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State of WI & Local Employers 2023 Open Enrollment: September 26th- October 21st

2023 Plan Documents

2022 Plan Documents

2022 Guides/Certificates/SOB

State active employees PO1

State retirees PO1

State and local retirees with Medicare (all but PO4/PO14)

Local HDHP PO7/PO17

Local health plan (coinsurance) PO6/PO16

Local traditional PO2/PO12

Local deductible PO4/PO14

Other Documents/Links

Grievance procedure for ETF

MercyCare is required to make a reasonable effort to resolve your problems and complaints. If you have a complaint regarding MercyCare, for example, the denial of a claim or referral, you should contact our customer service department to see if the problem can be resolved over the phone.

If you are unable to resolve your concern over the phone, you have the right to request a grievance hearing.

MercyCare will send you a written acknowledgement within five days of receipt of your grievance. If we are unable to overturn our original decision, we will offer you the opportunity to meet with our grievance committee to discuss your case. If you choose to attend, you may present written and/or oral information at the meeting to support your position.

The Grievance Committee will review and evaluate all available information pertinent to the grievance and conduct further investigation if necessary. MercyCare’s Grievance Coordinator will work with you throughout the process and will send you a letter advising you of the resolution of your grievance within thirty days of receiving the request.

In cases where your health may be put in jeopardy by a delay or there is an urgent clinical situation your request will be expedited and we will resolve your complaint within 72 hours.

Submit this form Grievance request form via:


Fax: 608.741.5238

Mail: MercyCare Health Plans, P.O. Box 550, Janesville, WI 53547-0550

Emergency Room vs. Urgent Care: Know where to go

Well Wisconsin/ WebMD portal

Archived Documents


Provider/Member Directory

It's Your Choice (IYC) guides/Certificates of Coverage

Local plans

State plans