Self-Insured Health Plans

Non-temporary Employees

Non-temporary employees must work at least 20 (50%) hours per week and have an appointment for nine (9) months or greater.

Temporary Unit Faculty

Temporary unit faculty are eligible for health insurance when their current assignment is 50% or greater FTE and they also had a 25% or greater FTE assignment in the prior academic semester or prior academic year.

Affordable Care Act (ACA) Eligibility

If you don’t meet one of the above criteria, you could still be eligible for ACA health insurance.

If someone on the UNI health insurance plans becomes ineligible for coverage they will be offered coverage through the Consolidated Omnibus Budget Reconciliation Act (COBRA).

Other healthcare options may be available to you through the Marketplace, your local bank, or through the Iowa Retired School Personnel Association (IRSPA).

Annual Open Enrollment

If you do not make any changes during open enrollment your coverage selection will remain the same.

Qualifying Life Event

You may also enroll, waive, or change your coverage selection based on a qualifying life event.

UNI Works

UNI Works is designed to help you enroll, make changes, and view your current benefit elections, dependents and beneficiaries all in one location. When logging into UNI Works, select Benefits and Pay from the Main Menu.

Coverage is available for:

• Yourself
• Your spouse
• Common law spouse or domestic partner
• Children to age 26;
  • Children who are unmarried full-time students over the age of 26;
  • Qualified children over age 26 who are totally and permanently disabled, provided the disability existed prior to age 26.

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.

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.

1. Everyday Benefit Terms
2. Cost Estimator Tool
3. WAIT... Do Not Fill Your Prescription Yet
4. You Have So Many Choices, Let Us Help You Choose!
5. Health Insurance Made Easy
6. What To Do In The Case of a Serious Health Condition
7. Preventive Care, FREE Services For You and Your Family
8. Employee Well-being
9. Healthy Weight @ UNI

Health Plan Comparison

1. Wellmark Blue Cross and Blue Shield
2. myWellmark and Mobile App
3. Notice Regarding Your Rights and Protections Against Surprise Medical Bills
4. Women’s Health and Cancer Rights Act Notice
5. Wellmark’s Privacy Policy
6. BeWell 24/7 Support
7. Pregnancy Support
8. Wellmark Forms

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.

• Summary of Benefits Coverage

  Overview of common medical events and how the plan coverage and your costs work.

• Coverage Manual

  This benefit booklet describes your rights and responsibilities under your group health plan.

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.
• 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.
• Access to doctors and hospitals in nearly 200 countries and territories around the world through the Blue Cross Blue Shield Global Core program.

• Summary of Benefits Coverage

  Overview of common medical events and how the plan coverage and your costs work.

• Coverage Manual

  This benefit booklet describes your rights and responsibilities under your group health plan.

The self-insured Blue HMO 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 (PCP) 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 you select a PCP to your plan. If you do not select one, Wellmark will assign you one.
• You can change your PCP at any time by calling the number on the back of your Wellmark ID.
• Requires that referrals to specialists outside of the Blue HMO 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.
• A list of participating providers may be found on Wellmark's website.
• Allows coverage for members who will be out of the network for 90 consecutive days or more through a Guest Membership.

UNI’s health plans cover prescriptions the same on each plan. The BlueRx Value PlusSM Formulary is utilized for prescription coverage.

The secure myWellmark® account and myWellmark® App provide tools and resources to help manage your health plan and prescriptions.

Both of UNI’s self-insured health plans cover telehealth visits. Wellmark contracts with Doctor on Demand® for telehealth services. You can utilize Doctor on Demand® to speak to a board-certified physician, or team of psychiatrists/psychologists.

If you are a member of a health insurance plan offered at UNI, then you are eligible for savings through the Blue Cross and/or Blue Shield Companies member discounts. Discounts may be available for vision materials purchases. Some deals will give you a coupon code instantly on the Blue365® site. This coupon code can be applied directly to a purchase on a vendor’s website or will provide a discounted option on a product or service.

Other deals may take you to a vendor’s website directly to make a discounted purchase or enroll in a special discounted program instantly.

Blue365® Categories

• Fitness
• Healthy Eating
• Personal Care
• Lifestyle
• Financial Health
• Wellness

You can find a provider or facility using your myWellmark® account, or by using the provider and facility search operated by Healthsparq®. Healthsparq® is an independent company providing provider, cost and quality information on behalf of Wellmark.

Getting Started with the Provider and Facility Search

• First enter the location of the provider or facility.
• Next, enter your plan information. Your plan information is a three digit code based on your enrolled health plan. For the UNI PPO (Alliance Select) health plan (Image 1, letter A), the code is UON (Image 1, letter B). For the UNI Blue HMO plan (Image 2, letter C), the code is XQW (Image 2, letter D).
• The search automatically defaults to All Categories. You can narrow your search results by doctors by name, doctors by specialty, places by name, or places by type.
• In the search field, enter in the doctors, hospitals and clinics by name or specialty.
• Finally, click or tap the search icon or press enter to run the search

To see which health plan you are enrolled in, log in to UNI Works.

How to Change Your Provider with Wellmark

If you are enrolled in the UNI Blue HMO health insurance plan and would like to change your Primary Care Physician (PCP), please call the Wellmark customer service 800 number located on the back of your card.

Emergency Health Insurance Coverage

Being a member of either of the two UNI health insurance plans ensures coverage when traveling and an emergency occurs. The UNI Blue 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.