UISelect and UIChoice Plan Comparison

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.

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)

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

Level 1: 

$0 copay

Level 2:

$0 copay

Level 1:

$0 copay

Level 2: 

$0 copay

Level 3:

$0 copay

Level 1:

$5 copay

Level 2:

N/A

Level 1:

$5 copay

Level 2:

N/A

Level 1:

$10 copay

Level 2:

$35 copay

Level 1:

$10 copay

Level 2:

$25 copay

Level 3:

50% coinsurance

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

Level 1:

$10 copay

Level 2:

$10 copay 

Level 1: 

$0 copay

Level 2: 

$0 copay

Level 3: 

50% coinsurance

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.)}

Tier 2
Name-brand drugs

Employee: $1,100

Family:  $2,200

Employee:  $1,100

Family:  $2,200