A PUBLICATION OF
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L I F E , H E A LT H & W E L L N E S S
Peace of Mind When it Mattered Most
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Spotting and Reporting Health Insurance Fraud
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Our Commitment to Wisconsin Goes Beyond Health Care
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Manage Your Health Plan Anytime with the Member Portal
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We’re Social by Nature and Wired for Connection
4 Help Protect Your Child with Recommended Vaccinations Important Member Information 5 Breast Cancer Screening: Early Detection Could Save Your Life
10 Mail-Order Pharmacy Options Prioritize Your Convenience 11 Protect Yourself and Your Family with Opioid Safety and Proper Disposal BACK COVER • Is Your Child Turning 26 Soon? • Turning 65 Soon?
FEATURE STORY
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Peace of Mind When it Mattered Most
EDITORIAL STAFF Vice President David Sengkhammee Marketing Strategic Marketing Courtnay Brummer and Communications Coordinator Supervisor Debra Sutton Creative Design
EDITORIAL BOARD
Michael Jurmu, Jennifer Quadracci, Ted Regalia, Carisa Satorius, Maggie Sigler, Susan Wendt, Kristy Yarcho Balance is published by Network Health. The health information contained in Balance is meant to supplement, not replace, the advice of health care professionals. © 2026 Network Health. No portion of this newsletter may be reproduced without written permission from Network Health.
Spotting and Reporting Health Insurance Fraud At Network Health, we take health insurance fraud seriously. Fraud, waste and abuse cost millions of dollars each year and contribute to higher health care costs for everyone. That’s why we investigate every report we receive.
Our members play an important role in helping us identify potential fraud, waste and abuse. If you believe you may have been affected, we encourage you to contact us.
Examples of possible fraud • A health care provider bills for services you never received. • A durable medical equipment (DME) supplier bills for equipment different than what was ordered and provided or was unsolicited. • Someone uses another person’s member ID card to get medical care, supplies or equipment. • Misrepresenting alternative medicine or cosmetic procedures as covered plan benefits.
If you have questions, suggestions or a story about how Network Health has made a difference in your life, send us an email at marketing@networkhealth.com.
YOU CAN ALSO WRITE TO US AT: Network Health Attention: Courtnay Brummer 16960 W. Greenfield Ave., Suite 5 Brookfield, WI 53005
What to do if you suspect fraud • Call your health care provider to make sure the bill is correct. • Call the Member Experience team at the number located on the back of your Network Health member ID card. • Email us at paymentintegrity@networkhealth.com
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HMO and POS plans underwritten by Network Health Plan. Self-insured plans administered by Network Health Administrative Services, LLC or Network Health TPA, LLC. 4553-04-0626 ne t wor khe al t h.c om
Manage Your Health Plan Anytime with the Member Portal View claims, access member ID cards, go paperless and more— all in one secure place.
Managing your health plan should be simple. With Network Health’s secure member portal, you can quickly access your plan information, track claims, view documents and manage your preferences whenever it’s convenient for you. The portal is personalized to your plan and works on your phone, tablet or computer, so your information is always within reach.
Go Paperless for Faster Updates Cut down on paper clutter and get updates faster by choosing to receive certain communications electronically. Email delivery is secure, convenient and gives you quicker access to important information—including this newsletter. Prefer some materials by mail? You can customize your preferences and choose which communications you’d like to receive electronically or as printed copies.
How to Update Your Preferences
Additional Tools and Resources
1. Log in to the member portal
You can also connect to helpful health and wellness resources, including:
2. Click your name in the upper-right corner 3. Select Change My Communication Preferences
• Pharmacy benefits and claims information*
4. Choose email delivery for some or all categories, and opt in to SMS messaging
• Virtual visits • Your health questionnaire
5. Click Next to save your selections
• Wellness programs and tools*
Your Plan Information in One Place
To help protect your information, the portal uses multi-factor authentication for added security and peace of mind wherever you access your account.
Use the member portal to: • View your benefits and coverage information • Track out-of-pocket expenses
To get started, scan the QR code
• Check claims details and status • Access monthly explanation of benefits (EOB) statements • View your digital Network Health member ID card or request a replacement card • Select or update your personal doctor • Complete your personal health representative form (PHI) *Not all Network Health plans have a wellness program or pharmacy benefits. Check your plan documents for details. ne t wor khe al t h.c om
or visit
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Help Protect Your Child with Recommended Vaccinations By Heather Konrad, quality care coordinator at Network Health
Vaccines help prevent serious illnesses and keep your family, school and community healthier. Childhood and adolescent vaccinations are one of the safest and most effective ways to protect your child’s health. Vaccines help build immunity against serious diseases and can prevent severe illness, complications and long-term health problems. Extensive research continues to show that vaccines are safe and highly effective. Staying up to date on recommended vaccines helps protect your child during important stages of growth and development. When more children are vaccinated, diseases have fewer opportunities to spread. This helps reduce outbreaks and protects people who may be more vulnerable to illness, including infants, older adults and those with weakened immune systems. Talk with your child’s doctor to make sure your child is current on recommended vaccinations. You can also review age-based vaccine schedules and learn more about vaccine safety on the Centers for Disease Control and Prevention (CDC) website at cdc.gov/vaccines.
Important Member Information
Learn about your rights, benefits, care options and other helpful health plan resources. At Network Health, we want to make it easy for you to understand your health plan, benefits and available services. The Wisconsin Group Insurance Board and Employee Trust Fund, as well as organizations such as the National Committee for Quality Assurance (NCQA), the Wisconsin Office of the Commissioner of Insurance (OCI) and the Centers for Medicare & Medicaid Services (CMS) help oversee health plans to support quality care and protect members. As part of these standards, health plans are required to provide information on important topics related to coverage, care options and member rights.
Available resources include: • Access to Network Health care management employees and services • Ensuring you receive the service you deserve • Evaluating new technologies • Falls and osteoporosis prevention • How health plan decisions are made • How to protect yourself from Medicare fraud • Member rights and responsibilities • Network Health’s commitment to quality • How to submit a claim for reimbursement • The importance of sharing health information • Understanding emergency care, urgent care and virtual visits • Population health management
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You can download a PDF of this information at networkhealth.com/required-info. If you’d prefer a printed copy, call the Member Experience team at the phone number on the back of your Network Health member ID card.
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life. health. wellness.
Breast Cancer Screening Early Detection Could Save Your Life
By Jennifer Footit-Tank, quality care coordinator at Network Health
Breast cancer screening is an important part of preventive health care for people of all genders and identities. In the United States, breast cancer is one of the most commonly diagnosed cancers among women, accounting for about 30 percent of new cases each year. While it’s more common in middle-aged and older adults, it can also occur in younger individuals, including those under age 45. Understanding your personal risk and screening options is an important step in protecting your health. For average-risk women, the American Cancer Society recommends annual mammograms from ages 40 to 54, followed by every two years starting at age 55, though screening frequency should always be discussed with your doctor. If you have genetic mutations, a personal or family history of breast cancer, prior chest radiation or certain syndromes, you may need earlier or more frequent screening. Transgender and nonbinary individuals may also benefit from personalized screening plans based on sex assigned at birth, hormone use, surgical history and overall risk. Although breast cancer is less common in men, it can still occur, especially with risk factors such as genetic mutations, family history or hormone therapy. The most important step is talking with your doctor about the right screening schedule for you.
Modern Mammograms are Faster, Easier and More Comfortable If you’re overdue for a mammogram or preparing for your first one, it’s normal to feel nervous or uncertain. Many people worry about discomfort, modesty, cost or what the exam might find. Fortunately, mammography technology has improved significantly in recent years. Features such as curved paddles, cushioning and patient-centered positioning help reduce discomfort, and most exams take only about 10 minutes in a calm, private setting. Many imaging centers now use 3D mammography, which creates more detailed images and can improve accuracy, especially for dense breast tissue. This technology may also reduce the need for follow-up scans. In some cases, results may be available within as little as 24 hours, depending on the facility. Cost is another common concern. Routine preventive mammograms are covered at no cost. If additional imaging is needed because of symptoms or findings, the exam may become diagnostic, which can involve different coverage or out-of-pocket costs. However, diagnostic does not mean cancer—it means more detailed evaluation is needed. For people with limited or no insurance, programs like the Wisconsin Well Woman Program may help cover screening and follow-up care for eligible individuals. Regular mammograms remain one of the best tools for early detection and improved outcomes. With today’s technology and support, screenings are more accessible, comfortable and effective.
Refer to your plan documents for coverage details. ne t wor khe al t h.c om
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Peace of Mind
When it Mattered Most By Courtnay Brummer / Photos by Kyle Halter
When Ty unexpectedly lost his job, health insurance became one of his biggest concerns. Like many people, Ty had always received coverage through his employer. Suddenly, he faced unfamiliar choices: Should he elect COBRA? Explore Marketplace options? Would he be able to afford coverage? Would his family have to find new doctors? During an already stressful time, finding answers became top priority. “When you’re going through a life transition, having health care resolved—or at least knowing it’s available—is paramount.” Thankfully his family wasn’t managing major medical conditions; however, they relied on regular care, access to doctors, prescription medications and reassurance. For Ty, health coverage represented the ability to continue providing for his family.
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As a parent and spouse, you want to feel good at night that you’re providing for your family. That means food, water, shelter and health care.
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Finding the Right Support While attending networking events during his job search, Ty discovered he wasn’t alone. Many others were facing the same difficult questions about health insurance. “People were trying to figure out, ‘How can I afford COBRA? Am I going to go without coverage and hope I find a job?’” One conversation changed his approach. A fellow job seeker recommended Network Health, and Ty decided to reach out directly rather than trying to navigate the Marketplace process alone. That’s when he connected with John, a Network Health account manager. “I told him I didn’t feel comfortable using the Exchange portal. John said, ‘Take a time-out. We’ll find a plan that works for your family.’” That reassurance immediately helped reduce stress.
Guidance Beyond Choosing a Plan Ty is someone who likes to understand the details before making decisions. Health insurance can be complicated. John took the time to walk through options with Ty, answered his questions and helped him think beyond his immediate needs. One moment stood out. Instead of simply answering the questions on Ty’s mind, John helped him review factors such as medical and drug deductibles, total costs, provider networks and how his family’s needs might evolve. “He wasn’t just helping me solve the immediate problem. He was already thinking about how to help me choose the right plan for the next full coverage year.”
Several family members also relied on routine medications, making uninterrupted access especially important. “The worst thing you want to think about is that you’re suddenly not going to be able to afford medications that are important to your family’s health.” Once his enrollment in a Network Health Individual and Family plan was complete, Ty knew his family not only had coverage, but it was coverage that he truly felt good about. “I could tell the rest of my family, ‘We’re good to go.’”
A Relationship Built on People Ty’s experience didn’t end after selecting a plan. When questions came up, he was able to call Network Health directly to speak to someone he knew could help. If John was unavailable, Dawn provided the guidance he needed. “I always want to provide compassionate, knowledgeable assistance,” Dawn says. “It’s important to build trust and help members feel confident navigating their health care benefits.” Follow-up communications and a welcome packet helped Ty understand what to expect and next steps, from connecting with providers to using his benefits. He also discovered his new coverage included benefits his former employer plan did not, including dental and vision. “Network Health became a step up in care for my family.” Though his family’s journey eventually led him to a different coverage program, the reassurance and support he found through Network Health during a challenging period left a lasting impression. Ty enjoys sharing his experience with others facing similar health insurance decisions. His advice is simple: Don’t try to figure it out alone. “Talk to someone first. They’ll help you build a game plan.”
He wasn’t just helping me solve the immediate problem. He was already thinking about how to help me choose the right plan for the next full coverage year.
He also notices Network Health’s presence throughout his southeastern Wisconsin community at local events, fairs and gatherings. “They’re warm, engaging people. They don’t ask if you need health care. They ask how you’re doing.” Looking back, Ty says Network Health provided what his family needed most during a challenging transition: confidence, stability and reassurance. “We could keep seeing the doctors we trusted. We knew we had coverage. We knew our family was protected.” The words that best describe his experience come easily to Ty.
Together, they reviewed the details and determined what would work best for Ty’s family and budget.
“Peace of mind. That’s priceless.”
Keeping Care Consistent One of Ty’s biggest concerns was the continuity of care. His family had established relationships with their physicians within the Froedtert ThedaCare system, and he wanted to avoid starting over with new providers. During his conversation with John, Ty learned more about the relationship between Network Health and Froedtert ThedaCare and how members can benefit from this partnership. Knowing his family could continue seeing the doctors they trusted and maintain access to their pharmacies provided a sense of security. “When you’re going through a compelling life event, continuity of care really means being able to sleep at night.”
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Our Commitment to Wisconsin Goes Beyond Health Care At Network Health, we’re building meaningful connections and bringing our community roadmap to life throughout Wisconsin. We live here, work here and raise our families here, and we’re proud to support the communities that make our state such a special place to call home. We’re truly Wisconsin. Over the past year, we partnered with 124 organizations across Wisconsin and supported 458 member and community events. Through these partnerships, we’re helping strengthen local communities and create lasting connections with the people we serve like you. We’re also committed to supporting Wisconsin businesses. In 2025, we returned more than $1.7 million to the local economy by purchasing goods and services from our own clients whenever possible. Our employees are the heart of our efforts and play a vital role. Together, they contributed more than 3,300 volunteer hours, with 57 percent of our workforce giving their time and talents to causes they care about. Through their volunteer efforts, 110 organizations received support that helped make a positive impact in communities across the state. From Milwaukee and Waukesha to Oshkosh, Fond du Lac, the Fox Cities, Green Bay and Door County, you’ll find Network Health actively engaged in our state’s northeast and southeast communities where our members live, work and thrive. We’re proud to invest in Wisconsin today and for generations to come.
For a complete list of upcoming events and details, scan the QR code or visit networkhealth.com/community. We can’t wait to see you and continue building a brighter future together.
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We’re Social by Nature and Wired for Connection
Feel stronger, happier and more connected with pickleball. Looking for a fun, approachable way to stay active without expensive equipment or prior experience? Pickleball is a great way to keep moving while being easy on the joints, and it can support your physical, emotional and social well-being. One of the reasons pickleball has grown so quickly is because it brings people together. The game is naturally social, encouraging conversation, teamwork and connection across all ages and skill levels. Whether with friends or new acquaintances, pickleball creates opportunities to meet new people, build relationships and feel part of a community.
Research continues to show that meaningful relationships and regular social interaction can help reduce stress, improve mental health and support a healthier, more active lifestyle. Sam Clark, wellness supervisor at Network Health
Our commitment to you At Network Health, we’re committed to improving community and population health. Access to fun, welcoming and low-barrier activities can help more people stay active, reduce social isolation and build healthier daily habits. Activities like pickleball make it easier to combine exercise, fun and connection in a way that supports whole-person wellness.
Get in the game with Network Health Community Play We’re excited to announce a new partnership between Network Health and Pickleball Kingdom, offering free indoor open play time for all Network Health members and the public. It’s a perfect partnership given our mission to create healthy and strong Wisconsin communities.
Whether you're a beginner or experienced player, join us for free Network Health Community Play on Tuesdays and Thursdays from 11 a.m. to 3 p.m. at Pickleball Kingdom clubs in Appleton and Menomonee Falls. Questions about Network Health Community Play? Scan the QR code or contact Pickleball Kingdom. Appleton: 920-610-5790 info@pickleballkingdomappleton.com Menomonee Falls: 262-286-4801 info@kingdommenfalls.com
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Mail-Order Pharmacy Options Prioritize Your Convenience At Network Health, we’re always looking for ways to help you get the medications you need while keeping your prescription costs as low as possible. That’s why we’re excited to offer you more in-network mail-order pharmacy choices. If you’re happy with Express Scripts™ Mail Order, you can continue using it. You now also have access to Mark Cuban Cost Plus Drugs (Cost Plus Drugs) as a new in-network, online mail-order pharmacy. Froedtert Home Delivery joined your in-network pharmacy options effective October 1, 2026.
Cost Plus Drugs Cost Plus Drugs offers deep discounts on thousands of commonly prescribed medications, with some of the biggest savings available on higher-cost generic drugs. By working directly with manufacturers and using a transparent pricing model, Cost Plus Drugs helps keep prescription costs low. Find out if your medication is available by visiting costplusdrugs.com. You can use your Network Health member ID card when filling eligible prescriptions through Cost Plus Drugs. That means you’ll receive your Network Health pharmacy benefit at checkout, eliminating the need to pay the full cost upfront and submit a reimbursement claim. Because lower prescription costs help control overall health care expenses, choosing Cost Plus Drugs when appropriate can also help support stable benefits and premiums for all members.
Froedtert Home Delivery If you prefer a more personalized experience, Froedtert Home Delivery is another in-network mail-order option. As a Wisconsin-based pharmacy, Froedtert Home Delivery is known for its exceptional customer service. You’ll be able to speak directly with a pharmacy team member to place an order, ask questions or get assistance with your prescriptions. Froedtert Home Delivery also offers competitive pricing and the same mail-order benefit available through your plan.
We’re here to help Not sure which mail-order pharmacy is right for you? Our Network Health pharmacists are here to help. They can answer questions, compare prescription costs, discuss alternative therapies and help you find the option that best meets your needs. Call 888-665-1246 Monday-Friday, 8 a.m. to 5 p.m., or send email to pharmacist@networkhealth.com.
Mail-Order Pharmacy Options Prioritize Your Convenience
You have three convenient ways to receive medications outside our otherwise expansive pharmacy network. Mark Cuban Cost Plus Drugs Froedtert Home Delivery Online mail-order pharmacy savings on thousands Wisconsin-based mail-order pharmacy of common prescriptions To sign up, visit costplusdrugs.com and click “Sign Up.” For instructional help, visit networkhealth.com/find-a-pharmacy. Make sure your provider includes your Cost Plus Drugs email address on your prescription. For more information, visit costplusdrugs.com/ contact-your-doctor.
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414-805-5690 Monday-Friday, 6:30 a.m. to 6:30 p.m. Visit froedtert.com/pharmacy for more information.
Express Scripts Home Delivery Mail-order option Call Express Scripts at the number on the back of your member ID card. 24 hours a day, seven days a week Visit express-scripts.com/rx for more information, or download the Express Scripts Pharmacy mobile app.
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Protect Yourself and Your Family with Opioid Safety and Proper Disposal Use and dispose of opioid medications safely and be prepared for an overdose emergency. By Beth Coopman, PharmD, pharmacist at Network Health
Opioids can be effective for short-term pain management when used as prescribed, but they also carry serious risks, including misuse, addiction and accidental overdose. Safe use and proper disposal help protect you, your family and your community. What are opioids?
Watch for warning signs
Opioids are prescription pain medications such as oxycodone, hydrocodone, morphine, codeine and fentanyl. They are typically used for short-term pain after surgery or injury and work by blocking pain signals.
• Seek help for extreme sleepiness, slow or shallow breathing, blue/gray lips or nails, or confusion.
Why opioid safety matters
• Unused opioids increase the risk of accidental ingestion, misuse or theft. Dispose of them promptly once they’re no longer needed.
Opioids can cause drowsiness, slowed breathing, nausea and constipation, and may lead to dependence or addiction. Even one incorrect dose—or use by someone it wasn’t prescribed for—can be dangerous, especially for children, older adults and pets.
Take only as prescribed • Follow instructions exactly and do not take extra doses or share medication.
Avoid mixing with other substances • Do not use with alcohol. • Avoid sedatives or sleep medications unless approved by your provider.
Store securely • Keep in original containers in a locked or safe location, out of reach of children, teens and pets.
When you no longer need opioids
Proper disposal options • Best option: Use pharmacy drop boxes or community take-back events. • Use FDA-approved disposal pouches if available. • Some medications may be flushed only if listed on the FDA flush list. For more information about safe opioid disposal, visit the U.S. Food and Drug Administration (FDA) website at fda.gov/drugs/safe-disposalmedicines/disposal-unused-medicines-what-you-should-know.
Do not:
• Save leftover opioids • Throw pills in the trash without protection • Crush or alter medications • Share medications
What about Naloxone? Naloxone can reverse an opioid overdose and is available over the counter as a nasal spray. Ask your provider or pharmacist if it’s recommended for you, and ensure family members know how to use it.
Talk to your provider or pharmacist Your health care provider or pharmacist can answer questions about safe opioid use, side effects, tapering or disposal options.
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PRESORT STD US POSTAGE PAID PERMIT 1033 GREEN BAY, WI
1570 Midway Pl. Menasha, WI 54952
Is Your Child Turning 26 Soon? Turning 26 is a big milestone and it often means it’s time to find new health insurance coverage. If your child will no longer be covered under a parent’s plan and isn’t enrolling in an employer-sponsored plan, Network Health is here to help. Our individual and family plans offer a variety of coverage options designed to fit different needs and budgets. Plus, as a Wisconsin-based health plan, we’re proud to provide the personal service and support our members like you count on. We know shopping for health insurance can feel confusing, especially if it’s your first time. That’s why we make it easier to understand your options and choose a plan with confidence. For more than 40 years, Network Health has helped members find quality, affordable coverage that puts people first. We’re here to help you stay on top of preventive care, routine checkups, dental visits and more so you can focus on staying healthy and feeling your best at 26 and every age.
Main
If you or someone you know will soon need health insurance for the first time, we can walk you through your options and help you choose a plan that fits your needs and budget. Visit networkhealth.com/ individual/available-plans or call 844-635-1322 to get started.
Turning 65 Soon? If you or someone you know is approaching age 65, now is a great time to learn more about Network Health Medicare Advantage plans. As you transition to Medicare, choosing the right coverage can feel overwhelming. You don’t have to do it alone. At Network Health, we make the process easier with local support, personalized guidance and plan options designed to fit your health care needs and budget. We are Wisconsin, just like you, and committed to providing the same friendly, one-on-one service you’ve trusted for years. While Original Medicare helps cover many health care expenses, it doesn’t cover everything. That’s why many people choose a Medicare Advantage plan for additional coverage and added value. With a Network Health Medicare Advantage plan, you can enjoy benefits beyond Original Medicare, along with plan options that may include a $0 monthly premium and extras that support your lifestyle and wellness goals. Whether you’re ready to enroll or just beginning to explore your options, we’re here to help every step of the way. You can also learn more about coverage options available through the State of Wisconsin Group Health Insurance Program by visiting etf.wi.gov.
To learn more about Network Health Medicare Advantage plans: • Call us at 866-755-5233 (TTY 711) • Visit networkhealth.com, select What We Offer, Medicare Plans To view a presentation that helps you navigate Medicare, visit
networkhealth.com/navigatingmedicare or scan this QR code.
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