2023 Prevea360 Health Plan Group Plan Book_LGP

You deserve a partner that helps you make sense of it all. Shop for health plans, and learn today what makes Prevea360 Health Plan different than competitors. Get simple, smart coverage your employees deserve and take the guesswork out of getting health care and coverage.

2023 Group Insurance Plan Book Choose Prevea360 Health Plan for your health journey

Contents Who We Are


Where to Go For Care


Find the Care that is Right For You

Insurance Designed with You in Mind


Additional Benefits

Getting the Most from Your Pharmacy Benefits 10 Lower Your Medication Costs

Prior Authorization


Prevea360 Health Plan Makes Change Easy


Comprehensive Wellness Plan


Programs and Features

About Your Coverage: Health Insurance 101


Terms and Coverage Details

Getting Started


How to Join Prevea360 Health Plan

General Limitations and Exclusions


Convenient Tools and Resources


Privacy and Confidentiality Statement


Member Portal and MyPrevea Health Records

Have questions? We are here to help.

By Phone Contact our Customer Care Center for questions about your benefits and more. 877-230-7555 (TTY: 711) Monday – Thursday, 7:30 am – 5 pm Friday, 8 am – 4:30 pm


Online Visit


prevea360.com/contactus and select “Send a message to Prevea360”

Traditionally, insurance companies and physicians measure success quite differently. This dynamic has led to a health care system that focuses more on illness than wellness. You Deserve Better A more beneficial experience is a member-focused plan with a holistic well-being approach to wellness. A health plan and health care that’s a part of your community and understands you and where you come from. That is Prevea360 Health Plan. Coordinated, Physician-led Coverage and Care With our integrated approach and focus on the doctor-patient relationship, know you’re a part of an innovative model of holistic care and coverage. That means health providers, a pharmacy benefits manager and a health plan all collaborating about your health and wellness and having a plan. That is why Prevea360 Health Plan is different. Meet an Innovative Health Plan Where Everyone Wins Choose benefits that go above and beyond, like Prevea Virtual Care on most plans, care options that meet your needs, access to personalized wellness plans and a health plan focused on the whole you — mind and body. Choose Prevea360 Health Plan.

Integrated Network

Health Plan Coverage




Pharmacy Benefit Manager (PBM)

Visit prevea360.com or call 877-230-7555 |


Call our Customer Care Center at 877-230-7555 (TTY: 711) Questions about health care services?

Insurance Designed with You in Mind The right care should fit into your schedule because coughs, fevers and injuries don’t happen at convenient times. Access our free 24/7 nurse line, virtual care and urgent care clinics, when you need care. Now you have benefits and tools that save time, convenient access to a large network of clinics, hospitals and benefits you understand.

Virtual Care Without an Appointment

Physicians Ready to Care for You • 2000+ physicians • 100+ primary care clinic locations • 250+ specialty care clinics Plus, you’re still covered for an emergency anywhere in the • Sacred Heart Hospital in Eau Claire Plus, additional medical facilities in your network throughout northeastern and western Wisconsin. See the back cover for a list of awards. Trusted Hospitals Prevea360 Health Plan gives you access to high-quality care and an exceptional patient experience at the following HSHS hospitals: • St. Vincen t in Green Bay • St. Mary’s in Green Bay • St. Nicholas in Sheboygan • St. Joseph’s Hospital in Chippewa Falls

We’re here to help you feel better quickly. With Prevea Virtual Care,* you can get care now, on your schedule, for most common conditions. No appointment needed. Accessible 24/7 for the whole family. Members can reach trusted Prevea Health providers with convenient online access. Visit prevea360.com/rightcare for more information.

Convenient Access Prevea360 Health Plan offers a

comprehensive network of hospitals, physicians and specialists throughout northeastern and western Wisconsin. Our HMO service area includes these northeastern counties: Brown, Calumet, Door, Kewaunee, Manitowoc, Marinette, Menominee, Oconto, Outagamie, Shawano and Sheboygan. In addition, we serve these western counties: Barron, Buffalo, Chippewa, Dunn, Eau Claire and Pepin. Find a clinic near you at prevea360.com/location

world. Find a provider at prevea360.com/providers

* Reference your summary of benefits and coverage for specific Virtual Care costs.


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Health Care Support Prevea Care After Hours ** is available 24/7/365 whenever you have a health question. If you’re not sure you need to see a doctor—or you’re wondering if you have a problem— connect with an experienced registered nurse at 888-277-3832 or 920-496-4700 . Learn more at prevea360.com/careafterhours

Out-of-Area Dependants ‡ Your kids may be out of sight, but they are never out of mind. Prevea360 has coverage for your dependents (until they turn age 26) who are living in another community, away at college, out on a backpacking adventure or giving adulting a try out of state. Need coverage for your kids? Learn more and complete the form at prevea360.com/outofarea Prior Authorization There are certain medical services or provider visits that must be authorized by Prevea360 Health Plan before we can provide a claims payment. A good rule to remember is that any time you seek services with an out-of-network provider, you will need to get prior authorization.† We require these authorizations so our Medical Affairs team can make sure you are getting the appropriate care. Visit prevea360.com/priorauthorization to learn more.

Currently Undergoing Treatment? Our Care Managers can answer

questions about health care services and provide the support you need if you’re currently undergoing treatment – whether it’s complex care, mental health or pregnancy – as you transition care to Prevea360 Health Plan. Assistance is also available to move prescription medications from your previous health plan to Prevea360 Health Plan. Learn more at prevea360.com/caremanagement

** Prevea Care After Hours is only available to residents of Wisconsin due to licensing regulations.

† HMO members will need to get prior authorization any time they seek services with an out-of-network provider. Plan providers request prior authorization for POS and PPO members.

‡ Out-of-area dependent coverage for non-urgent and non-emergency care applies to large group employer (51+ employees) plans only; please check with your employer’s benefits administrator if you have questions.

Visit prevea360.com or call 877-230-7555 |


Your comprehensive wellness program Be A Healthier You

Prevea360 Health Plan in partnership with WebMD offers a variety of programs focusing on the whole person across eight dimensions of wellness, making healthy living achievable and fun.

Wellness Programs and Features Health Assessment Based on your individual questionnaire results, WebMD provides recommendations for each lifestyle category. A variety of interactive self-management tools are customized to your needs. Case Management Provides support through complex health situations. Wellness Care Package A monthly brochure highlighting programs, education and health observances. Partner Perks Discounts for gyms, spas, golfing, devices, equipment, nutrition and more. Nicotine Cessation Nicotine cessation and vape free programs for families. Free medications may be available. R.E.A.L. Goals (Realistic, Easy, Attainable, Life Goals) Preset goals covering all eight dimensions along with tips and trackers to help you achieve success. Preventive Health Toolkits Download our toolkits that include education and awareness for many national observances and seasonally-appropriate topics. Events Calendar Access live monthly Book Club discussions, Move with a Doc, Learning Loft, and more webinars covering the eight dimensions of wellness. Events are virtual, and you can attend from anywhere. Learn more at prevea360.com/events Nutrition Members can access WebMD resources, challenges, webinars and a monthly Made from Scratch newsletter.

Your lowest risks are…

Emotional Health


Cervical Cancer Screening

You should work on…

Blood Pressure



Optimal YOU is 100 You scored a 41 out of 100


Health Assessment Example

Earn up to $150 * in rewards! See back for details


| 2023 Group Insurance Plans * Adult dependents (ages 18 and older) who are covered under a family member’s policy can earn up to $100 in Prevea360 Health Plan’s Living Healthy Rewards program.

prevea360.com/wellness Learn more at...

Additional Wellness Programs

Resources and rewards to help you achieve your health and wellness goals.

Living Healthy Rewards Prevention or early detection of common diseases is the best way to be the healthiest you and earn up to $150 in rewards! * There are many common preventive and screening services proven to improve health and it is important to check with your primary care provider to determine which tests are appropriate for you, based on your medical history and family history. Earn points and money for taking care of you! Visit prevea360.com/livinghealthy to access your resources and start your Health Assessment today! Mental Health Stress, anxiety and depression can happen to anyone at any time in their lives. No one is exempt. Know that whatever stage of life and whatever stress you’re experiencing, you’re not alone. Focused on a holistic approach to your wellbeing, Prevea360 Health Plan meets you where you are and provides the benefits and support you need. Visit prevea360.com/mentalhealth to access our resources. Make Advance Care Planning a Priority One of the most challenging situations is to make health care decisions for people who can’t make decisions for themselves. When that time comes, being prepared is the best way to provide your family comfort. Starting an advance care plan allows you to consider their goals, values, and beliefs, and how these may influence future medical decisions. We can help you start the conversation today at prevea360.com/acp

WebMD Living Healthy Portal Through our partnership with WebMD One, you can create a customized health experience to help you on your journey to achieve your best health. With thousands of resources like monthly interactive wellness challenges, wellness and exercise videos, mental health podcasts and nutritional resources, you can find the

tools you need to be successful. Start now at prevea360.com/livinghealthy

Scan the QR code to download the Wellness At Your Side app for Living Healthy on the go. Know Where You Stand with WebMD’s Health Assessment Based on your individual questionnaire results, WebMD provides health recommendations and a variety of interactive, self-management tools are customized to your health and wellness needs. Start today at prevea360.com/livinghealthy Wellness Video Library Watch a variety of videos that can help support your wellness goals. From stress management and mental health to nutritional advice and exercise, we have content

waiting for you. Check them out youtube.com by searching for “Prevea360.”

* Only Preve360 Health Plan members age 18 and older are eligible for Living Healthy rewards. Check with your plan administrator for reward offerings specific to your plan. Covered adult children (ages 18 and older) can earn up to $100 per year. Visit prevea360.com/livinghealthy for full details. School District members should visit prevea360.com/schooldistrict for details. Visit prevea360.com or call 877-230-7555 | 7

Prevea360 Health Plan Makes Change Easy After enrolling with Prevea360 Health Plan, we encourage you to follow these steps. If you need us, our Customer Care Center is here to help answer your questions along the way.

Decide Where You Prefer to Receive Your Primary Care Doing this makes it easier to schedule a visit when you need one. Go to prevea360.com/location to find a primary care clinic near you. Find a Primary Care Provider Our network is full of exceptional primary care providers who will work hard to earn and keep your trust. We encourage you to form a relationship with a primary care provider so they can help keep you at your healthiest. Visit prevea360.com/doctors to search our online provider directory. Transfer Medical Records Once you’re established with a new primary care clinic and provider, you may wish to have your medical records sent from your previous clinic to your new clinic. Contact your previous clinic to fill out an “Authorization to Release Protected Health Information” form.




Member Portal Visit prevea360.com/login and use your member number located on your ID card to activate your account. • View insurance plan details • Request member ID cards or download a digital copy • Change your primary care clinic • View and pay your premium bill • Review past claim details and more

MyPrevea MyPrevea.com allows you to send secure messages to your physician’s office and to view your health records from the comfort of your home and with your mobile device. When you create your Member Profile, you’ll have access to your insurance claims, cost estimates and documentation anytime. Learn more at prevea360.com/memberportal


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Not sure of the type of care you need?

Where to Go for Care

Call 888-277-3832 anytime to speak with a registered nurse, they are ready to help 24/7/365.

For Virtual Care options, visit prevea360.com/rightcare

The Right Care for Your Needs Knowing your care options before you need them saves you time and money The Right Care for Your Needs As a member, you can choose from a variety of care options, whether it’s during regular office hours or late at night. Knowing your options for care before you need it is good for your health — and it can save you money!

Virtual Care

Primary Care

Urgent Care

Emergency Care




Life-threatening illness or injury? Go to the nearest emergency room or call 911. Heart attack, stroke, head injury, severe pain.

Primary care clinic full or closed? Visit your nearest Urgent Care facility. When your normal clinic is full or closed.

Wish to see your doctor for care? Schedule an appointment at your primary care clinic. Same-day appointments are usually available. In-person treatments and annual checkups.

Too sick to drive to the doctor? Fill out an online questionnaire, receive a written diagnosis, treatment, and a prescription. Cold/flu, allergies, lice, etc.

Visit prevea360.com or call 877-230-7555 |


Getting the Most from Your Pharmacy Benefits We know you are concerned about the cost of medications. Prevea360 Health Plan has created a package of pharmacy benefits that provides convenience and increases access to more medications at lower costs.

90-day Generic Maintenance Drug Program† By providing 90-day supplies of maintenance drugs, you’re spending less and getting more of the medication you need. Member cost share for 90-day fills*: • 2 times your copay for all tier 1 and tier 2 medications through a mail-order pharmacy • 2.5 times your copay for tier 1 and tier 2 generic maintenance medications at retail pharmacies

Expanded Preventive Drug List† Now more medications are covered at $0 for large group members which helps you manage drug costs. New drugs added to the Preventive Drug List include: • Preferred mental health medications • Preferred brand diabetes medications • Preferred Insulin • Preferred inhalers and nebulizer solutions To see the most up-to-date list of $0 preventive drugs*, visit prevea360.com/pharmacybenefits or check out the Member Document Center on prevea360.com Generic Medications Generic medications have the same active ingredients as brand-name medications. They are safe and effective but are far less expensive. Your pharmacist can find available manufacturer coupon programs for high-cost specialty drugs or your doctor may be able to recommend a generic at a lower cost.

• Tier 3 at 3 times your copay (both mail-order and retail) • Tier 4 is not eligible for a 90-day supply

$0 Preferred Diabetic Supplies ** Cost should not be a barrier to controlling your diabetes. That’s why all formularies will include preferred diabetic supplies such as syringes, lancets, and pen needles at $0 for large and small group members. This way you can focus on staying healthy, not the cost of getting there.

$35 Cost-Sharing Cap on Preferred Insulin††

† Benefits are available only for large group (51+ employees) plans. †† B enefit available for ACA-compliant small group plans. All ACA-compliant small group members, including High Deductible Health Plans (HDHP), will not pay more than $35 a month for preferred insulin. * Members with tier 1 or tier 2 pharmacy benefits with coinsurance will still be charged the full coinsurance amount. ** B enefit is available for both large group (51+ employees) plans and ACA-compliant small group (2 - 50 employees) plans.

Lower costs on the diabetic medication you need. Access your formulary for the most up-to-date listing of insulins.


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prevea360.com/newmember For more informations visit:

First Impressions Matter

We understand that switching your insurance and providers can be overwhelming. We make it easy to connect with the resources you need, for a seamless transition from start to finish. Here’s what you can expect when you join Prevea360 Health Plan.

Onboarding Process Here’s what you can expect as you join Prevea360 Health Plan:

Learn about your benefits

Complete and submit your enrollment application

We mail your new Member ID cards

We mail your Member Guide

Your Plan is activated

Ambassador Program Think of our Ambassador Program as your personal concierge to help you find a Prevea Physician or Specialist. This program is designed to help you transition to Prevea360 Health Plan as easily as possible. • Green Bay – Call 920-272-1113 or email GB.Ambassador@prevea.com • Sheboygan – Call 920-892-8590 or email Sheb.Ambassador@prevea.com • Eau Claire – Call 715-717-4340 / 715-717-5035 or email EC.Ambassador@prevea.com

New Member Guide We mail you a New Member Guide at enrollment, which introduces you to your new plan and health partner, Prevea360 Health Plan. Your guide will: • Provide details like where to find important member documents • Explain where to go for primary, urgent and emergency care • Define common insurance terms and more

Health Insurance Documents 101:

The following three documents are important as a member. They include:

1. Your Member Certificate This is detailed information explaining how your plan works and what medical benefits you have. You’ll find information like patient rights, benefit limitations and exclusions, cost-sharing requirements and prior authorization requirements.

2. Summary of Benefits and Coverage (SBC) An SBC is a snapshot of Prevea360 Health Plan’s costs, benefits, covered health care services, and other features. It also explains our unique features like cost-sharing rules and includes significant limits and exceptions to coverage in easy-to- understand terms.

3. Summary of Employer-Specific Coverage This summary is specific to your company’s coverage information, and it is included with this packet. You can also ask your plan administrator or benefits specialist for your specific benefits and coverage information.


Call our Customer Care Center at 877-230-7555 (TTY: 711) Questions about health care services?

About Your Coverage: Health Insurance 101 Health insurance can be complicated, and that’s why we try to make it easy to understand your coverage and financial responsibilities. Take a moment to learn about important terms and where to find your specific coverage details.

Sharing the Cost of Care

Your policy may use a system of cost sharing that can include a copay, coinsurance, deductible or any combination of the three.*

Deductible Each time you receive medical services, you’ll pay the bill towards these services up to a certain amount. This amount is your deductible, which is what you must pay for covered health care services each year before we begin to pay. Coinsurance† Once you’ve paid the deductible amount, your insurance will then start splitting the cost of additional medical services with you. This is known as coinsurance, where you only pay a percentage or part of the total cost of services and we’ll pay the rest.



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Deductible and Coinsurance Limit – There is a dollar limit to the amount you’ll pay towards your deductible and coinsurance. Copays


A copay is a fixed dollar amount, which you pay at the time you receive medical services (for things like an office visit) and prescriptions. All your copays add up toward your Maximum Out-of-Pocket total.

* Not all of the cost-sharing terms listed here apply to all members. Refer to your Member Policy document to understand which apply to you. Smart Plan medical copayment applies towards the out-of-pocket maximum, which is the amount you are required to pay toward the covered cost of your healthcare. The out-of-pocket maximum amount is calculated on a calendar year basis. For members with PPO and POS Smart Plans, coinsurance and copays apply. † Coinsurance is your share of the costs of a covered health care service. It’s calculated as a percent of the allowed amount for the service.

Maximum Out-of-Pocket – There’s a dollar limit to all your cost sharing. You reach this amount by means of your deductible, plus your coinsurance, plus your copays. Once this limit is reached, you’ll pay nothing on subsequent covered medical charges for the remainder of your policy year.


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Preventive Services

Essential Health Benefits

A holistic care approach focuses on wellness and prevention. At the heart of our preventive care is a promise that you’ll get the support needed to remain healthy and enjoy life. Prevea360 Health Plan provides the following preventive services with no copays, coinsurance or deductibles:* • Annual Preventive Office Visit, which includes important preventive services • Screenings for breast, cervical and colon cancer • Cholesterol screenings • Routine vaccinations for adults and children • And more services Visit prevea360.com/preventivecare or call the customer care center at 877-230-7555 (TTY:711) for a comprehensive list of covered preventive services.

Defined as the 10 categories of common benefits that are deemed essential,** these Essential Health Benefits cannot be subject to dollar limits, either annually or on a lifetime basis. Depending on the type of plan you purchased, services associated with Essential Health Benefits may still require cost sharing in the form of copays, coinsurance and deductibles. These include:

• Preventive*, wellness and disease management services • Emergency care • Hospitalization • Ambulatory care • Maternity and newborn services • Prescription drug coverage

• Pediatric services† • Laboratory services • Rehabilitative and habilitative services • Mental health and substance abuse services, including mental health treatment

Check out our glossary of common terms at prevea360.com/insuranceterms

* No cost share responsibilities apply when services are delivered by a network provider, and when all preventive services criteria are met Visit prevea360.com/preventivecare for a comprehensive list of covered preventive services. ** A ll small group plans (2–50 employees) cover Essential Health Benefits. However, if you work for a larger employer (51+ employees) your benefits may vary. Contact your human resources or benefits department for information about your specific coverage. † Prevea360 Health Plan does not offer pediatric dental services. This coverage is available on the Health Insurance Marketplace (healthcare.gov) and can be purchased as a stand-alone product. Please contact your benefits administrator or the Marketplace if you wish to purchase pediatric dental coverage or a stand-alone dental services product.

Visit prevea360.com or call 877-230-7555 |


General Limitations and Exclusions All benefits are subject to limitations and exclusions as described in your Schedule of Benefits and in your certificate. The following list is not exhaustive and may vary based on your policy. For a complete listing refer to your certificate.

• Court-ordered drug testing unless Medically Necessary • Cytotoxic testing and sublingual antigens associated to allergy testing • Hair analysis (unless lead or arsenic poisoning is suspected) • Preimplantation genetic testing of embryos and gametes • Convenience items for a Member or a Member’s family, unless stated otherwise in this policy • Drugs provided or administered by a physician or other provider, except those drugs that meet the definition of Professionally Administered Drugs • Infertility drugs, including, but not limited to, those administered by a medical provider for the purpose of Assisted Reproductive Technology (ART) • Outpatient prescription drugs, except those prescriptions otherwise covered under this policy • Oral nutrition: oral nutrition is not considered a medical item. We do not cover nutritional support that is taken orally (i.e., by mouth), unless mandated by state law or covered under our medical policy for a specific condition. Examples include, but are not limited to, over-the-counter nutritional supplements, infant formula, and donor breast milk. • Replacement of an item if the item is lost, stolen, unusable or nonfunctioning because of misuse, abuse, or neglect • Sexual dysfunction devices and supplies, including but not limited to medications and injections • Autopsy • Consultation, treatment, or procedures for ART • Charges directly related to a non-covered service, such as hospitalization charges, except when a complication results from the non-covered service that could not be reasonably expected and the complication requires medically necessary treatment. The treatment of the complication must be a covered benefit.

• Consultation for, or procedures connected to in vitro fertilization, embryo transplantation, and/or any other assistive reproductive technique (e.g., GIFT, ZIFT) • Cosmetic services, including cosmetic surgery • Experimental or investigational services, treatments, or procedures, and any related complications as determined by us, unless coverage is required by state or federal law • Non-medical services provided in a Hospital or medical setting, not otherwise listed as covered in this certificate • Items that can be purchased over the counter and considered to be for comfort, convenience and/or personal hygiene, examples include, but are not limited to: seasonal affective disorder light units, disposable undergarments, wigs and modification to a Member’s home such as ramps, grab bars, stair lifts and bench/chair lifts. • Podiatry services or routine foot care provided when there is no localized illness, injury, or symptoms. These include, but are not limited to 1) the examination, treatment, or removal of all or part of corns, calluses, hypertrophy or hyperplasia of the skin or subcutaneous tissues of the feet; the cutting, trimming, or other non-operative partial removal of toenails; or 3) any treatment or services in connection with any of these. • Obesity-related services, including any weight loss method, surgical treatment or hospitalization for the treatment of obesity, unless specifically covered under this certificate • Reversal of voluntary sterilization and related procedures • Services, treatment, and supplies provided to a Member while the Member is held or detained in custody of law enforcement officials, or imprisoned in a local, state, or federal penal or correctional institution • Services and supplies furnished by a government plan, hospital, or institution the law requires you to pay


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Privacy and Confidentiality Statement Prevea360 Health Plan is required by law to maintain the privacy of your personal health and financial information (collectively referred to as “nonpublic personal information”) and provide you with written notification of our legal duties and privacy practices concerning that information. Please visit prevea360.com/privacy or call 877-230-7555 (TTY: 711) to request a copy.

• Services, treatment, and supplies provided in connection with any illness or injury caused by: a Member engaging in an illegal occupation or b) a Member committing or attempting to commit, a felony. (Note that this exclusion does not apply to the treatment of injuries that result from an act of domestic violence, if that treatment would otherwise be covered). • Services provided by Members of the subscriber’s immediate family or any person living with the subscriber • Services or supplies associated to a denied prior authorization • Services or supplies associated to a denied admission • Services or supplies not medically necessary, not recommended or approved by a provider, or not provided within the scope of the provider’s license • Services or items provided as a result of war or any act of war, insurrection, riot or terrorism • Services or supplies provided for an injury sustained while performing military service • Services or supplies for which a Member receives or is entitled to receive any benefits, settlement, award, or damages, or following any claim under, any Workers’ Compensation Act, employer’s liability insurance plan, or similar law or act. “Entitled” means the Member is actually insured under Workers’ Compensation. • Surrogacy services, for a non-Member • Sexual dysfunction treatment and services including, but not limited to surgery • Sterilization procedures for men • Sterilization procedures for women and patient education and counseling related to contraception for all women with reproductive capacity. (Although these are technically excluded from your group’s health plan insurance coverage, we will pay for them as preventive services, as required by federal regulations)

• Take home drugs and supplies unless a written prescription is obtained and filled at a network pharmacy • Acupuncture • Chelation therapy for atherosclerosis • Coma stimulation programs • Alternative medicine, not otherwise listed in the policy • Low level light therapy • Massage therapy • Prolotherapy • Swim or pool therapy, unless prior authorization is obtained • Administrative examinations such as employment, licensing, insurance, adoption, or participation in athletics • Court-ordered care, unless medically necessary and otherwise covered under this certificate • Educational services, except for diabetic self- management classes • Internet consultations, including all related charges and costs, excepts as defined by our medical policy • Missed appointment charges • Telephone consultation charges between providers • Charges or costs exceeding a benefit maximum or maximum allowable fee, where applicable • Expenses incurred before the supply or service is actually provided unless prior authorized by us This notice was last updated August 15, 2022.

Visit prevea360.com or call 877-230-7555 |


Hospital and Health System Awards HSHS St. Mary’s Hospital Medical Center • Named a Top 100 hospital in the nation designated Baby-Friendly birth facility • Guardian of Excellence Award® for achieving and sustaining excellence in clinical quality – Press Ganey • Accredited by the Joint Commission of Accreditation of Healthcare Organizations • Partner for Change Award – Practice Greenhealth • Greening of the OR Award – Practice Greenhealth HSHS St. Vincent Hospital • Accredited by the Joint Commission of Accreditation of Healthcare Organizations • Green Bay’s first and only dedicated children’s hospital and a Level II trauma center • Certified Comprehensive Stroke Center • Greenhealth Emerald Award – Practice Greenhealth • Greening of the OR Award – Practice Greenhealth HSHS St. Vincent Hospital Cancer Centers • Accredited by the Commission on Cancer for more than 55 years • Recognized as an Integrated Network Cancer Program – highest level of accreditation possible for a non-teaching hospital HSHS St. Clare Memorial Hospital • Guardian of Excellence Award® for achieving and sustaining excellence in clinical quality – Press Ganey

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Prevea360 Health Plan PO Box 56099 Madison WI 53705-9399 Toll-free 877-230-7555 (TTY: 711) prevea360.com

Prevea360 Health Plan does not discriminate on the basis of disability in the provisions of programs, services or activities. If you need this printed material interpreted or in an alternate format, or need assistance in using any of our services, please contact a Customer Care Specialist at 877-230-7555 (TTY: 711) .

©2022 Prevea360 Health Plan, Inc. Prevea360 is underwritten by Dean Health Plan • 512923R04_2205

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