2016 Plan Information for Pennsylvania
Choose a Location, Employee Type, & Payment Period
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Location Specific Rates
| Contract | Enrollment Code | Enrollment Type | Option/Enrollment Type | Payment Period | Employee Payment |
|---|---|---|---|---|---|
| Aetna Direct | 224 | Non-Postal | HDHP Self | Monthly | 130.08 |
| Aetna Direct | 225 | Non-Postal | HDHP Self & Family | Monthly | 286.94 |
| Aetna Direct | 226 | Non-Postal | HDHP Self Plus One | Monthly | 281.31 |
| Aetna Direct | N61 | Non-Postal | CDHP Self | Monthly | 118.33 |
| Aetna Direct | N62 | Non-Postal | CDHP Self & Family | Monthly | 298.42 |
| Aetna Direct | N63 | Non-Postal | CDHP Self Plus One | Monthly | 259.5 |
| Aetna HealthFund CDHP and Aetna Value Plan | H41 | Non-Postal | CDHP Self | Monthly | 215.17 |
| Aetna HealthFund CDHP and Aetna Value Plan | H42 | Non-Postal | CDHP Self & Family | Monthly | 485.89 |
| Aetna HealthFund CDHP and Aetna Value Plan | H43 | Non-Postal | CDHP Self Plus One | Monthly | 530.14 |
| Aetna HealthFund CDHP and Aetna Value Plan | H44 | Non-Postal | Basic Self | Monthly | 134.18 |
| Aetna HealthFund CDHP and Aetna Value Plan | H45 | Non-Postal | Basic Self & Family | Monthly | 307.96 |
| Aetna HealthFund CDHP and Aetna Value Plan | H46 | Non-Postal | Basic Self Plus One | Monthly | 301.92 |
| Aetna Open Access | P31 | Non-Postal | High Self | Monthly | 905.41 |
| Aetna Open Access | P32 | Non-Postal | High Self & Family | Monthly | 2257.6 |
| Aetna Open Access | P33 | Non-Postal | High Self Plus One | Monthly | 2284.31 |
| Aetna Open Access | P34 | Non-Postal | Basic Self | Monthly | 639.28 |
| Aetna Open Access | P35 | Non-Postal | Basic Self & Family | Monthly | 1498.4 |
| Aetna Open Access | P36 | Non-Postal | Basic Self Plus One | Monthly | 1532.63 |
| Aetna Open Access | YE1 | Non-Postal | High Self | Monthly | 247.54 |
| Aetna Open Access | YE2 | Non-Postal | High Self & Family | Monthly | 723.99 |
| Aetna Open Access | YE3 | Non-Postal | High Self Plus One | Monthly | 765.91 |
| Geisinger Health Plan | GG4 | Non-Postal | Standard Self | Monthly | 186.08 |
| Geisinger Health Plan | GG5 | Non-Postal | Standard Self & Family | Monthly | 432.88 |
| Geisinger Health Plan | GG6 | Non-Postal | Standard Self Plus One | Monthly | 492.42 |
| Highmark Choice Company | NP1 | Non-Postal | High Self | Monthly | 136.62 |
| Highmark Choice Company | NP2 | Non-Postal | High Self & Family | Monthly | 309.92 |
| Highmark Choice Company | NP3 | Non-Postal | High Self Plus One | Monthly | 257.12 |
| UPMC Health Plan | 8W1 | Non-Postal | High Self | Monthly | 309.79 |
| UPMC Health Plan | 8W2 | Non-Postal | High Self & Family | Monthly | 755.93 |
| UPMC Health Plan | 8W3 | Non-Postal | High Self Plus One | Monthly | 738.31 |
| UPMC Health Plan | 8W4 | Non-Postal | HDHP Self | Monthly | 128.25 |
| UPMC Health Plan | 8W5 | Non-Postal | HDHP Self & Family | Monthly | 295.65 |
| UPMC Health Plan | 8W6 | Non-Postal | HDHP Self Plus One | Monthly | 284.3 |
| UPMC Health Plan | UW4 | Non-Postal | Standard Self | Monthly | 144.89 |
| UPMC Health Plan | UW5 | Non-Postal | Standard Self & Family | Monthly | 340.48 |
| UPMC Health Plan | UW6 | Non-Postal | Standard Self Plus One | Monthly | 326 |