Own Your Benefits
Wellmark Blue Cross Blue Shield, our health insurance provider, will provide an Explanation of Benefits (EOB) each time a health or prescription claim is processed. Understanding your EOB is very important. The document tells you:
- Your doctor’s appointment/service, or prescription, has been reviewed by Wellmark.
- How much our health plan account will pay towards what is owed for the appointment.
- What you will owe as 'patient responsibility'.
An EOB is not a bill, if you owe anything the bill should come from the doctors office. By knowing your plan, and reading your Explanation Of Benefits, you can double check what you are paying towards your appointment or service is correct. You should always receive an EOB prior to receiving your bill, this way you understand why you are being charged.
For example, your provider could incorrectly submit a claim resulting in Wellmark denying the claim. You could then receive a bill for the service when UNI’s plan actually covers the service that you received. By understanding your health plan, you can double check these charges and save yourself money. If you have questions on any charges relating to your health insurance, please call the number on the back of your Wellmark ID and/or your provider. To learn more please watch our video.
A common misconception about an Explanation of Benefits (EOB) is that it is a bill. An EOB is a document sent by your insurance company, and a bill for service is sent from your providers office. Your EOB tells you how much the provider charged, how much your insurance company is paying for the service, the network savings, and how much (if any) you are responsible for. You should always receive an EOB prior to receiving a bill.
You can sign up to receive electronic EOB’s through your myWellmark® account with four simple steps:
- Log in or register for myWellmark® at Wellmark.com.
- Select My Account from the menu at the top.
- Click Edit under My Web Account.
- Under Information and Messaging, select "I agree to receive important information about my plan electronically" and Save Changes.
Visit our Health Insurance Made Easy webpage to learn more about how to read an EOB as well as how to sign up for a MyWellmark account.
Wellmark®, UNI’s health insurance vendor, offers tools to help members determine the cost of an appointment prior to visiting the doctor’s office. These tools are called the Wellmark Care Finder and Cost Estimator Tool located within the MyWellmark system. These tools will show you what your out-of-pocket cost will be for different types of services and appointments. Keep in mind that services done within the state of Iowa cost the self-insured plans less than when services are done outside of the state. The Care Finder tool also provides ratings and reviews on providers when you complete a search. We have put together a website called Know Before You Go to help you select your care.
Many of the benefits offered by the University have their own unique platform in which a member can log into to assist in managing their benefits. The platforms may contain specific data pertaining to the members account, or additional benefits and tips to utilizing the plan. Examples would be MyWellmark for your health plan, Delta Dental for your dental plan, ASI Flex for your flex spending account, or IPERS and TIAA for retirement. If you want more information regarding a specific benefit, and how to log in, please take a look at Human Resource Services How to Access Your Online Benefits Accounts webpage.
Teeth cleanings do not only benefit our oral health but our overall health as well. UNI’s dental plan provides all members two teeth cleanings per year which are 100% covered. New to our dental plan in 2018 is Enhanced Benefits, which provides additional paid teeth cleanings for those who have certain health conditions. For example, an individual with diabetes can receive two additional paid teeth cleanings per year. Anyone covered on your dental plan can take advantage of this program. Review the Enhanced Dental Benefits handout for more information.