Bronze health plan options
2023 ACA Plan Comparison Guide | Iowa Small Group Plans
With a bronze tier, overall Wellmark pays about 60 percent and your employees will pay about 40 percent of the plan's cost-sharing requirements, which can include the deductible, coinsurance and copays. Consider a bronze plan if you want lower monthly premiums compared to gold and silver plans.
Bronze plan details
Regardless of the network you choose, all plans below are available. Amounts in the table reflect covered, in-network services only. For PPO and POS plans, additional cost shares will apply to out-of-network services. All plans include easy-to-navigate pharmacy benefits with Blue Rx EssentialsSM. Blue Rx Essentials prescription tiers are designated based on factors like cost and effectiveness when compared to similar drugs.
| myBlue HDHPSM Bronze | SimplyBlueSM 6000 | SimplyBlueSM Primary | ||
|---|---|---|---|---|
| Medical deductible — annual amount you pay before Wellmark pays | ||||
| Single | $7,500 | $6,000 | $7,000 | |
| Family | $15,000 | $12,000 | $14,000 | |
| Coinsurance — portion of medical cost you pay after your deductible is met | 0% | 50% | 50% | |
| Out-of-pocket maximum (OPM) — the most you'll spend in a year | ||||
| Single | $7,500 | $9,000 | $9,000 | |
| Family | $15,000 | $18,000 | $18,000 | |
| Medical benefits | ||||
| Preventive care screenings | Free | Free | Free | |
| Virtual visits | Deductible | $0 | $0 | |
| Primary care office services | $70 | $25 | ||
| Non-primary care office services | $150 | $120 | ||
| Emergency room visit | Deductible plus 50% coinsurance | Deductible plus 50% coinsurance | ||
| Outpatient | ||||
| Hospitalization | ||||
| Pharmacy benefits — Blue Rx EssentialsSM | ||||
| Preventive | Free | Free | Free | |
| Tier 1 | Deductible | $30 | $25 | |
| Tier 2 | Deductible plus 50% coinsurance | Deductible plus 50% coinsurance | ||
| Tier 3 | ||||
| Biosimilar and generic specialty | ||||
| Specialty preferred | ||||
| Specialty non-preferred | ||||
| Other benefits | ||||
| Qualifies for health savings account (HSA) | Yes | No | No | |
| Medicare Part D Creditable Coverage | No | No | No | |
| myBlue HDHPSM Bronze | ||||
|---|---|---|---|---|
| Medical deductible — annual amount you pay before Wellmark pays | ||||
| Single | $7,500 | |||
| Family | $15,000 | |||
| Coinsurance — portion of medical cost you pay after your deductible is met | 0% | |||
| Out-of-pocket maximum (OPM) — the most you'll spend in a year | ||||
| Single | $7,500 | |||
| Family | $15,000 | |||
| Medical benefits | ||||
| Preventive care screenings | Free | |||
| Virtual visits | Deductible | |||
| Primary care office services | ||||
| Non-primary care office services | ||||
| Emergency room visit | ||||
| Outpatient | ||||
| Hospitalization | ||||
| Pharmacy benefits — Blue Rx EssentialsSM | ||||
| Preventive | Free | |||
| Tier 1 | Deductible | |||
| Tier 2 | ||||
| Tier 3 | ||||
| Biosimilar and generic specialty | ||||
| Specialty preferred | ||||
| Specialty non-preferred | ||||
| Other benefits | ||||
| Qualifies for health savings account (HSA) | Yes | |||
| Medicare Part D Creditable Coverage | No | |||
| SimplyBlueSM 6000 | ||||
|---|---|---|---|---|
| Medical deductible — annual amount you pay before Wellmark pays | ||||
| Single | $6,000 | |||
| Family | $12,000 | |||
| Coinsurance — portion of medical cost you pay after your deductible is met | 50% | |||
| Out-of-pocket maximum (OPM) — the most you'll spend in a year | ||||
| Single | $9,000 | |||
| Family | $18,000 | |||
| Medical benefits | ||||
| Preventive care screenings | Free | |||
| Virtual visits | $0 | |||
| Primary care office services | $70 | |||
| Non-primary care office services | $150 | |||
| Emergency room visit | Deductible plus 50% coinsurance | |||
| Outpatient | ||||
| Hospitalization | ||||
| Pharmacy benefits — Blue Rx EssentialsSM | ||||
| Preventive | Free | |||
| Tier 1 | $30 | |||
| Tier 2 | Deductible plus 50% coinsurance | |||
| Tier 3 | ||||
| Biosimilar and generic specialty | ||||
| Specialty preferred | ||||
| Specialty non-preferred | ||||
| Other benefits | ||||
| Qualifies for health savings account (HSA) | No | |||
| Medicare Part D Creditable Coverage | No | |||
| SimplyBlueSM Primary | ||||
|---|---|---|---|---|
| Medical deductible — annual amount you pay before Wellmark pays | ||||
| Single | $7,000 | |||
| Family | $14,000 | |||
| Coinsurance — portion of medical cost you pay after your deductible is met | 50% | |||
| Out-of-pocket maximum (OPM) — the most you'll spend in a year | ||||
| Single | $9,000 | |||
| Family | $18,000 | |||
| Medical benefits | ||||
| Preventive care screenings | Free | |||
| Virtual visits | $0 | |||
| Primary care office services | $25 | |||
| Non-primary care office services | $120 | |||
| Emergency room visit | Deductible plus 50% coinsurance | |||
| Outpatient | ||||
| Hospitalization | ||||
| Pharmacy benefits — Blue Rx EssentialsSM | ||||
| Preventive | Free | |||
| Tier 1 | $25 | |||
| Tier 2 | Deductible plus 50% coinsurance | |||
| Tier 3 | ||||
| Biosimilar and generic specialty | ||||
| Specialty preferred | ||||
| Specialty non-preferred | ||||
| Other benefits | ||||
| Qualifies for health savings account (HSA) | No | |||
| Medicare Part D Creditable Coverage | No | |||
Virtual Visits with Doctor On Demand®
Reduce absenteeism and costs while increasing employee satisfaction with virtual visits, included in all our plans. Offered at a lower cost than an office visit, Doctor On Demand allows employees to connect face-to-face with a board-certified doctor or mental health professional from virtually anywhere.
