Medical Benefits

WellSpan Health offers bold and innovative approaches to healthcare delivery that drives value, affordability, quality and experience. New medical plan offerings are now available to employers through the following options:

Capital Blue Cross Performance PPO plan
Highmark Blue Shield Choice Blue Plan
WellSpan Population Health third-party administrative services

WellSpan has a unique and special partnership with both Capital Blue Cross and Highmark Blue Shield to deliver enhanced value through special rates, enhanced medical and utilization management initiatives and proactive health initiatives. These medical plans utilize a high-performance network bringing greater value and affordability to both employers and their employees. You will experience significant cost savings over broad network PPO plans.

CAPITAL BLUE CROSS – PERFORMANCE PPO:

Capital’s Performance PPO product reflects an industry wide shift toward better outcomes and value through a collaboration with providers. Using clinical data to identify high-performing providers, Performance PPO places those doctors and hospital systems in a select lower cost tier. It provides your employees with more control over their overall health with a distinct network design that keeps cost effciency top of mind. These high-performing providers can be found throughout our region and over a wide range of specialty care. Your employees enjoy lower out-of-pocket costs when they seek care from:

WellSpan Health
Penn Medicine Lancaster General Health
Penn State Health
St. Luke’s University Health Network

HIGHMARK BLUE SHIELD – CHOICE BLUE:

Highmark’s Choice Blue product gives your members unbeatable access to top quality care throughout Central Pennsylvania. When members choose these health providers, they receive a higher level of medical benefits compared to selecting other providers. Some of the top doctors and hospital systems that participate are:

WellSpan Health
Penn Medicine Lancaster General Health
Penn State Health
Geisinger Holy Spirit
Providers in the Allegheny Health or Lehigh Valley Health Network

WELLSPAN POPULATION HEALTH SERVICES –
THIRD-PARTY ADMINISTRATION SERVICES

Employers can choose to work directly with WellSpan as a third-party administrator (TPA). A TPA is responsible for processing medical and pharmacy benefits. These services can include:

Pharmacy benefit management
Compliance
Utilization management
Claims payments
Stop loss insurance oversight
Total joint replacement, uncomplicated maternity, diagnostic imaging, and bariatric surgery bundled payments