Did you know... PPOs, while difficult to define, have a number of common operational elements that account for their quiet, yet extraordinary success in today’s health care market.

Throughout the 80’s and 90’s, the "experts" continued to predict that PPOs were only a transitional healthcare solution while moving fee-for-service business into managed care. Once again the "experts" misunderstood the public’s desire for greater access and choice.

As a result of the proven PPO benefits of access, choice and quality, PPOs have continued to grow faster and serve an ever increasing and far larger segment of the health care market than any other health care delivery system model. Source: American Association of Preferred Provider Organizations.

What is a PPO?
Answer: The PPO negotiates with various medical providers, doctors, hospitals, optometrists, dentists, etc.. on behalf of it's member health plans, to obtain services at a discounted rate.

In exchange for the discounts, the PPO recommends the providers to it's insured members who then can choose to use any of the providers and receive the services at the reduced rate. This creates a larger pool of potential patients for the provider and since the patients are covered by an insurance plan, the provider is assured of prompt payment of claims.

The insurance plans give incentives to it's insured members which encourages it's members to use the preferred providers. These incentives vary from plan to plan but may include reductions in co-pays or deductibles or other incentives which will in effect save both the member and the plan money and thereby reduce the cost of the insurance plan.

How can I or my health fund become a participant in the alliance?
Answer: The health fund can enroll by completing a participation agreement and paying the affiliation fee on the number of participants enrolled in it's plan within the state of Wyoming or those who may use the alliance's benefits.

What does it cost my plan and / or I to enroll or use the benefits of the plan?
Answer: The initial affiliation fee is a one time charge of $2.00 per participant, thereafter payment of 20% of the savings to UPHS ( Union Pacific Health Systems ) and 10% to WHFA are required. If there are no savings then there is no charge. Some of the benefits, such as prescription eye wear, and orthopedic appliance contracts negotiated by WHFA are available with no charge. The Children's Hospital of Colorado program is an independent WHFA contract and only the 10% WHFA fee is applicable to services at this hospital.

Where can I get a list of providers and services that are available?
Answer: By using our Provider Search tool.