Silver health plan options
2023 ACA Plan Comparison Guide | Iowa Small Group Plans
With a silver tier, overall Wellmark pays about 70 percent and your employees will pay about 30 percent of the plan's cost-sharing requirements, which can include the deductible, coinsurance and copays. Consider a silver plan if you want to balance monthly premium costs vs. out-of-pocket expenses for your employees when they receive care.
Silver 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 Silver | CompleteBlueSM 4000 | CompleteBlueSM 5000 | CompleteBlueSM Primary | ||
---|---|---|---|---|---|
Medical deductible — annual amount you pay before Wellmark pays | |||||
Single | $5,000 | $4,000 | $5,000 | $5,800 | |
Family | $10,000 | $8,000 | $10,000 | $11,600 | |
Coinsurance — portion of medical cost you pay after your deductible is met | 0% | 30% | 30% | 30% | |
Out-of-pocket maximum (OPM) — the most you'll spend in a year | |||||
Single | $5,000 | $9,000 | $9,000 | $8,900 | |
Family | $10,000 | $18,000 | $18,000 | $17,800 | |
Medical benefits | |||||
Preventive care screenings | Free | Free | Free | Free | |
Virtual visits | Deductible | $0 | $0 | $0 | |
Primary care office services | $40 | $50 | $15 | ||
Non-primary care office services | $100 | $100 | $100 | ||
Emergency room visit | $700 | $600 | Deductible plus 30% coinsurance | ||
Outpatient | Deductible plus 30% coinsurance | Deductible plus 30% coinsurance | |||
Hospitalization | |||||
Pharmacy benefits — Blue Rx EssentialsSM | |||||
Preventive | Free | Free | Free | Free | |
Tier 1 | Deductible | $30 | $35 | $15 | |
Tier 2 | $60 | $70 | Deductible plus 30% coinsurance | ||
Tier 3 | $150 | $140 | |||
Biosimilar and generic specialty | $135 | $170 | |||
Specialty preferred | $150 | $200 | |||
Specialty non-preferred | $500 | $500 | |||
Other benefits | |||||
Qualifies for health savings account (HSA) | Yes | No | No | No | |
Medicare Part D Creditable Coverage | Yes | Yes | Yes | No |
myBlue HDHPSM Silver | |||||
---|---|---|---|---|---|
Medical deductible — annual amount you pay before Wellmark pays | |||||
Single | $5,000 | ||||
Family | $10,000 | ||||
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 | $5,000 | ||||
Family | $10,000 | ||||
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 | Yes |
CompleteBlueSM 4000 | |||||
---|---|---|---|---|---|
Medical deductible — annual amount you pay before Wellmark pays | |||||
Single | $4,000 | ||||
Family | $8,000 | ||||
Coinsurance — portion of medical cost you pay after your deductible is met | 30% | ||||
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 | $40 | ||||
Non-primary care office services | $100 | ||||
Emergency room visit | $700 | ||||
Outpatient | Deductible plus 30% coinsurance | ||||
Hospitalization | |||||
Pharmacy benefits — Blue Rx EssentialsSM | |||||
Preventive | Free | ||||
Tier 1 | $30 | ||||
Tier 2 | $60 | ||||
Tier 3 | $150 | ||||
Biosimilar and generic specialty | $135 | ||||
Specialty preferred | $150 | ||||
Specialty non-preferred | $500 | ||||
Other benefits | |||||
Qualifies for health savings account (HSA) | No | ||||
Medicare Part D Creditable Coverage | Yes |
CompleteBlueSM 5000 | |||||
---|---|---|---|---|---|
Medical deductible — annual amount you pay before Wellmark pays | |||||
Single | $5,000 | ||||
Family | $10,000 | ||||
Coinsurance — portion of medical cost you pay after your deductible is met | 30% | ||||
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 | $50 | ||||
Non-primary care office services | $100 | ||||
Emergency room visit | $600 | ||||
Outpatient | Deductible plus 30% coinsurance | ||||
Hospitalization | |||||
Pharmacy benefits — Blue Rx EssentialsSM | |||||
Preventive | Free | ||||
Tier 1 | $35 | ||||
Tier 2 | $70 | ||||
Tier 3 | $140 | ||||
Biosimilar and generic specialty | $170 | ||||
Specialty preferred | $200 | ||||
Specialty non-preferred | $500 | ||||
Other benefits | |||||
Qualifies for health savings account (HSA) | No | ||||
Medicare Part D Creditable Coverage | Yes |
CompleteBlueSM Primary | |||||
---|---|---|---|---|---|
Medical deductible — annual amount you pay before Wellmark pays | |||||
Single | $5,800 | ||||
Family | $11,600 | ||||
Coinsurance — portion of medical cost you pay after your deductible is met | 30% | ||||
Out-of-pocket maximum (OPM) — the most you'll spend in a year | |||||
Single | $8,900 | ||||
Family | $17,800 | ||||
Medical benefits | |||||
Preventive care screenings | Free | ||||
Virtual visits | $0 | ||||
Primary care office services | $15 | ||||
Non-primary care office services | $100 | ||||
Emergency room visit | Deductible plus 30% coinsurance | ||||
Outpatient | |||||
Hospitalization | |||||
Pharmacy benefits — Blue Rx EssentialsSM | |||||
Preventive | Free | ||||
Tier 1 | $15 | ||||
Tier 2 | Deductible plus 30% coinsurance | ||||
Tier 3 | |||||
Biosimilar and generic specialty | |||||
Specialty preferred | |||||
Specialty non-preferred | |||||
Other benefits | |||||
Qualifies for health savings account (HSA) | |||||
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.