Information and Resources for Employees and Covered Family Members

The Alliance negotiates reduced rates from healthcare professionals and facilities on behalf of our employer-members and their employees.

1. All providers we negotiate discounts with are added to The Alliance networks, which you have access to as an employee of an employer-member.
2. We are not an insurance company — instead, think of us as a link between your doctor’s office and you.
3. We make sure you are charged the lowest negotiated rate.

The Alliance is based in Fitchburg, Wisconsin, but services other parts of the Midwest, including Illinois, Iowa, Minnesota, and Michigan. As a not-for-profit cooperative of employers who are committed to helping their employees make the best healthcare choices, The Alliance helps your employer provide you with access to healthcare providers at a reasonable cost.

Learn more about The Alliance

You can find out by looking for one of The Alliance logos on your health ID card.

Use our Find a Doctor tool. This resource lets you take charge of your search for doctors, hospitals, clinics, and procedures. The search tool features simple navigation and a mobile-friendly design for easy access, whether you are on your smartphone, tablet, or computer.

Explore your options by looking up procedures, specialties, facility types, and physicians. Enhance your search by sorting search results by name, distance, gender, or languages spoken. If you have questions, contact The Alliance customer service advocates by calling 800.223.4139 (select Option 3).

To find out what is covered, check the health plan information you received from your employer. If you don’t have that, speak to your human resources representative or contact your Third-Party Administrator (TPA). A TPA is hired by and works with your employer to process your claims.

Your TPA’s number can be found on the back of your health insurance ID card.

Many of The Alliance’s employer-members offer an additional network that provides plan members access to providers while traveling outside of The Alliance’s service area. Please check your ID card to determine if an additional network logo and phone number are listed and contact them directly for more information.

If you cannot find any reference to additional networks on your ID card, please contact your Third-Party Administrator (TPA) directly for further assistance. Your TPA’s number can be found on the back of your health insurance ID card.

If you learn that your health care provider is not part of The Alliance® networks you can recommend them to be contacted by The Alliance. Unfortunately, this does not guarantee that a provider will become a part of our network. The Alliance determines provider network growth based on: employer needs and network adequacy for our enrollees. Any services provided will be billed at out-of-network rates until an agreement is reached between The Alliance and the recommended provider.

Fill out this form to recommend a provider or you can call The Alliance at 800.223.4139 and ask to speak to Customer Service.

Your Third-Party Administrator (TPA) has access to your benefit plan, including what type of services are covered and what you’re responsible for. For questions about pre-certification, call the number on your health ID card or your TPA.

To learn more about your group health plan’s deductible, co-pay, and coinsurance levels, check the health plan information you received from your employer. If you don’t have that, speak to your human resources representative or contact your Third-Party Administrator (TPA). Your TPA’s number can be found on the back of your health insurance ID card.

Your Third-Party Administrator (TPA) is responsible for applying and tracking how much of your deductible and coinsurance obligation has been satisfied. Please contact them directly for this information. Your TPA’s number can be found on the back of your health insurance ID card.

Your employer does not work with The Alliance to provide dental or prescription drug coverage. To answer these questions, you will need to speak to a representative from one of these plans.

If you’re not sure who administers your dental or prescription benefit, please speak with your human resources representative.

ID cards are issued by your Third-Party Administrator (TPA). Please contact them directly or speak with your human resources representative for further assistance.

Your Third-Party Administrator (TPA) has access to your benefit plan, including what type of services are covered and what you’re responsible for. Your TPA’s number can be found on the back of your health insurance ID card.

Make sure you always show your health plan ID card when you visit the doctor or another healthcare professional. That way, they will know how to process your bill. They’ll send your bill to The Alliance first to ensure you receive the lowest cost available to you.

Contact The Alliance Customer Service by calling 800.223.4139 (select Option 3).

Going to the doctor sometimes seems like the easiest part of the equation. Find out what happens between the time you visit the doctor and the time you pay your bill.

1. You visit the doctor.
2. The doctor creates and sends a claim to The Alliance.
3. We apply the agreed-upon rate to the claim for any services you received. In healthcare terms, we reprice the claim.
4. Next, we forward it to your Third-Party Administrator (TPA). This all happens within less than 3 days from the day we receive your claim.
5. Your TPA reviews the claim and your healthcare coverage and pays any amount due to the provider under your plan, except for coinsurance and deductibles.
6. Your TPA sends you an Explanation of Benefits (EOB).
7. The doctor sends you a bill for the difference, if any, between the payment received from the TPA and what you owe based on your benefit plan, such as a co-pay or deductible.

We serve as a relentless advocate for you, your family, and your employer in securing the best care at the lowest cost. By directly negotiating lower prices on your employer’s behalf, we incentivize providers to deliver higher-quality care at a more affordable price. And with easy access to our vast network of doctors and facilities, you have more options when it comes to choosing a healthcare provider.

The Alliance has prepared a handy page that defines key terms related to health benefits.