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My Benefits | Health Benefits

Self-insured Health Plan

Administered By Wellmark Blue Cross Blue Shield

Eligibility

Non-temporary Employees

  • Must work at least half-time (20 hours per week) or more.
  • Must be appointed for nine (9) months or more.

Temporary Faculty

  • Appointed for nine (9) months working at 50% or more.
  • Appointed for a second consecutive semester at 50% or more.
  • Coverage will continue as long as the faculty member is continuously employed at 50% or more.
Health Benefits Coverage Starts
Life Event Coverage Starts Days to Initiate a Change
New Hire Based on your start date, coverage begins the first day of the next month. 30 Days After the Event
Qualifying Employment Event Based on the event date, coverage begins the first day of the next month 30 Days After the Event
Qualifying Life Events Based on the event date, coverage begins the first day of the next month. 30 Days After the Event
Adoption, Placement for Adoption Coverage starts as of the date on the adoption decree. 60 Days After the Event
Birth Coverage starts the date the baby is born. 60 Days After the Event
Open Enrollment Changes not associated with a life event must be made during the Annual Open Enrollment period. These changes will be effective January 1 of the upcoming year. Defined Open Enrollment Period
Health Benefits Coverage Ends
Life Event Coverage Ends
Reduction in Working Hours Coverage ends the last day of the month the appointment is no longer eligible.
Separation of Employment Coverage ends the last day of the separation month.
Qualifying Life Events Coverage ends the last day of the month in which the qualifying event occurred.
Open Enrollment If there are changes to end coverage during the Annual Open Enrollment period, coverage will end December 31 of the current year.

Who Can Be Covered?

Coverage is available for:

Returning to Work

If a retiree returns and is eligible for benefits, they can either:

  1. Select the active employee benefits and waive retiree coverage
    or
  2. Waive the active employee benefits and continue with the retiree benefits.

Once the retiree coverage is waived, the retiree cannot re-enroll in retirement coverage.

An employee can only retire from UNI once.

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What Does Self-insured Mean?

When a plan is self-insured the employee and employer premiums are put into an account. When a claim occurs, money from that account is used to pay that claim. If claim costs increase, then premiums must increase to cover the additional costs.

Health Premium Payroll Deductions

Health premiums are withheld from your pay as a pre-tax deduction, which reduces your taxable income and the amount of taxes you pay at the time of payroll. This is a default selection by the University.

If you would like to opt out of the pre-tax premium option, please complete the After-Tax Premium Option form and submit to the Human Resource Services Office.

Shopping cart with stethoscope

Health Plans

  • UNI PPO (Alliance Select) Plan PPO plans allow you to visit any in-network physician or healthcare providers without first requiring a referral from a Designated Personal Doctor.
  • UNI Blue Advantage (HMO) Plan Groups of doctors, clinics, hospitals, pharmacies and other providers who work together to take care of their members' health care needs.

Health Plan Comparison

Simplified side-by-side comparison of the health insurance plans. Access Plan Comparison

UNI PPO (Alliance Select) Plan

Plan Information Effective: January 1, 2018 through December 31, 2019

Summary of Benefits and Coverage

Overview of common medical events and how the plan coverage and your costs work. UNI PPO (Alliance Select) Benefits Summary

Coverage Manual

This benefit booklet describes your rights and responsibilities under your group health plan. UNI PPO (Alliance Select) Coverage Manual

Plan Details

The self-insured UNI PPO plan is a Preferred Provider Organization (PPO) plan and is administered by Wellmark Blue Cross and Blue Shield. This health plan:

  • Contracts with a network of "preferred" providers in the Alliance Select network from which you can choose.
  • Does not require you to select a Primary Care Physician.
  • Does not require referrals to see other providers in the network.
  • Consists of 99% of physicians and 100% of hospitals in Iowa covered in the network, and 92% of physicians and 96% of hospitals who participate nationwide.

As a Blue Cross and Blue Shield Plan member, your health care benefits are with you at home and abroad. Outside the United States, you have access to doctors and hospitals in nearly 200 countries and territories around the world through the Blue Cross Blue Shield Global Core program.

If you receive your care from a doctor in the Alliance Select network you will be responsible for an annual deductible and any applicable coinsurance, or a copayment for your visit. If you get health services from a doctor or hospital that is not in the preferred network (known as going "out-of-network") you will pay a higher coinsurance amount, and you may need to pay the doctor directly and file a claim with the Wellmark BCBS to get reimbursed.

Premiums January 1, 2018 - December 31, 2019
Coverage Employee 1/12 Annual Premium Employee Annual Premium UNI Annual Premium
Single $21.00 $252.00 $8,915.52
Family $357.55 $4,290.60 $17,162.76
Shared Family $178.80 $2,145.60 $19,308.00

UNI Blue Advantage (HMO) Plan

Plan Information Effective: January 1, 2018 through December 31, 2019

Summary of Benefits and Coverage

Overview of common medical events and how the plan coverage and your costs work. UNI Blue Advantage (HMO) Benefits Summary

Coverage Manual

This benefit booklet describes your rights and responsibilities under your group health plan. UNI Blue Advantage (HMO) Coverage Manual

Plan Details

The self-insured Blue Advantage is a Health Maintenance Organization (HMO) administered by Wellmark Blue Cross/ Blue Shield of Iowa. This plan:

  • Requires members to designate a Primary Care Physician and this person becomes the gatekeeper for your health care. If your PCP is not available you may schedule with another provider within the same clinic without being penalized.
  • Requires that referrals to specialists outside of the Blue Advantage network be coordinated by your Primary Care Physician.
  • Allows females to designate both a Primary Care Physician and OB/GYN.
  • Allows coverage outside of the network for emergencies.
  • Allows coverage for members who will be out of the network for 90 consecutive days or more through a Guest Membership.

A list of participating providers may be found on Wellmark's website. You may also ask providers whether they are part of the Blue Advantage network or contact Wellmark at (800) 600-4149 to inquire about the status of specific providers.

Premiums January 1, 2018 - December 31, 2019
Coverage Employee 1/12 Annual Premium Employee Annual Premium UNI Annual Premium
Single $0.00 $0.00 $ 8,484.12
Family $188.85 $2,266.20 $17,162.76
Shared Family $20.10 $241.20 $19,308.00

Health Insurance Coverage - What To Do When Traveling Internationally

International Health Insurance Emergency Coverage
Plan Coverage Emergency Coverage
UNI PPO Offers coverage nationally and internationally Offers coverage nationally and internationally
UNI Blue Advantage (HMO) Iowa and South Dakota only Offers coverage nationally and internationally

Being a member of either of the two UNI health insurance plans ensures coverage when traveling and an emergency occurs. The UNI Blue Advantage (HMO) plan only offers coverage outside of the state of Iowa for accidental injuries and emergencies. While on the PPO health plan you can receive coverage nationwide and around the world.

If you traveling outside of the United States on the PPO Plan, and need coverage, please complete the following steps:

  1. Call the number on the back of your Wellmark ID.
    • Explain your situation and ask about coverage.
    • Ask for steps in order to pay for the service.
  2. Access the International Claim Form.

In the case of a true emergency please always seek help immediately.