the GHC provider network. Any follow-up care resulting from these visits requires you to utilize a provider within our network.
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Coverage Termination
My coverage was terminated with GHC and I don't feel it should have been terminated.
Group Health Cooperative obtains termination information from the State of Wisconsin. Please see your Human Resource Representative to discuss the reasons for your policy termination.
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My coverage will be terminated with the State of Wisconsin - what date will my coverage actually end?
For most plans, coverage will end on the last day of the month in which coverage is terminated. However, because this criteria is set by your employer, please see your Human Resources Representative to confirm the date on which your coverage will end. You may also wish to discuss COBRA options, which may allow you to purchase continued coverage.
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