Network Health Services
Network Health is a Wisconsin-based, provider-owned health insurer (owned by Froedtert ThedaCare Health) offering Medicare Advantage, individual/family, employer, and government plans to over 120,000 Wisconsin residents since 1982.
- Company typePrivate
- Founded1982
- HeadquartersNashville, United States
- Headcount501–1,000
- GTM typeB2B and B2C
- OfferingServices
What Network Health Services does
Network Health Services is a Wisconsin-based, provider-owned health insurance company founded in 1982 and headquartered in Menasha, WI, with a secondary office in Brookfield, WI. The company offers a comprehensive portfolio of health plans across Medicare Advantage (11 PPO plans including Anywhere, Armor, Bravo, Choice, Select, Zero, PlusRx, PremierRx, Go, Prime MSA, and Cares D-SNP), individual and family plans (Prestige Bronze, Silver, and Gold tiers available on and off the Health Insurance Exchange), employer plans (Small Group ACA, Assure Level-Funded, mid-size/large group), Group Medicare Advantage, and specialized coverage for State of Wisconsin employees. Network Health is wholly owned by Froedtert ThedaCare Health, Inc., which enables tight integration with the Froedtert ThedaCare provider network and other major Wisconsin systems including Aurora Health Care (in-network January 2026) and ProHealth Care (in-network August 2025).
The company operates a healthcare administration platform that includes a member portal, provider directory search (via HealthSparq), medication lookup with formulary tiers, and mobile ID card functionality. Pharmacy benefits are administered through Express Scripts with mail-order delivery, prior authorization via CoverMyMeds/ExpressPAth, and a specialty savings program (SaveOnSP). Ancillary benefits are delivered through a vendor ecosystem including MDLIVE (virtual care), EyeMed (vision), TruHearing (hearing), Say Cheese Dental Network and Delta Dental, and One Pass (fitness with 28,000+ gym locations). The 2025 partnership with Mark Cuban Cost Plus Drug Company added transparent cost+15% mail-order pharmacy as an in-network option for Medicare Advantage members.
Network Health generates revenue through monthly health insurance premiums (Medicare Advantage, employer group, individual/family), third-party administration fees for self-funded employer plans, and government business services including NCQA-accredited Medicaid and Medicare enrollment/eligibility management. Pricing ranges from $0 monthly premium Medicare Advantage plans with Part B premium giveback to HSA-compatible Bronze plans with deductibles of $0-$7,750. Distribution is multi-channel: direct website/phone sales, licensed agent and broker networks (with $18 PMPM individual commissions and bonus programs), the federal Health Insurance Marketplace, and dedicated employer/Medicare sales teams. The company serves over 120,000 members, employs 501-1,000 people, and has achieved 95% Medicare Advantage member retention and five consecutive years of CMS 5-star customer service ratings (2022-2026).
Network Health Services firmographics
Firmographics- Name
- Network Health Services
- Legal name
- Network Health
- Website
- https://networkhealth.com
- Company type
- Private
- Founded year
- 1982
- Operating status
- Operating
- Headcount range
- 501–1,000 employees
- Short description
- Network Health is a Wisconsin-based, provider-owned health insurer (owned by Froedtert ThedaCare Health) offering Medicare Advantage, individual/family, employer, and government plans to over 120,000 Wisconsin residents since 1982.
- Ownership category
- akta.pro rank
Where Network Health Services is headquartered
LocationHeadquarters
- HQ city
- Nashville
- HQ country
- United States
- HQ region
- North America
Offices2 records
Markets served
Network Health Services business model
Business model- GTM type
- B2B and B2C
- Offering type
- Services
- Cost components
- Personnel, Operations, Technology or R&D, Marketing or Sales, Infrastructure
Revenue model
- Health Insurance Premiums: Network Health generates revenue primarily through收取医疗保险保费。Medicare Advantage plans, employer group plans, and individual/family plans all involve monthly premium payments from members or employers.
- Third Party Administration (TPA) Services: Administrative services for self-funded employer plans including claims processing, eligibility management, and reporting. Offered through both commercial group and government business services platforms.
- Government Business Services: NCQA accredited platform providing Medicaid and Medicare enrollment/eligibility management, claims processing, and compliance services to partner organizations.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Monthly | Medicare Advantage PPO Plans - Multiple Tiers |
| Subscription | Monthly | Individual and Family Plans - Bronze, Silver, Gold Tiers |
| Subscription | Monthly | Small Business Employer Plans |
| Subscription | Monthly | Group Medicare Advantage Plans |
Go-to-market motion3 records
Distribution channels5 records
Marketing channels6 records
Network Health Services product offering
Product offeringCore offering
Network Health Services is a Wisconsin-based health insurance company that sells Medicare Advantage PPO plans, individual and family plans (Bronze, Silver, Gold tiers), employer group plans (small business, large group, group Medicare Advantage), Medicaid plans, and Third Party Administration services to Wisconsin residents and employers. The company is provider-owned by Froedtert ThedaCare Health, Inc. and integrates medical, pharmacy, dental, vision, hearing, and fitness benefits through a coordinated care model.
Product overview
Network Health is a Wisconsin-based health insurance company offering a comprehensive portfolio of health plans across multiple segments. The core offering consists of 11 Medicare Advantage PPO plans (Network Health Anywhere, Armor, Bravo, Choice, Select, Zero, PlusRx, PremierRx, Go, Prime MSA, and Cares D-SNP) providing medical, drug, dental, vision, hearing, and fitness benefits. Individual and family plans are offered as Prestige Bronze, Silver, and Gold tier HMO plans available on and off the Health Insurance Exchange. Employer solutions include Small Group ACA Plans, Assure Level-Funded Plans, Mid-Size/Large Group Plans, and Group Medicare Advantage. Additional offerings include Third Party Administration services and specialized State of Wisconsin Group Health Insurance Program. Plans integrate with vendors including Express Scripts (pharmacy), MDLIVE (virtual care), HealthSparq (provider directory), EyeMed (vision), TruHearing, Say Cheese Dental Network, One Pass (fitness), Cost Plus Drugs (mail-order pharmacy), and CoverMyMeds (prior authorization). The company is provider-owned by Froedtert ThedaCare Health and serves over 120,000 members across Wisconsin.
Differentiator
Problem solved
Functional benefit
Products and services
- Network Health Anywhere (PPO) Medicare Advantage PPO plan offering comprehensive coverage including $0 Part B premium option, vision allowance, dental coverage, quarterly OTC benefit, and hearing exam coverage for Wisconsin seniors.
- Network Health Armor (PPO) Medicare Advantage PPO plan featuring 100% in-network dental coverage including one implant and resin, $400 annual vision allowance, $5,000 combined dental annual maximum, and hearing aid coverage.
- Network Health Bravo (PPO) Medicare Advantage PPO plan with 100% in-network dental coverage including one implant and resin, $400 vision allowance, $5,000 combined dental annual maximum, and hearing aid coverage.
- Network Health Choice (PPO) Medicare Advantage PPO plan with $1,500 combined annual dental maximum, $200 vision allowance, $40 quarterly OTC benefit, comprehensive coverage, and Part B Premium Giveback.
- Network Health Select (PPO) Medicare Advantage PPO plan with Pick Your Perks benefit up to $550 per plan year for supplemental benefits including dental, vision, personal training, meals, transportation, and OTC items.
- Network Health Zero (PPO) Medicare Advantage PPO plan with $0 monthly premium, Pick Your Perks benefit up to $625 per plan year, Part B Premium Giveback, and comprehensive Medicare coverage.
- Network Health PlusRx (PPO) Medicare Advantage PPO plan with built-in pharmacy coverage, $750 combined dental annual maximum, $140 quarterly OTC benefit, and Part B Premium Giveback.
- Network Health PremierRx (PPO) Medicare Advantage PPO plan with comprehensive drug coverage including preventive dental (one exam/cleaning per year, $30 copay in-network) and Part B Premium Giveback.
- Network Health Go (PPO) Medicare Advantage PPO plan with Pick Your Perks benefit up to $1,155 per plan year for supplemental benefits including dental, vision, personal training, meals, transportation, OTC, and acupuncture.
- Network Health Prime (MSA) Medicare Medical Savings Account (MSA) plan with $4,000 annual deductible, $0 monthly premium, and tax-advantaged savings features for cost-conscious beneficiaries.
- Network Health Cares (PPO D-SNP) Special Needs Plan (PPO D-SNP) for dual-eligible members with Medicare and Wisconsin Medicaid coverage, offering tailored benefits and care coordination for members with special health care needs.
- Prestige Bronze Plans Individual and family health plans at Bronze metal tier including Prestige Bronze Plus ($7,500 deductible), Prestige Bronze Essential with dental/vision and 3 free PCP visits ($7,750 deductible), Prestige Bronze 20 HDHP, and Prestige Bronze $0 Medical Deductible. All 2026 Bronze plans are HSA-eligible.
- Prestige Silver Plans Individual and family health plans at Silver metal tier offering deductibles and coinsurance midway between Bronze and Gold, including Prestige Silver and Prestige Silver Essential with dental/vision and 3 free PCP visits.
- Prestige Gold Plans Individual and family health plans at Gold metal tier with the lowest deductible options, including Prestige Gold, Prestige Gold Essential with dental/vision and 3 free PCP visits, and Prestige Gold 50 with the lowest deductible.
- Assure Level-Funded Plan Small business employer plan combining fixed monthly premiums with self-insured advantages. Employers eligible for funding surplus if claims are less than funded amount. Available for companies with 2-100 enrolled employees with optional stop-loss coverage.
- Small Group ACA Plans Affordable Care Act compliant group plans for small businesses with 2-50 enrolled employees. Features preventive dental coverage, prescription drug coverage, HSA-qualified options, and over 30 plan choices.
- Mid-Size and Large Group Employer Plans Customizable employer health plans with comprehensive coverage for wide range of medical services, cost-effective in-network provider options, care coordination, and transparent fee structure. Includes Administrative Services Only (ASO) arrangements.
- Group Medicare Advantage Plans Passive PPO employer group Medicare Advantage plans allowing retirees to access any Medicare provider. Covers Parts A and B, may include Part D drug coverage and extra benefits like dental, vision, hearing, OTC, Part B Premium Giveback, virtual visits, and fitness.
- State of Wisconsin Group Health Insurance Program Specialized health plan for State of Wisconsin employees featuring local provider network including Froedtert, ThedaCare, Ascension Wisconsin, Children's Wisconsin, ProHealth Care, and Aurora Health Care. Includes IYC Health Plans, HDHP options, Local Traditional plans, care management, condition management, and wellness programs.
- Third Party Administration (TPA) Services Administrative services for self-funded employer plans and government health programs, including local customer service, claims processing, employer portal with analytics and reporting, access to provider network and contracted rates, and configurable government business services platform for Medicaid and Medicare enrollment/eligibility management.
- Medicaid Plans Medicaid managed care plans for Wisconsin beneficiaries, served through partnership with MHS Health Wisconsin, providing access to Wisconsin healthcare providers.
Quantifiable outcome
- 95% member retention rate for Medicare Advantage plans in 2025
- +3 more outcomes
Companies that use Network Health Services
Customer profileNamed customers8 records
Segments7 records
Ideal customer profiles7 records
Network Health Services technology and API
TechnologyTechnology focussed No
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Integration16 records
Feature3 records
Network Health Services partnerships and signals
Strategic signalPartnerships
Twelve partnerships are on record, tiered core and major.
- Mark Cuban Cost Plus Drug CompanycoreNetwork Health partnered with Cost Plus Drugs to become the first Wisconsin-based health plan to offer Mark Cuban's online pharmacy as an in-network mail-order pharmacy for Medicare Advantage plans. Members can save on over 1,000 generic medications using transparent pricing (cost + 15% model).
- Froedtert ThedaCare Health, Inc.coreFroedtert ThedaCare Health owns Network Health, ensuring members have access to high-quality coordinated care. The ownership structure enables deep integration between the health plan and provider network for seamless care delivery.
- Aurora Health CaremajorAurora Health Care became in-network as of January 1, 2026 for Medicare Advantage, commercial group, group Medicare Advantage, State of Wisconsin, and Assure health plans. Also in-network for small group ACA products.
- ProHealth CaremajorProHealth Care hospital and clinic locations became in-network effective August 1, 2025, significantly expanding the provider network for individual and family plans.
- Express ScriptscoreExpress Scripts handles pharmacy benefit management for Network Health members including mail-order pharmacy services, prior authorization processing, and prescription drug claim reimbursement.
- MDLIVEcoreMDLIVE provides virtual doctor visit services available 24/7 for treatment of common conditions and prescription fulfillment. Includes board-certified physicians for a wide range of medical issues.
- TruHearingcoreTruHearing provides hearing benefits including annual routine hearing exams, high-quality hearing aids (Signia, Widex, ReSound, Starkey, Oticon, Phonak), fittings and follow-up care with copayments ranging from $495-$1,695 per aid.
- EyeMedcoreEyeMed provides vision benefits including annual routine vision exams at in-network providers and allowances for contact lenses and glasses. Provider network for vision services.
- Say Cheese Dental NetworkcoreSay Cheese Dental Network provides dental care benefits across Network Health Medicare Advantage plans with various coverage levels and annual maximums up to $5,000 depending on plan.
- One PasscoreOne Pass provides a nationwide gym membership program included with most Medicare Advantage plans. Includes unlimited access to YMCAs, 24,000+ virtual fitness classes, and access to 28,000+ premium and core fitness center locations.
- Delta DentalcoreDelta Dental administers dental benefits for State of Wisconsin Group Health Insurance Program members through a dedicated portal.
- NavituscoreNavitus manages pharmacy benefits for State of Wisconsin Group Health Insurance Program members.
Scale indicators4 records
Recent moves6 records
Expansion highlights5 records
Network Health Services competitors and assessment
Company assessmentMarket position
Competitive moat5 records
Key risks6 records
Key highlights7 records
Customer concentration
Network Health Services social profiles
Digital presenceNetwork Health Services compliance and trust
Trust signalCompliance4 records
Network Health Services financial estimates
Financial estimateRevenue estimate
Valuation estimate
Network Health Services leadership team
Management profileNumber of profiles
Profiles2 records
Network Health Services funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Network Health Services M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Network Health Services
What does Network Health Services do?
Network Health Services is a Wisconsin-based health insurance company that sells Medicare Advantage PPO plans, individual and family plans (Bronze, Silver, Gold tiers), employer group plans (small business, large group, group Medicare Advantage), Medicaid plans, and Third Party Administration services to Wisconsin residents and employers. The company is provider-owned by Froedtert ThedaCare Health, Inc. and integrates medical, pharmacy, dental, vision, hearing, and fitness benefits through a coordinated care model.
Is Network Health Services a public or private company?
Network Health Services is a private company. It is classified as corporate owned and is currently operating.
When was Network Health Services founded?
Network Health Services was founded in 1982. It employs 501 to 1,000 people.
Where is Network Health Services based?
Network Health Services is headquartered in Nashville, United States, in the North America region.
How does Network Health Services make money?
Three revenue lines are on record. Health Insurance Premiums are the primary driver. The others are third Party Administration (TPA) Services and government Business Services.
Does Network Health Services have an API?
No public API is recorded for Network Health Services.