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Your Health Insurance Benefit Information

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Your Health Insurance Benefit Information
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Member-Owner Materials

As a GHC-SCW member-owner, you have access to south central Wisconsin’s only non-profit Cooperative health plan and a network of the area’s best specialty and hospital care. Getting the most out of your health plan starts with understanding all the benefits included with your coverage.

These links will help answer your questions about your health plan and your health care. And our Member Services team is here to help if you need it. Call Member Services at (608) 828-4853 or toll-free at (800) 605-4327.

Details About Your Plan

Better understand your current GHC-SCW plan coverage and find all your important plan documents using MyPlanFinder. You can view, save or print important information about your benefits and coverage. To access your plan information, have your plan number (found on your membership card) ready.

MyPlanFinder

Documents you can find in your MyPlanFinder and what they mean:

  • Benefit Summary: a quick overview of just some of the benefits and covered services included in your health plan.
  • Summary of Benefits and Coverage (SBC): an outline of your benefit plan that has most details you need to know, with information like costs, benefits, covered health care services, unique features, plus a glossary to explain common medical and insurance terms.
  • Member Certificate: a full and complete description of covered services. This describes your plan in detail and can be a long document that outlines which benefits and services are included and excluded under your benefit plan and also describes the terms, conditions and limitations of the benefits you receive.
  • Formulary: a list of prescription drugs available in your health plan.
  • Any Amendments or Riders: these details change the general Member Certificate document to include, exclude or modify any benefits you’re receiving.

If you want, GHC-SCW will print and mail you a free copy of your Summary of Benefits and Coverage (SBC), Benefits Summary or other member materials. Call our Member Services team at (608) 828-4853 or toll-free at (800) 605-4327 and request Member Services, or email us.

Membership Guides

When you first enroll in a GHC-SCW health plan, we’ll send you a Membership Guide. It’ll include your membership ID card, contact information for important GHC-SCW departments and general information on your GHC-SCW coverage and care. Keep that booklet, or bookmark this page to find the most updated Membership Guides:

 

2024 Membership Guides

Call To Action

Questions? Call Member Services

Have questions about your member-owner benefits? We’re here to help! Call GHC-SCW Member Services at (608) 828-4853 or (800) 605-4327 and request Member Services.

Health Coverage Tax Documents (1095-B form)

On your state or federal taxes, you’ll indicate that you had health coverage throughout the year. If for some reason the Internal Revenue Service (IRS) or Franchise Tax Board (FTB) asks you to provide proof of “minimum essential coverage,” you’ll need to request a 1095-B form from GHC-SCW.

We will mail your 1095-B Health Coverage tax forms directly to you. It may take up to 30 days from the date we receive your request for these documents.

If you had coverage through more than one insurance plan or policy during the year, you will receive a 1095-B Form for each plan or policy for the time period that you had coverage.

You can also get your 1095-B Form:

  1. At any time, easily view, download and print a copy through your GHCMyChartSM account.
  2. Email a request to enrollment@ghcscw.com with “1095-B Form” in the subject line and include your name and member number.
  3. Mail a written request to:
    Group Health Cooperative – Enrollment Department
    1265 John Q Hammons Drive
    Madison, Wisconsin 53717

Have questions? Reach out to our Member Services department (608) 828-4853 or toll-free at (800) 605-4327.​​​​