Wellmark plan comparison guide for Iowa small groups | High Deductible Health Plans (HDHP)
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High-Deductible Health Plans (HDHP)

2020 ACA Plan Comparison Guide | Iowa

Wellmark's myBlue HDHPSM encourages employee engagement in their health care. Because your employees pay the full cost of care (excluding preventive care) and prescriptions until they reach their deductible, an HDHP helps them understand the true cost of care — and offers the lowest monthly premiums.

Help your employees save with an HSA

When your employees enroll in a qualified HDHP, they can also open a health savings account (HSA). An HSA is an individual savings account employees can contribute to, invest in, and receive certain distributions from.

Integration between Wellmark claims and consumer-driven accounts from WageWorks® External Site means reimbursement is automatic, and employees can view their account balances on their personal myWellmark® account.

WageWorks also offers an easy-to-use mobile app, EZ Receipts® External Site, to help put your employees in control of their health care.

With an HSA, see triple tax-free savings

  1. When employees put money into their HSA.
  1. When the HSA accumulates.
  1. When employees spend money from their HSA.

Employees won't be taxed when they take money out of their HSA as long as they use the funds exclusively to pay for qualified medical expenses.*

*If employees use any HSA funds to pay for expenses other than qualified medical expenses, they may be subject to income taxes and additional penalties.

Here's how an HSA works

Employees contribute money into a health savings account tax-free.  The HSA account can be used to pay for qualified expenses like doctor visits, prescriptions drugs, eyeglasses and dental care, tax free. Unspent funds rollover for future health care expenses.
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High-deductible health plan options

Regardless of the network you choose, all the products in the table are available. Amounts shown reflect covered in-network services only. For PPO and POS plans, additional cost shares will apply to out-of-network services.

All plans use Blue Rx EssentialsSM pharmacy benefits.

Plan Details myBlue HDHPSM Bronze myBlue HDHPSM Silver
Annual Benefit — Deductible in-network1
Single deductible $6,750 $4,500
Family2 deductible $13,500 $9,000
Coinsurance — member pays 0% 0%
Annual benefit — Out-of-Pocket Maximum (opm) In-network
Single out-of-pocket maximum $6,750 $6,750
Family3 out-of-pocket maximum $13,500 $13,500
Preventive care4 screenings, immunizations Free Free
Virtual Visit5 Deductible applies $0 after deductible
Primary care office services6 Deductible applies $0 after deductible
Non-primary care office services Deductible applies $60 after deductible
Emergency room Deductible applies $250 after deductible
Prescription drugs - Blue Rx EssentialsSM
Tier 1 Deductible applies $20 after deductible
Tier 2 $60 after deductible
Tier 3 $125 after deductible
Specialty preferred $150 after deductible
Non-preferred $200 after deductible
Medicare Part D Creditable Coverage7 No Yes

Your employees will be required to use Blue Distinction® Centers for bariatric surgery and transplants in 2020.

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1 Both in-network and out of-network services apply toward a single deductible. However, out-of-pocket costs for in-network services only apply to the in-network out-of-pocket maximum. Only out-of-pocket costs for out-of-network services apply to the out-of-network out-of-pocket maximum.
2 The family deductible can be met through any combination of family members for all plans. No one member will be required to meet more than the single deductible amount to receive benefits for covered services during a benefit period.
3 The family out-of-pocket maximum (OPM) can be met through any combination of family members. No one member will be required to meet more than the single OPM amount to receive benefits for covered services during a benefit period.
4 All costs waived when using an in-network or participating provider on PPO plans. On all other available networks, costs are waived when using an in-network provider. One preventive exam with a separate gynecological exam per member per benefit period. Preventive care includes gynecological exam, preventive exam, screening mammography, well-child care and newborn care. For plans on the Wellmark Value Health Plan HMO Network, a designated personal doctor must be seen for preventive care/screenings and immunizations. One preventive exam with separate gynecological exam per member per benefit period. Well-child care up to age 7 (includes normal newborn care, physical examinations, assessments and immunizations.)
5 Wellmark’s preferred virtual visit partner is Doctor On Demand.
6 The primary care office copay applies to family practitioners, general practitioners, obstetricians/gynecologists, pediatricians, physicians’ assistants and advanced registered nurse practitioners. This lower office copay also applies to in-network chiropractors, physical therapists, occupational therapists, and in some cases, mental health or chemical dependency visits. All other in-network practitioners are subject to the non-primary care office copay. The copay applies per practitioner, per visit.
7 Medicare Part D creditable coverage status applies for 2020 plan year only.
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