This page provides a summary side-by-side comparison of health plan options for benefits-eligible university employees. Use it to inform your health insurance selections and compare each health plans’ network coverage, deductibles, copays, coinsurance, out-of-pocket maximums, and more.

Description of Plans

PLAN UISELECT UICHOICE
DESCRIPTION AND HIGHLIGHTS

UISelect is designed for employees who value high-quality coverage and want more of a say over their spending to meet financial needs. Members would pay lower monthly premiums than UIChoice, and if they use their coverage, they will pay a higher out-of-pocket cost for medical services.

Highlights:

  • Lower premiums, higher out-of-pocket costs.
  • Covers level 1 and level 2 providers, meaning it only covers medical providers in Iowa.
  • Coverage outside of Iowa is not covered except in emergencies or with Doctor on Demand.
    (Dependent children attending college, long-term travelers, and families living apart may be covered through guest membership)

UIChoice is a high-quality plan with extensive coverage inside and outside of Iowa. Premiums for UIChoice are higher than UISelect, and the out-of-pocket costs for medical services are lower. 

Highlights:

  • Higher premiums, lower out-of-pocket costs.
  • Covers providers nationwide; how much you pay depends on the benefit level of the provider you choose.
  • Medical services are covered outside of Iowa, and costs are lower in-network.

*Active Employee Premium Rates

  UISelect UIchoice
Employee Only $0 $81
Employee+Spouse $311 $389
Employee+Child(ren) $254 $317
Employee+Family $333 $416
Double Spouse Family $0 $208

*The rates listed above are active employee rates. Please visit the Retiree Health Insurance Rates page to review retirees' rates. 

Plan Provisions

  UISELECT UICHOICE

 

PROVIDERS

Level 1:  

All UI Health Care locations, including
UI Hospitals & Clinics,
UI Urgent Care, and 
UI QuickCare.

Level 2: 

Providers in the Blue Access network 

Level 3: 

Not covered, except in emergencies.

(Dependent children attending college, long-term travelers,
and families living apart may be covered through guest membership)

Level 1: 

All UI Health Care locations, including
UI Hospitals & Clinics,
UI Urgent Care, and 
UI QuickCare.

Level 2:

Providers from the Blue Choice network

Level 3:

Participating providers from the BlueCard network.

Non-participating providers outside of the network. (subject to balance billing)
ANNUAL DEDUCTIBLE

Level 1: 

Single: $500

Family: $1,000

Level 2: 

Single: $950

Family: $1,900

None.

Deductible for inpatient care only for levels 1, 2, and 3. See Inpatient Care Deductible below.

ANNUAL INPATIENT CARE DEDUCTIBLE

Level 1:

See Deductible above.

Level 2:

See Deductible above.

Level 1:  

$500 deductible, followed by 10% coinsurance

Level 2:  

$750 deductible, followed by 10% coinsurance

Level 3:  

$1,000 deductible, followed by 40% coinsurance

COINSURANCE

Level 1:

15%

Level 2: 

25%

Level 1: 

10%

Level 2: 

20%*
*services excluding inpatient care (see above). 

Level 3:

Varies based on location & service

COPAY

Level 1:

Primary care
$15 copay

Specialists:
$25 copay

Level 2: 

Primary Care
$40 copay

Specialists:
$55 copay

Level 1: 

$15 copay

Level 2: 

$30 copay

Level 3: 

No copay. Subject to coinsurance depending on service.

ANNUAL OUT-OF-POCKET MAXIMUM (OPM)

Level 1: 

Single: $2,300

Family $4,000

Level 2: 

Single: $3,500

Family: $7,000

Level 1:
Blue Card Participating

Single: $2,000

Family: $4,000

Non-participating Providers:

N/A

Level 2:
Blue Card Participating

Single: $2,000

Family: $4,000

Non-participating providers:

N/A

Level 3:
Blue Card Participating

Single: $2,000

Family: $4,000

Non-participating providers:

Single: $2,500

Family: $5,000
  UISelect UIChoice

PREVENTIVE CARE

Level 1: 

$0 copay

Not subject to deductible

Level 2: 

$0 copay

Not subject to deductible

Level 1: 

$0 copay

Level 2:

$0 copay

Level 3: 

Participating Providers:
0% coinsurance

Non-participating Providers:
Outpatient 40% coinsurance, In office 50% coinsurance
(Coinsurance waived
for out-of-network immunizations &
well-child care)
DOC ON DEMAND
(Mental health and chemical dependency services NOT covered)

Level 1: 

$0 copay

Level 2:

$0 copay

Level 1:

$0 copay

Level 2: 

$0 copay

Level 3:

$0 copay
UI QUICKCARE

Level 1:

$10 copay

Level 2:

N/A

Level 1:

$10 copay

Level 2:

N/A

 Level 3:
N/A
URGENT CARE

Level 1:

$15 copay

Level 2:

$40 copay

Level 1:

$15 copay

Level 2:

$30 copay

Level 3:

50% coinsurance
OFFICE VISITS

Level 1:

Primary Care
$15 copay
Primary care copay will apply to chiropractic care, physical, speech & occupational therapies.

Level 1:

Specialists Care
$25 copay

Level 2:

Primary Care
$40 copay
Primary care copay will apply to chiropractic care, physical, speech & occupational therapies.

Level 2:

Specialists Care
$55 copay

Level 1: 

$15 copay

Level 2: 

$30 copay

Level 3: 

50% coinsurance
ROUTINE EYE & HEARING EXAMS

Level 1:

$40 copay

Level 2:

$55 copay

Level 1:

$15 copay

Level 2:

$30 copay

Level 3:

50% coinsurance
MENTAL HEALTH CARE VISITS

Level 1:

$15 copay

Level 2:

$15 copay 

Level 1: 

$0 copay

Level 2: 

$0 copay

Level 3: 

50% coinsurance
EMERGENCY ROOM VISITS

Level 1:

$150 copay followed by 10% coinsurance
(Copay waived if admitted and Level 1 deductible applied followed by Level 1 coinsurance.)

Level 2:

$150 copay followed by 10% coinsurance
(Copay waived if admitted and Level 2 deductible applied followed by Level 2 coinsurance.)

Level 1:

$125 copay followed by 10% coinsurance
(Copay waived if admitted and Level 1 inpatient deductible applied followed by Level 1 coinsurance.)

Level 2:

$125 copay followed by 10% coinsurance
(Copay waived if admitted and Level 1 inpatient deductible applied followed by Level 1 coinsurance.)

Level 3:

$125 copay followed by 10% coinsurance
(Copay waived if admitted and Level 1 inpatient deductible applied followed by Level 1 coinsurance.)

Prescriptions Drugs

Plan Formulary Name:  

  • Blue Rx Value Plus (UISelect)
  • Blue Rx Complete (UIChoice)

To review each specific Wellmark formulary drug list, please visit Wellmark.com. Then, scroll down and choose the specific drug plan link you wish to access, and enter the name of the drug in the top left-hand corner to begin your search. 

Note: Formulary Drug Lists are best viewed in Chrome.

Pharmacy Program Plan UISelect
Blue Rx Value Plus		 UIChoice
Blue Rx Complete
Tier 1
Generic Drugs		 $0 copay $0 copay

Tier 2
Name-brand drugs

 30% coinsurance 30% coinsurance
Tier 3
Name-brand, non-formulary drugs		 50% coinsurance 50% coinsurance
Tier 4
Name-brand, non-formulary drugs		 N/A 50% coinsurance
Pharmacy Out-of-Pocket Maximum

Employee: $2,000

Family:  $4,000

Employee:  $1,600

Family:  $3,200

 

Need help in selecting the best plan for you?

ABOUT OUR SITE: 
The information presented on our website describes only the highlights of the plans and does not constitute official plan documents. Additional terms and conditions may apply. If there are any discrepancies between the information contained herein and the official plan documents, the plan documents will govern. For more detailed information, contact Wellmark Blue Cross/Blue Shield at the toll-free number 800-524-9242 (TTY: 888-781-4262), Monday through Friday, from 7:30 a.m. to 5:00 p.m. (Central Time). For more efficient service, please have your member ID number handy - it can be found on the front of your card.