The University of Iowa is committed to prioritizing the overall well-being of our campus community. This pilot will measure the feasibility of a GLP-1 program for weight management that is flexible, accessible, and financially sustainable for our employees and the institution.
The UI GLP-1 Pilot Program is a joint effort between University Benefits, UI health plans, University of Iowa Health Care, and pilot program participants. Together, we're working to identify a financially sustainable way to cover GLP-1 medications for weight management. For the pilot, plan coverage of GLP-1 medications for weight management is only available through Approval by Exception.
Approval by Exception means the health plan member must get written approval from the health plan (UIChoice or UISelect) to receive coverage. The member is responsible for the cost of medication until the out-of-pocket maximum is reached. See the financial estimate table below for more information.
The two-year pilot program involving 500 UI employees will investigate various plan design features for incorporating weight management medications, such as FDA-approved Zepbound and Wegovy, into UIChoice and UISelect health plans.
To receive health plan coverage, you must be accepted into the pilot.
Offering this pilot program for our employees is just one way the University of Iowa strives to prioritize the physical, mental, and financial well-being of our university community. Our intention is to design a positive program that is flexible, accessible, and financially sustainable for the UI and our employees.
Questions? Email HR-GLP1-Pilot@uiowa.edu.
The application period ended at 5 p.m. Nov. 8, 2024.
Eligibility
To participate in the pilot program, you must be a current University of Iowa employee and meet the following criteria.
- BMI 40 or greater, or a BMI 35 or greater with two co-morbidities*, as already identified by your health care provider.
- Actively enrolled in a university-sponsored health plan (UIChoice or UISelect) for the duration of the pilot.
- One of 500 applicants randomly selected to participate in the pilot.
- Approved by GLP-1 Pilot Program administrators to participate in the pilot.
- Complete the Personal Health Assessment in 2024, 2025, and 2026.
Once approved for the pilot program, participants must also engage in an online weight management program, Wondr Health. Participants must complete eight of 12 sessions in the Wondr Health program to maintain eligibility for medication coverage.
Co-Morbidities
*Co-Morbidities
- Hypertension (high blood pressure)
- Dyslipidemia (high cholesterol)
- Coronary artery disease
- Heart failure
- Obstructive sleep apnea (confirmed by sleep study)
- Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis
- Intracerebral hemorrhage (stroke)
- Gastroesophageal reflux disease
- Osteoarthritis
- Obesity hypoventilation syndrome/Pickwickian syndrome (confirmed by sleep study)
- Metabolic syndrome
Enrollment
- The Enrollment Application period opens at 8 a.m. CT on Oct. 31, 2024, and closes at 5 p.m. Nov. 8, 2024. All benefits-eligible employees can review the program, determine if they meet eligibility criteria, and apply if desired.
- Participant lottery: All completed applications received during the enrollment application period will be placed in a lottery to identify 500 pilot program participants. Individuals can submit their names once and will be selected by a random number generator. Employees selected by the lottery process will be notified of selection on or before 5 p.m. Nov. 18, 2024. Individuals have until 5 p.m. Nov. 20, 2024, to accept.
- Once accepted into the pilot, individuals will be scheduled for an initial visit with a UI Health Care provider participating in the GLP-1 pilot.
- Requirement: To receive coverage of GLP-1 medications through UIChoice or UISelect, you must enroll in a health plan and be accepted into the pilot.
- You have until 11:59 p.m. Nov. 19, 2024, to update your benefits confirmation statement and enroll in a UI health plan.
Once all lottery spots are accepted, participants are randomly assigned to a monthly cohort. This cohort will determine when a participant has their first clinical visit with an approved health care provider.
Monthly Cohort (Randomly Assigned) | Begin Clinical Visits (Initial Visit with UI Health Care Provider) | Begin Wondr Health (Online Weight Management Program) |
January 2025 | January | January |
February 2025 | February | January |
March 2025 | March | February |
April 2025 | April | March |
May 2025 | May | April |
Follow-up visits for medication management: After participants' first clinical visit, they will follow up with their pilot health care provider at two, four, eight, 12, and 18-24 months. All appointments (except 18-24 months) can be conducted via telehealth.
Costs
GLP-1 medications will be covered for the duration of the pilot through Approval by Exception. Standard plan design for UIChoice and UISelect applies to the pilot as it relates to co-pays, co-insurance, and out-of-pocket maximum coverage.
Beginning Jan. 1, 2025, UI health plans will cover 50% of participants' medication costs until the health plan's out-of-pocket-maximum is reached. Participants may also use their flexible spending account (FSA) to cover prescription drug costs.
Estimated payments in 2025 and 2026 are below.
| UIChoice Health Plan | 2025-Participant | 2026-Participant Estimate* |
| Annual Out-of-Pocket Maximum (total cost of all prescription drugs) | $1,850 | $1,850 |
| Wondr Health | $0 | $0 |
| Clinical visits | $15 per primary care office visit** | $15 per primary care office visit** |
| liveWELL Health Coach | $0 | $0 |
*Note: Costs are subject to change depending on plan design and medication cost changes for Jan. 1, 2026.
**Primary care office visits = $15
| UISelect Health Plan | 2025-Participant | 2026-Participant Estimate* |
| Annual Out-of-Pocket Maximum (total cost of all prescription drugs) | $2,450 | $2,450 |
| Wondr Health | $0 | $0 |
| Clinical visits | $15 per primary care office visit** | $15 per primary care office visit** |
| liveWELL Health Coach | $0 | $0 |
**On UISelect, specialist care office visits through endocrinology/diabetes = $25
2025 estimated monthly cost to participants (If GLP-1 is the only medication a participant is on with an out-of-pocket expense)
UIChoice
- January - $675
- February - $675
- March - $500
- April–December - $0
UISelect
- January - $675
- February - $675
- March - $675
- April - $425
- May–December -$0
Frequently Asked Questions
Who should I contact with questions about this pilot?
Email HR-GLP1-Pilot@uiowa.edu. Please do not contact the UI Weight Management clinic or the physicians participating in the pilot program.
What are GLP-1 medications?
GLP-1 medications mimic the natural hormone GLP-1, influencing appetite, insulin secretion, and cardiovascular events. The medications are used for weight management and treating type 2 diabetes.
How much do GLP-1 medications cost?
The annual cost ranges from $13,000 to $14,000. Pilot program participants will share the cost with their UI health plan. Specific payment amounts depend on whether you're enrolled in UIChoice or UISelect. See the financial estimate table above for more information.
Who is eligible to participate in the pilot program?
- Current University of Iowa employee
- BMI 40 or greater or BMI 35 or greater with two co-morbidities, as already identified by your health care provider
- Actively enrolled in UIChoice or UISelect
- Complete the PHA in 2024, 2025 and 2026
- Approved to participate in the GLP-1 Pilot Program
Which co-morbidities determine eligibility with a BMI 35 or greater?
- Hypertension (high blood pressure)
- Dyslipidemia (high cholesterol)
- Coronary artery disease
- Heart failure
- Obstructive sleep apnea (confirmed by sleep study)
- Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis
- Intracerebral hemorrhage (stroke)
- Gastroesophageal reflux disease
- Osteoarthritis
- Obesity hypoventilation syndrome/Pickwickian syndrome (confirmed by sleep study)
- Metabolic syndrome
What is the timeline to participate in the GLP-1 Pilot Program and receive Approval by Exception?
- Employees must determine if they meet the eligibility criteria.
- If you meet the eligibility criteria, complete the GLP-1 Pilot Program application.
- If selected as one of the 500 lottery participants, you will be contacted by GLP-1 administrators to schedule your enrollment in the online weight management program and to schedule your first appointment with an approved UI Health Care provider. Enrollment occurs in waves of 100. You will get access to the online weight management program, Wondr Health, one month prior to the month you meet with your provider. (January enrollees will start the online weight management program in January.)
- Attend the pilot initial clinical visit to confirm eligibility with the GLP-1 health care provider. At your first appointment you and the GLP-1 Provider will complete the Clinical Attestation Form, to ensure documents for Approval by Exception are complete.
- After your visit and confirmation of eligibility, your prescription will be filled 3-5 days* after your visit. UI Specialty Pharmacy will contact you to gather information to fill the prescription and mail your GLP-1 medication directly to your home.
*3-5 days are required for the health plan to provide proper notification for Approval by Exception to the Pharmacy Benefit Manager.
What if I am not enrolled in a UI health plan and want to participate?
If you are not enrolled in a UI health plan when you complete the GLP-1 Enrollment Application, you need to participate in benefits open enrollment Nov. 1-15, 2024, and select a UI health plan for 2025 (and remain on a plan through 2026). Employees must be enrolled in a UI health plan (UIChoice or UISelect) to be eligible for this pilot.
If I'm accepted into the pilot, will I have time to adjust my benefits enrollment?
Yes. You have until 11:59 p.m. Nov. 19 to update your benefits confirmation statement and enroll in a UI health plan.
What does it mean to have Approval by Exception?
Approval by Exception means the health plan member must get written approval from the health plan (UIChoice or UISelect) to receive coverage. The health plan member is responsible for the patient's cost of the medication until the out-of-pocket maximum is reached.
How will I get my medication?
UI Specialty Pharmacy will contact you to gather information to fill the prescription and mail the medication directly to your home.
Does my UI health plan now cover weight loss medication?
No. The two-year pilot program will enroll 500 eligible UI employees. Participating in a UI health plan does not guarantee acceptance into the pilot program.
How will the pilot program be conducted?
The program will enroll 500 randomly selected UI employees who apply and meet eligibility requirements. The pilot begins Jan. 1, 2025, and ends Dec. 31, 2026. Participants will follow a structured plan involving medication, health assessments, and support programs.
Who are the approved UI Health Care providers?
UI Weight Management Clinic Providers and select UI Family Medicine Providers
What is the online weight management program?
Wondr Health is a digital weight management program that focuses on lifestyle behavior changes to meet the needs of employees with on-the-go lifestyles and a 24/7 work environment. This program can be done anytime, anywhere.
You will be guided through weekly lessons and encouraged to practice skills to increase physical activity, eat mindfully, manage weight, reduce stress, get more sleep, increase energy, and more.
In addition to the weekly lessons, you will have access to tools to track your progress and find inspiration.
If you're not accepted into the pilot program but still want to participate in Wondr Health, UI employees can apply here.
Will my medications be covered if I stop working at the University of Iowa during the pilot?
To maintain coverage, participants must be actively enrolled in a university-sponsored health plan (UIChoice or UISelect) beginning Jan. 1, 2025, through Dec. 31, 2026.
Will my medications be covered if I retire from the University of Iowa during the pilot?
To maintain coverage, participants must be actively enrolled in a university-sponsored health plan (UIChoice or UISelect) beginning Jan. 1, 2025, through Dec. 31, 2026.
Why is the pilot limited to employees and not everyone covered by UIChoice or UISelect health plans?
With the limited number of slots available for the pilot (500) and the large number of employees enrolled in UI health plans (18,000+), it was decided to prioritize employees in this pilot program.
I have a non-UI primary care provider – can they prescribe GLP-1 medications as part of the pilot?
To receive Approval by Exception in the GLP-1 Pilot Program, a patient must work with in the pilot providers at UI Health Care. Participants will be contacted directly and be scheduled to meet with an approved provider once they're accepted into the pilot.
If my BMI drops below 40 or 35 during the pilot, will I still have access to the GLP-1 medications?
That is a discussion for you and your health care provider. Approval by Exception is provided for the duration of the pilot.
How do I participate if I live out-of-state?
If a GLP-1 Pilot participant lives outside the state of Iowa, all visits must be in-person. Telehealth visits are only available to patients that have an Iowa residential mailing address.
