Member Materials

For member materials, please choose your plan type:

I have health insurance through my employer.

I have health insurance as an individual, not through an employer.
Please select your plan type above to find information regarding the appeal process.

Forms

Case Management Referral

Coordination of Benefits (COB) Verification
If you are covered by more than one health insurance plan, please complete this form to help ensure that your future health insurance claims are processed correctly.

COB determines which plan is responsible for paying a claim first (primary) and which plan is responsible for paying a claim second (secondary).

Dental Provider Selection

Disclosure Authorization

Foreign Claims 

Medical Transition of Care

Pharmacy Transition of Care 

Wisconsin Advance Directive


Connect with MyUnityPoint or UW Health MyChart

MyUnityPoint (formerly MyChart) and  UW Health MyChart provide secure online access to portions of your medical records with UnityPoint Health – Meriter or UW Health.

  • Schedule, cancel and view appointments
  • Receive test results
  • View your medications, immunizations and diagnoses
  • Send secure electronic messages to your health care providers
Login to MyUnityPoint (formerly MyChart) or UW Health MyChart today.

Summary of Benefits & Coverage (SBC)

You may request your SBC by submitting this form to Member Services, or giving us a call at (608) 282-8900 or (800) 545-5015. View the Uniform Glossary of Health Coverage and Medical Terms.


Medical Loss Ratio Information

The Affordable Care Act requires health insurers in the individual and small group markets to spend at least 80 percent of the premiums they receive on health care services and activities to improve health care quality (in the large group market, this amount is 85 percent). This is referred to as the Medical Loss Ratio (MLR) rule or the 80/20 rule. If a health insurer does not spend at least 80 percent of the premiums it receives on health care services and activities to improve health care quality, the insurer must rebate the difference.

A health insurer’s Medical Loss Ratio is determined separately for each State’s individual, small group and large group markets in which the health insurer offers health insurance. In some States, health insurers must meet a higher or lower Medical Loss Ratio. No later than August 1, 2014, health insurers must send any rebates due for 2013 and information to employers and individuals regarding any rebates due for 2013.

Physicians Plus had a Medical Loss Ratio for 2013 that met or exceeded the required Medical Loss Ratio. For more information on Medical Loss Ratio and your health insurer’s Medical Loss Ratio, visit www.HealthCare.gov.