The State of Iowa offers all employees (except SPOC employees) the same health coverage (one plan) with a choice between two network options.
Health Insurance Resources
|One Plan, Two Options||Health Insurance Options Side-by-Side Comparison|
|New Health Benefit - Telemed||2018 Iowa Choice benefit booklet|
|Important Information about Iowa Choice||Summary of Benefits and Coverage (SBC) Iowa Choice|
|Guest Membership for Iowa Choice||2018 National Choice benefit booklet|
|Travel Out of the Country||Summary of Benefits and Coverage (SBC) National Choice|
|Double Spouse||Wellmark: Find a Doctor or Hospital|
|More Information||Wellmark: Drug List (Formulary: Blue Rx Complete sm)|
|HealthCare.gov Preventive health services|
|Registering for MyWellmark|
Health Insurance Premium
|Health Insurance Premium All Employees (except SPOC-covered employees)|
Health Insurance Notices Required by Law
Health Insurance Information
|HIPAA Privacy Practice Notice||Understand Your Out-Of-Pocket Costs|
|Health Insurance Marketplace Notice||Explanation of Benefits: If it’s not a bill, then what is it?|
|“Michelle's Law” Notice||Understanding Jargon: Copay (Wellmark YouTube video)|
|Women's Health and Cancer Rights Act||Understanding Jargon: Coinsurance (Wellmark YouTube video)|
|Understanding Jargon: Deductible (Wellmark YouTube video)|
|Understanding Jargon: OPM (Wellmark YouTube video)|
|Understand Your Out-of- Pocket Costs (Wellmark flyer)|
All State employees will be offered the same health coverage (one plan) with a choice between two network options:
- Iowa Choice: Offers access to a large selection of doctors and hospitals in Iowa and in counties sharing a border with Iowa. Iowa Choice includes coverage should you have an emergency while out of the state. The provider network includes 100 percent of Iowa hospitals and 96 percent of Iowa doctors. Not all providers in the counties sharing a border with Iowa participate in the Iowa Choice network.
- National Choice: Offers access to a large selection of doctors and hospitals in Iowa and nationwide. With National Choice, you may seek health care from any provider located in the United States. In Iowa, in-network care can be received at 100 percent of hospitals and 99 percent of doctors. Outside of the state, you'll have access to 96 percent of hospitals and 93 percent of doctors. Keep in mind with this option you can see any provider you choose, but you will have lower out-of-pocket expenses if you choose a network provider.
Refer to the Health Insurance Options Side-by-Side Comparison.
A new benefit in 2018 will be Telemed (Doctor On Demand). The service allows you to visit a doctor on your smartphone or tablet from almost anywhere. Through this new service, you may get treatment for cold and flu, bronchitis and sinus infections, urinary tract infections, sore throats, allergies, fever, headache, pink eye, skin conditions, and more. Telemed (Doctor on Demand) also provides mental health services. More information is available at Feeling Better Should Be Easy. There is a $10 copay per visit for this service.
Iowa Choice is a managed care plan. As such, health care services are provided by a statewide network of participating health care providers. Providers who participate in these plans are called Wellmark Health Plan Network providers.
Benefits for covered services are available only when received from Wellmark Health Plan Network providers.
It is your responsibility to ensure that providers you seek services from are part of the Wellmark Health Plan managed care network. Services received from non-participating providers will not be paid by Wellmark. Visit the Wellmark website to check participating providers in your area.
Services received from out-of-network providers may be covered in the case of accidental injuries or emergencies.
Guest Membership. Members traveling long-term, any covered dependents attending college out of state, or covered family members living apart are eligible to become a guest member any time they are outside the Wellmark Health Plan Network area for at least 90 days. Not all services covered under your medical benefits are covered under Guest Membership. To determine which services are covered under the Guest Membership program, call us.
To receive covered services under the Guest Membership program, you must receive the service(s) from a Participating Provider.
Before you leave the Wellmark Health Plan Network area, call Customer Service at 800-622-0043 to set up a guest membership.
National Choice: Under the National Choice plan, you have access to doctors and hospitals in more than 200 countries around the world through the Blue Cross Blue Shield Global™ (BCBS Global™) Core Program. With the BlueCard Program, you can locate international doctors and hospitals by visiting bcbs.com and searching the National Doctor and Hospital Finder or by calling 800-810-BLUE (2583). When you receive non-emergency care from providers outside the BlueCard service area, these services would be covered at the out of network level and you will typically have to pay the providers and submit the claims yourself to obtain reimbursement for these services.
Iowa Choice: Under the Iowa Choice program, you are only covered for emergency care or care for an accidental injury when you receive care in a foreign country.
If you and your spouse are both employees of the State of Iowa, you are eligible to have your health and dental family premiums divided between the two of you. For more information refer to the DAS Double Spouse webpage.
For more information about health insurance, please contact Wellmark customer service at 800-622-0043.
The Benefits Management Team of the Iowa Department of Administrative Services developed this website to provide you with information about your benefit options and serve as a valuable resource for information about your benefits. The benefits described at this webpage are subject to change. Nothing herein shall be construed as a guarantee of benefits. This webpage is not a complete description of the State of Iowa’s benefit plans. Nothing on this website supersedes or changes any of the terms and conditions of any plan documents, insurance policies, or other legal agreements. If the wording in this webpage contradicts any plan documents, laws, regulations, administrative rules, insurance policies, or other legal agreements, the wording in the official documents and agreements will govern. If you have any questions, please contact your human resources associate.