Group Health Cooperative of South Central Wisconsin
- Company typePrivate
- Founded1976
- HeadquartersMadison, United States
- Headcount501–1,000
- GTM typeB2B and B2C
- OfferingServices
Group Health Cooperative of South Central Wisconsin firmographics
Firmographics- Name
- Group Health Cooperative of South Central Wisconsin
- Legal name
- Group Health Cooperative of South Central Wisconsin
- Website
- https://ghcscw.com
- Company type
- Private
- Founded year
- 1976
- Operating status
- Operating
- Headcount range
- 501–1,000 employees
- Ownership category
- akta.pro rank
Group Health Cooperative of South Central Wisconsin industry classification
Industry- Product category
- Health Insurance & Integrated Healthcare Delivery
- NAICS
- HMO Medical Centers (621491), Ambulatory Health Care Services (621), Other Outpatient Care Centers (62149)
- SIC
- Services-Misc Health & Allied Services, Nec (8090), Services-Membership Organizations (8600)
- akta.pro primary industry
- Group HMO Plans (FSAIAFAK)
Keywords
Where Group Health Cooperative of South Central Wisconsin is headquartered
LocationHeadquarters
- HQ city
- Madison
- HQ country
- United States
- HQ region
- North America
Offices7 records
Markets served
Group Health Cooperative of South Central Wisconsin business model
Business model- GTM type
- B2B and B2C
- Offering type
- Services
- Cost components
- Personnel, Operations
Revenue model
- Health Insurance Premiums: GHC-SCW generates primary revenue through health insurance premium payments from employer groups, individuals, and government programs. The company offers HMO, PPO, and POS plan structures with various metal tiers (Bronze, Silver, Gold, Platinum) for different market segments.
- Government Program Contracts: Revenue from government-sponsored health programs including Medicare Supplement plans and BadgerCare Plus (Wisconsin Medicaid) enrollment.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Monthly | Bronze tier plans offer lowest monthly premiums with highest out-of-pocket costs when care is needed. |
| Subscription | Monthly | Silver tier plans provide medium monthly premiums with medium cost-sharing, often qualifying for cost-sharing reductions. |
| Subscription | Monthly | Gold tier plans have higher monthly premiums but lower costs when receiving care. |
| Subscription | Monthly | Platinum tier plans offer highest monthly premiums with lowest costs when receiving care. |
| Subscription | Monthly | HMO (Health Maintenance Organization) plans emphasize wellness and prevention with in-network coverage. |
| Subscription | Monthly | PPO (Preferred Provider Organization) plans offer broader provider choice with in and out-of-network options. |
| Subscription | Monthly | POS (Point of Service) plans combine HMO and PPO features with primary care provider selection. |
Go-to-market motion3 records
Distribution channels5 records
Marketing channels7 records
Group Health Cooperative of South Central Wisconsin product offering
Product offeringCore offering
Group Health Cooperative of South Central Wisconsin (GHC-SCW) is a non-profit, member-owned health plan cooperative that provides health insurance plans (HMO, PPO, POS) and delivers integrated healthcare services through owned primary care clinics, pharmacies, labs, imaging, and specialty care to over 70,000 members in South Central Wisconsin. The cooperative offers health plan designs for employer groups, individuals and families, Medicare beneficiaries, federal/state employees, and BadgerCare Plus Medicaid members, with virtual care delivery through its GHCMyChart patient portal and GHC Care OnDemand platform.
Product overview
Group Health Cooperative of South Central Wisconsin (GHC-SCW) is a non-profit, member-owned health plan offering a comprehensive portfolio of health insurance plans (HMO, PPO, POS) and healthcare services to over 70,000 members in South Central Wisconsin. The core offering centers on GHC-SCW Health Insurance Plans across multiple network options, supported by in-house clinical care through six GHC-SCW Clinics and three in-house pharmacies. Digital health services are delivered through the GHCMyChart patient portal integrated with Epic EMR, featuring Epic AI Charting for AI-powered clinical documentation, and GHC Care OnDemand offering virtual care through KeyCare (urgent care, E-Visits) and MDLIVE (therapy/psychiatry). Specialty services include behavioral health programs (individual therapy, psychiatry, GHC Foundations IOP), eye care, radiology/imaging, physical/occupational therapy, and sports medicine. Member benefits include the GHC Experience Guarantee and Member-Owner Rewards program.
Differentiator
Problem solved
Functional benefit
Products and services
- GHC-SCW Health Insurance Plans Non-profit, member-owned health insurance plans providing HMO, PPO, and POS options across multiple networks (Dane Choice HMO, Neighbors HMO, Better Together HMO, Partners HMO, Partners Plus POS, BadgerCare Network, Connections PPO) for individuals, families, employers, Medicare beneficiaries, and government employees in South Central Wisconsin.
- GHC-SCW Clinics Six primary care clinic locations (Capitol Clinic, East Clinic, Hatchery Hill Clinic, Sauk Trails Clinic, Madison College Community Clinic, Olin Clinic) providing primary care, specialty care, urgent care, pharmacy, lab, and imaging services to members.
- GHCMyChart Patient Portal Secure patient portal providing members access to health records, appointment scheduling, video visits, messaging with providers, bill payment, prescription refills, test results, and family health record management through GHCFamilyChart proxy access.
- GHC Care OnDemand Virtual Care
Quantifiable outcome
- 26% reduction in after-hours documentation time for clinicians using Epic AI Charting
- +4 more outcomes
Companies that use Group Health Cooperative of South Central Wisconsin
Customer profileNamed customers3 records
Segments6 records
Ideal customer profiles6 records
Group Health Cooperative of South Central Wisconsin technology and API
TechnologyTechnology focussed No
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Integration5 records
AI capability4 records
Feature4 records
Group Health Cooperative of South Central Wisconsin partnerships and signals
Strategic signalPartnerships
Six partnerships are on record, tiered core and minor.
- UW Health / UW HospitalcoreLong-standing partnership with UW Health and UW Hospital for specialty care referrals. GHC-SCW members access elite network of hundreds of specialty providers and world-class hospital care at UW facilities, including U.S. News and World Report top-ranked services.
- UnityPoint Health-MeritercorePartnership with UnityPoint Health-Meriter Hospital for emergency and hospital care. Meriter is the designated facility for pregnancy complications and serves as an in-network hospital option for GHC-SCW members.
- KeyCarecoreKeyCare powers GHC-SCW's virtual urgent care and e-visit services, providing 24/7/365 access to licensed providers for non-emergency medical care. Members access services through GHCMyChart with no appointment required.
- MDLivecoreMDLive provides virtual therapy and psychiatry services for GHC-SCW members, enabling 24/7/365 access to licensed therapists and board-certified psychiatrists via phone or secure video for non-emergency behavioral health conditions.
- Navitus Health SolutionscorePharmacy benefits management partner handling prior authorization requests and drug formulary management. Providers submit prior authorization requests through Navitus portal for review and approval.
- VaxProminorVaccine clinic partner facilitating on-site flu, COVID-19, and RSV vaccination clinics for employer groups. Requires minimum 25 participants per clinic and can bill multiple insurance plans.
Scale indicators9 records
Recent moves6 records
Expansion highlights6 records
Group Health Cooperative of South Central Wisconsin competitors and assessment
Company assessmentDirect peers
- Security Health Plan: Wisconsin-licensed HMO affiliated with Marshfield Clinic Health System. Sells group, individual, and Medicare Supplement coverage across Wisconsin with an integrated payer-provider structure analogous to GHC-SCW.
- HealthPartners: Minnesota-based consumer-governed, integrated health plan and care system. Closest analog to GHC-SCW's member-owned, payer-provider model at slightly larger scale (~1M+ members), serving as a peer on cooperative governance philosophy and integrated delivery.
- Gundersen Health Plan: Wisconsin-based integrated insurer-provider sponsored by Gundersen Health System. Competes in the Wisconsin commercial and Medicare Advantage markets with a similar integrated payer-plus-clinic model and shared regional employer base.
- Network Health: Wisconsin-licensed health plan (owned by Froedtert Health and Ascension Wisconsin) selling HMO/PPO products to employers and individuals in eastern Wisconsin. Competes for Wisconsin-wide employer RFPs and individual exchange membership.
- Dean Health Plan: Wisconsin-based integrated health plan with owned physician practice (SSM Health/Dean Clinic) operating in largely overlapping Madison-area markets. Closest direct competitor on HMO/PPO products, integrated clinic footprint, and employer-group book of business.
- Quartz Health Solutions: Wisconsin regional health plan offering HMO, POS, and PPO products to employer groups and individuals across the state. Operates an integrated provider network that overlaps GHC-SCW's South Central Wisconsin service area and competes for the same employer RFPs.
- Aspirus Health Plan: Wisconsin regional health plan affiliated with Aspirus Health system, offering employer, individual, and Medicare products in central and northern Wisconsin. Overlaps with GHC-SCW on HMO product design and integrated provider strategy.
Broad incumbents
- Kaiser Permanente (formerly Group Health Cooperative): National, member-governed integrated payer-provider system that historically grew out of the original Group Health Cooperative (Seattle). The closest philosophical peer to GHC-SCW's cooperative, vertically integrated model — operating at far greater scale and geographic reach.
- Anthem Blue Cross and Blue Shield of Wisconsin: Wisconsin's Blue Cross Blue Shield licensee and dominant statewide commercial insurer. Broader incumbent offering full HMO/PPO/POS plus national network and ASO products that GHC-SCW cannot match on multi-state employers.
- UnitedHealthcare Wisconsin: National payer operating one of the largest Wisconsin footprints across employer, individual (HealthCare.gov), and Medicare Advantage. Competes on scale, network breadth, and pricing — often the foil for GHC-SCW's community-cooperative positioning.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat5 records
Key risks6 records
Key highlights7 records
Customer concentration
Group Health Cooperative of South Central Wisconsin social profiles
Digital presenceGroup Health Cooperative of South Central Wisconsin compliance and trust
Trust signalCompliance1 record
Group Health Cooperative of South Central Wisconsin financial estimates
Financial estimateRevenue estimate
Valuation estimate
Group Health Cooperative of South Central Wisconsin leadership team
Management profileNumber of profiles
Profiles1 record
Group Health Cooperative of South Central Wisconsin funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Group Health Cooperative of South Central Wisconsin 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 Group Health Cooperative of South Central Wisconsin
What does Group Health Cooperative of South Central Wisconsin do?
Group Health Cooperative of South Central Wisconsin (GHC-SCW) is a non-profit, member-owned health plan cooperative that provides health insurance plans (HMO, PPO, POS) and delivers integrated healthcare services through owned primary care clinics, pharmacies, labs, imaging, and specialty care to over 70,000 members in South Central Wisconsin. The cooperative offers health plan designs for employer groups, individuals and families, Medicare beneficiaries, federal/state employees, and BadgerCare Plus Medicaid members, with virtual care delivery through its GHCMyChart patient portal and GHC Care OnDemand platform.
Is Group Health Cooperative of South Central Wisconsin a public or private company?
Group Health Cooperative of South Central Wisconsin is a private company. It is classified as nonprofit foundation owned and is currently operating.
When was Group Health Cooperative of South Central Wisconsin founded?
Group Health Cooperative of South Central Wisconsin was founded in 1976. It employs 501 to 1,000 people.
Where is Group Health Cooperative of South Central Wisconsin based?
Group Health Cooperative of South Central Wisconsin is headquartered in Madison, United States, in the North America region.
How does Group Health Cooperative of South Central Wisconsin make money?
Two revenue lines are on record. Health Insurance Premiums are the primary driver. The others are government Program Contracts.
Who are Group Health Cooperative of South Central Wisconsin's main competitors?
Direct peers on record are Security Health Plan, HealthPartners, Gundersen Health Plan, Network Health, Dean Health Plan, Quartz Health Solutions and Aspirus Health Plan. Broad incumbents are Kaiser Permanente (formerly Group Health Cooperative), Anthem Blue Cross and Blue Shield of Wisconsin and UnitedHealthcare Wisconsin.
Does Group Health Cooperative of South Central Wisconsin have an API?
No public API is recorded for Group Health Cooperative of South Central Wisconsin.
What industry is Group Health Cooperative of South Central Wisconsin in?
Group Health Cooperative of South Central Wisconsin's product category is Health Insurance & Integrated Healthcare Delivery. Its primary akta.pro industry code is FSAIAFAK, Group HMO Plans. Its NAICS code is 621491 and its SIC code is 8090.