Dean Health Plan

What Dean Health Plan does

Dean Health Plan, Inc. (DBA Dean Health Plan by Medica) is a Wisconsin-domiciled, private health insurance company headquartered at 1277 Deming Way, Madison, Wisconsin, founded in 1987 and operating as a subsidiary of Medica, an independent nonprofit health plan headquartered in Minnetonka, Minnesota. The company underwrites and administers a comprehensive portfolio of health insurance products — Medicare Advantage (Dean Advantage HMO/HMO-POS), Medicare Cost (DeanCare Gold), Medicare Supplement (DeanCare Select), individual and family EPO/HMO/Focus Network plans offered through healthcare.gov and direct channels, small group (2–50 employees) and large group (51+) fully-funded and self-funded employer plans, level-funded hybrids (5–50 employees), and Wisconsin Medicaid (BadgerCare Plus) managed care — serving more than 415,000 members across 1,300+ employer groups in 20 counties of South Central Wisconsin. Its core technology architecture combines a shared Medica claims processing platform, Navitus PBM, Availity multi-payer provider portal, First Health PPO for out-of-area access, Carelon for select utilization management and Prime Therapeutics for medical-benefit specialty drug prior authorization, plus the SSM Health MyChart patient portal.

Revenue is generated through recurring monthly premiums on fully-insured commercial, Medicare Advantage/Cost/Supplement, and Medicaid products, supplemented by Administrative Services Only (ASO) fees, stop-loss insurance commissions, level-funded administrative and claims funding arrangements (with 50% of unused claims returned to employers), and unit-priced virtual-care services ($39 e-visit / $59 video visit). Distribution is multi-channel: direct field sales to employer groups with named large-group and small-group account executives, a licensed agent/broker network using the Medica Broker Portal, healthcare.gov marketplace enrollment, HealthSherpa and destinationRX online enrollment for individual/Medicare business, and Medicare seminars. The company markets differentiated offerings including Smart Plans (no-deductible, no-coinsurance employer plans), Copay Elite tiered-benefit plans, Value Choice tiered-network plans, the WebMD-powered Living Healthy wellness portal with up to $150 annual rewards, the Dean On Call 24/7 nurse advice line, SSM Health e-visits and video visits, and the Mental Health as One employer program — all anchored to its Integrated Delivery Network with SSM Health spanning 3,700+ providers, 33 hospitals, and 230 primary care sites.

The operating model is defined by deep integration with SSM Health (clinic and hospital delivery), administrative alignment with parent Medica (shared claims platform and back-office technology adopted in the 2023 partnership), and a regional South Central Wisconsin geographic footprint. Named customers include the State of Wisconsin, Dane County, Rock County, multiple Wisconsin school districts, and Aon (active health exchange). Recent strategic activity has centered on vendor modernization — Carelon for UM effective October 1, 2024 (replacing NIA Magellan) and Prime Therapeutics for specialty drug PA effective July 1, 2026 — alongside product launches in self-funded/level-funded, Smart Plans, and tiered-network employer designs. Member retention is reported at more than 98% annually. Revenue is not publicly disclosed.

Name

Dean Health Plan

Legal name

Dean Health Plan, Inc.

Website

https://deancare.com

Company type

Private

Founded year

1987

Operating status

Operating

Headcount range

501–1,000 employees

Short description

Dean Health Plan is a Madison, Wisconsin-based private health insurer (subsidiary of Medica) underwriting Medicare Advantage, Medicare Supplement/Cost, individual/family, small and large employer, and Medicaid (BadgerCare Plus) plans, serving 415,000+ members across 20 South Central Wisconsin counties through an SSM Health integrated delivery network and shared Medica claims platform.

Ownership category

akta.pro rank

Product category

Health Insurance

NAICS

Direct Health and Medical Insurance Carriers (524114), Direct Life, Health, and Medical Insurance Carriers (52411), Health and Welfare Funds (52512)

SIC

Accident & Health Insurance (6321), Hospital & Medical Service Plans (6324)

akta.pro primary industry

Managed Care / Network-Based Group Health Plans (Carrier Network Products) (FSAIAFAO)

akta.pro secondary industries

Medicare Advantage (MA) Plans (FSAIAGAA), Level-Funded Group Health Plans (FSAIAFAC), MA Prescription Drug Plans (MA-PD) (HLAEACAF), MA Chronic Condition Management & Supplemental Benefits (SSBCI) (HLAEACAI)

Keywords

• Health insurance plans
• Medicare Advantage plans
• Employer group coverage
• Self-funded ASO plans
• Managed care plans

Headquarters

HQ city

Madison

HQ country

United States

HQ region

North America

Offices2 records

Markets served

GTM type

B2B and B2C

Offering type

Services

Revenue model

1. Health Insurance Premiums - Employer Group Plans: Dean Health Plan generates primary revenue through monthly premium payments from employer groups (small groups with 2-50 employees and large groups with 51+ employees) for fully-funded insurance plans. Employers pay monthly premiums to the insurance company which assumes the risk of medical claims.
2. Health Insurance Premiums - Individual and Family Plans: Revenue from individual and family health insurance plans purchased directly or through healthcare.gov marketplace, including EPO and HMO options.
3. Medicare Advantage Plans: Revenue from Medicare Advantage plans including Dean Advantage HMO/HMO-POS and DeanCare Gold Cost plans, with Medicare contracts for Part A, Part B, and Part D coverage.
4. Administrative Services Only (ASO): Self-funded plan administration fees from employers who assume risk of medical claims but pay monthly administrative fees. Includes stop-loss coverage options and comprehensive services like medical claims administration, network management, and utilization management.
5. Level-Funded Plans: Hybrid insurance model combining predictability of monthly payments with flexibility of self-funding for groups with 5-50 employees, with potential return of unused claim funds.
6. Medicaid/BadgerCare Plus: Revenue from BadgerCare Plus Medicaid managed care plans for Wisconsin residents meeting eligibility requirements.

Pricing tiers

Go-to-market motion3 records

Distribution channels6 records

Marketing channels8 records

Core offering

Dean Health Plan is a Wisconsin-based health insurance company that sells fully-funded and self-funded health plans, including HMO, PPO, EPO, POS, and Medicare Advantage products, to employer groups, individuals, families, Medicare beneficiaries, and Medicaid members. It administers coverage through an Integrated Delivery Network with SSM Health covering 20 counties in South Central Wisconsin, leveraging a shared claims platform with parent company Medica.

Product overview

Dean Health Plan by Medica is a health insurance company providing comprehensive health coverage through multiple plan types across Wisconsin. The product portfolio includes Medicare Advantage plans (Dean Advantage), Medicare Cost plans (DeanCare Gold), Medicare Supplement plans (DeanCare Select), Individual and Family plans (EPO/HMO/Focus Network), employer group plans (Small Group and Large Group), and Medicaid (BadgerCare Plus). Employer offerings include Smart Plans with no deductibles, Value Choice tiered benefit plans, Copay Elite plans, Level-Funded hybrid plans, and ASO self-funded administrative services. Digital health services include E-Visits and Video Visits through SSM Health, the Dean On Call nurse advice line, and Living Healthy wellness program powered by WebMD. The integrated delivery network includes SSM Health system with over 3,700 providers, 33 hospitals, and 230 primary care sites across 20 counties in South Central Wisconsin.

Differentiator

Problem solved

Functional benefit

Brands

• Dean Advantage: Medicare Advantage HMO/HMO-POS plan offering health coverage for Medicare-eligible individuals.
• DeanCare Gold
• DeanCare Select
• Dean On Call
• Copay Elite
• Smart Plans
• Dean ASO

Products and services

• Dean Advantage Medicare Advantage HMO/HMO-POS plan providing Medicare Part A and B coverage, Part D pharmacy benefits, and additional benefits for Medicare-eligible seniors.
• DeanCare Gold (Cost) Medicare Cost plan offering coverage through a network of providers with options for out-of-network care for Medicare beneficiaries.
• DeanCare Select Medicare supplement plan providing additional coverage to fill gaps in Original Medicare benefits.
• Individual and Family Plans Health insurance plans for individuals and families not covered through employer or government programs, available as EPO, HMO, and Focus Network options through the healthcare.gov marketplace.
• Small Group Plans Health insurance plans for employers with 2-50 employees, available as fully-funded and level-funded options with various network choices.
• Large Group Plans Health insurance plans for employers with 51 or more employees offering customizable benefit designs and integrated delivery network access.
• Smart Plans Health plan featuring no deductibles and no coinsurance with transparent copay structure for employer groups; preventive care covered at 100%.
• Value Choice Plan Large group employer plan offering lower premiums with tiered copay benefits; Tier 1 providers include SSM Health for reduced office visit costs.
• Copay Elite Plans Tiered benefit health plans offering lower copays for primary care visits at Tier 1 providers within the integrated care network; available in Green Lake, Iowa, and Jefferson counties for small group members.
• Level-Funded Plans Hybrid insurance model for groups with 5-50 employees combining predictability of monthly payments with flexibility of self-funding; 50% of unused claims funds returned to employer annually.
• ASO (Administrative Services Only) Plans Self-funded administrative services plans allowing large employers to customize health benefits including deductibles, coverage options, networks, pharmacy choices, and wellness programs with full control of plan design.
• BadgerCare Plus Wisconsin Medicaid program providing health coverage for eligible low-income individuals and families.
• E-Visits Asynchronous telehealth service allowing members to receive diagnoses and prescriptions from SSM Health providers via online symptom questionnaire within 60 minutes; covered at $39 or standard copay.
• Video Visits Real-time video consultations with SSM Health providers through MyChart for after-hours care and non-emergency conditions; available 6 a.m. - 10 p.m. daily at $59 or standard copay.

Quantifiable outcome

• More than 98% member retention each year
• +3 more outcomes

Named customers5 records

Segments6 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration16 records

Feature7 records

Partnerships

Eleven partnerships are on record, tiered major, core and minor.

• Prime TherapeuticsmajorTechnology or Integration · 1 July 2026Prime Therapeutics Management manages specialty drug prior authorization reviews and approvals for certain specialty drugs effective July 1, 2026. The Medical Pharmacy Solutions team handles review and approval for professionally administered drugs that fall under the medical benefit.
• CarelonmajorTechnology or Integration · 1 October 2024Dean Health Plan partnered with Carelon, a utilization management (UM) program vendor, effective October 1, 2024, to support provider submission and medical necessity review for select musculoskeletal (MSK), interventional pain management, cardiology, and radiology services. This replaced previous services managed by NIA Magellan.
• MedicacoreStrategic or Co-development PartnerDean Health Plan has partnered with Medica, an independent, nonprofit health plan headquartered in Minnetonka, Minnesota. The partnership aligns best practices and shares technology, including a shared claims processing platform. Medica branding appears in association with Dean Health Plan as part of this strategic alignment.
• SSM HealthcoreStrategic or Co-development PartnerDean Health Plan operates an Integrated Delivery Network (IDN) with SSM Health, which is known for its high quality of care and access to hundreds of specialists. SSM Health provides inpatient and outpatient healthcare services through SSM Health Dean Medical Group clinics, SSM Health St. Mary's Hospital - Madison, SSM Health St. Clare Hospital, and SSM Health St. Mary's Hospital - Janesville.
• First HealthmajorTechnology or IntegrationDean Health Plan has partnered with First Health to provide PPO network access for members outside the service area. First Health offers providers and facilities within and outside Wisconsin, providing coverage options for members traveling or living outside the Dean Health Plan service area.
• NavituscoreTechnology or IntegrationDean Health Plan partners with Navitus as its pharmacy benefits manager (PBM). Navitus provides formulary access, prior authorization forms, P&T committee updates, and pharmacy network management including specialty pharmacy services.
• WebMDmajorTechnology or IntegrationDean Health Plan's Living Healthy wellness portal is powered by WebMD Health Services. The portal provides thousands of resources including monthly interactive challenges, wellness and exercise videos, mental health podcasts, nutritional information, and self-assessments for members.
• AvailitymajorTechnology or IntegrationAvaility Essentials is a multi-payer provider portal used by Dean Health Plan providers for member eligibility/benefits verification, prior authorization submission, and claims status review.
• WalgreensminorChannel Partner/ Reseller/ DistributorWalgreens team pharmacy network available for Walgreens team members. Separate pharmacy network map provided for Walgreens team member pharmacy locations.
• MyChart (SSM Health)majorTechnology or IntegrationMyChart patient portal integration allows Dean Health Plan members to securely make appointments, message providers, view lab results, and access health records through the SSM Health MyChart platform.
• SSM HealthcoreTechnology or IntegrationE-visit and video visit services provided through SSM Health's Zipnosis platform and Express Virtual Care, allowing members to access care from SSM Health providers from home via smartphone, computer, or tablet.

Scale indicators6 records

Recent moves6 records

Expansion highlights5 records

Broad incumbents

• Humana: National health insurer with a significant Medicare Advantage focus competing directly with Dean's Dean Advantage HMO/HMO-POS products in Wisconsin. Comparable MA product strategy and broker-driven distribution model.
• Medica: Dean Health Plan's parent company, an independent nonprofit health plan headquartered in Minnesota. Comparable employer group, MA, and individual product lines; provides shared claims platform and back-office services for Dean.
• Anthem Blue Cross Blue Shield Wisconsin: Wisconsin market leader under the Blue Cross Blue Shield brand, offering a full spectrum of employer group, individual, and Medicare plans statewide. Competitor in the same employer and ASO segments with broader network reach.
• UnitedHealthcare (Wisconsin): Largest U.S. health insurer operating across all Wisconsin counties with broad PPO/HMO/MA and ASO offerings. Directly competes in employer group and Medicare Advantage but operates at national scale with materially larger provider discounts and broker reach.

Direct peers

• Network Health (Wisconsin): Wisconsin-licensed health insurance carrier offering Medicare Advantage, individual/family, and employer group plans in the northeastern and southeastern Wisconsin markets. Comparable across product mix, geography overlap, and IDN-affiliated delivery model.
• Security Health Plan: Wisconsin-licensed health plan serving employer groups, Medicare Advantage, and individual members, integrated with Marshfield Clinic Health System. Directly comparable network-based HMO/POS model anchored to a major Wisconsin delivery network.
• Quartz Health Solutions: Wisconsin-headquartered health plan offering HMO/POS and Medicare Advantage products to employers and individuals in southern Wisconsin. Directly comparable in service area, network-based delivery model, and product portfolio (employer group, MA, individual).
• MercyCare Health Plans: Regional Wisconsin health plan affiliated with Mercyhealth, offering HMO, PPO, and Medicare Advantage products to employers, individuals, and Medicare beneficiaries in southern Wisconsin and northern Illinois. Overlaps in product type and care-delivery model.

Regional players

• Molina Healthcare: Operates a Wisconsin Medicaid managed care contract (BadgerCare Plus) and selected Medicare Advantage plans, overlapping Dean's Medicaid line. Primarily government-program focused with comparable regulatory exposure.

Emerging players

• Dean Health Plan (SSM Health) affiliate analysis: Gundersen Health Plan: Wisconsin/regional provider-affiliated health plan offering employer group and individual products anchored to a regional delivery network. Comparable network-based HMO model and product scope, though smaller and focused on western Wisconsin.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat6 records

Key risks5 records

Key highlights6 records

Customer concentration

• YouTubeyoutube.com/choosedean
• Facebookfacebook.com/deanhealthplan
• LinkedInlinkedin.com/company/dean-health-plan-inc-
• Instagraminstagram.com/deanhealthplan

Revenue estimate

Valuation estimate

Number of profiles

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Dean Health Plan