UISelect and UIChoice Plan Comparison

This page provides a summary side-by-side comparison of health plan options for benefit 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 and Rates 

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 would 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.
RATES UISelect Monthly Premiums UIChoice Monthly Premiums
Employee Only $0 $72
Employee+Spouse $285 $342
Employee+Child(ren) $233 $279
Employee+Family $306 $367
Double Spouse Family $0 $183

 

Plan Provisions

PLAN 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: $400

Family: $800

Level 2: 

Single: $800

Family: $1,600

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:  

$400 deductible, followed by 10% coinsurance

Level 2:  

$600 deductible, followed by 10% coinsurance

Level 3:  

$800 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
$10 copay


Specialists:
$20 copay

Level 2: 

Primary Care
$35 copay


Specialists:
$50 copay

Level 1: 

$10 copay

Level 2: 

$25 copay

Level 3: 

No copay. Subject to coinsurance depending on service.

ANNUAL OUT-OF-POCKET MAXIMUM (OPM)

Level 1: 

Single: $2,000

Family $3,400

Level 2: 

Single: $3,000

Family: $6,000

Level 1:
Blue Card Participating

Single: $1,700

Family: $3,400


Non-participating Providers:

N/A

Level 2:
Blue Card Participating

Single: $1,700

Family: $3,400


Non-participating providers:

N/A

Level 3:
Blue Card Participating

Single: $1,700

Family: $3,400


Non-participating providers:

Single: $2,000

Family: $4,000

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

Level 1: 

$0 copay

Level 2:

$0 copay

Level 1:

$0 copay

Level 2: 

$0 copay

Level 3:

$0 copay

UI QUICKCARE

Level 1:

$5 copay

Level 2:

N/A

Level 1:

$5 copay

Level 2:

N/A

Level 3:
N/A
URGENT CARE

Level 1:

$10 copay

Level 2:

$35 copay

Level 1:

$10 copay

Level 2:

$25 copay

Level 3:

50% coinsurance

OFFICE VISITS

Level 1:

Primary Care
$10 copay
Primary care copay will apply to chiropractic care, physical, speech & occupational therapies.


Level 1:

Specialists Care
$20 copay

Level 2:

Primary Care
$35 copay
Primary care copay will apply to chiropractic care, physical, speech & occupational therapies.


Level 2:

Specialists Care
$50 copay

Level 1: 

$10 copay

Level 2: 

$25 copay

Level 3

50% coinsurance

MENTAL HEALTH CARE VISITS

Level 1:

$10 copay

Level 2:

$10 copay 

Level 1: 

$0 copay

Level 2: 

$0 copay

Level 3: 

50% coinsurance

EMERGENCY ROOM VISITS

Level 1:

$100 copay followed by 10% coinsurance
(Copay waived if admitted and Level 1 deductible applied followed by Level 1 coinsurance.)

Level 2:

$100 copay followed by 10% coinsurance
(Copay waived if admitted and Level 2 deductible applied followed by Level 2 coinsurance.)

Level 1:

$100 copay followed by 10% coinsurance
(Copay waived if admitted and Level 1 inpatient deductible applied followed by Level 1 coinsurance.)

Level 2:

$100 copay followed by 10% coinsurance
(Copay waived if admitted and Level 1 inpatient deductible applied followed by Level 1 coinsurance.)

Level 3:

$100 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. Scroll down and choose the specific drug plan link you wish to access and enter the name of the drug in the top lefthand 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: $1,100

Family:  $2,200

Employee:  $1,100

Family:  $2,200

 

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 you may contact Wellmark Blue Cross/Blue Shield at 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.