Group PPO Plan for Employers with Six or more Enrolled Employees
Unity’s PPO Plan (formerly called Extended Access) provides In-Network and Out-of-Network benefits to employees outside of Dane County Wisconsin and in other states with the exception of New York and Virginia.
To offer a Group PPO Plan:
- 6 or more employees must enroll in the plan
- Your company must be located in Unity’s 20 county service area
- Your employees must reside in Wisconsin (except for Dane County) OR in other states except New York and Virginia
- The product must be paired with a Unity HMO Plan and at least 50% of employees need to be enrolled in the HMO
PPO Provider Network -- HealthEOS (Wisconsin) & MultiPlan (Other U.S. States)
To offer a statewide and national PPO network, Unity contracts with HealthEOS/Associates for Healthcare (AHC) and MultiPlan. HealthEOS/AHC providers include hospitals, clinics and physicians throughout Wisconsin. The MultiPlan provider network delivers healthcare services nationwide.
Benefit Highlights
Selecting a Primary Care Physician (PCP) is not required and authorization is not needed to seek care from an Out-of-Network specialist. Out-of-Network care is paid at a lower benefit level. In-Network care is paid at a higher benefit level. Some procedures require prior authorization [PDF]. This means that the treating physician must obtain approval from Unity before the service will be authorized for coverage. Prior authorization is required for some services (i.e., transplants and dental anesthesia).
When receiving care from a participating provider, the provider will submit the claim. If care is received from a non-participating provider, a claim form must be submitted by the member to HealthEOS/AHC or MultiPlan within 90 days from the date the services were received.
Helping Keep Employees and their Family Members Healthy
Unity understands that keeping employees healthy impacts insurance costs, workplace productivity and a company’s bottom line. These are just some of the reasons why we offer Fitness First, Fitness First for Kids and many other popular Wellness and Health First programs. Fitness First and Fitness First for Kids programs are independent of the group PPO policy and there is no extra employee cost involved.
We even work with employers to develop a tailored Employer Wellness program that addresses an organization’s specific needs. Program features include offering health risk assessments, health screenings, lunch and learn sessions, group consultations and custom reports.
Learn More
Act Now
Contact your Agent for more information about Unity’s Group PPO Policy or call the Unity Sales Department at 1-800-926-8227.
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