2017 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 | 138.7 |
| Aetna Direct | 225 | Non-Postal | HDHP Self & Family | Monthly | 305.95 |
| Aetna Direct | 226 | Non-Postal | HDHP Self Plus One | Monthly | 299.95 |
| Aetna Direct | N61 | Non-Postal | CDHP Self | Monthly | 120.05 |
| Aetna Direct | N62 | Non-Postal | CDHP Self & Family | Monthly | 302.77 |
| Aetna Direct | N63 | Non-Postal | CDHP Self Plus One | Monthly | 263.29 |
| Aetna HealthFund CDHP and Aetna Value Plan | H41 | Non-Postal | CDHP Self | Monthly | 271.91 |
| Aetna HealthFund CDHP and Aetna Value Plan | H42 | Non-Postal | CDHP Self & Family | Monthly | 620.04 |
| Aetna HealthFund CDHP and Aetna Value Plan | H43 | Non-Postal | CDHP Self Plus One | Monthly | 666.83 |
| Aetna HealthFund CDHP and Aetna Value Plan | H44 | Non-Postal | Value Self | Monthly | 139.55 |
| Aetna HealthFund CDHP and Aetna Value Plan | H45 | Non-Postal | Value Self & Family | Monthly | 320.28 |
| Aetna HealthFund CDHP and Aetna Value Plan | H46 | Non-Postal | Value Self Plus One | Monthly | 314 |
| Aetna Open Access | P31 | Non-Postal | High Self | Monthly | 939.4 |
| Aetna Open Access | P32 | Non-Postal | High Self & Family | Monthly | 2347.41 |
| Aetna Open Access | P33 | Non-Postal | High Self Plus One | Monthly | 2377.09 |
| Aetna Open Access | P34 | Non-Postal | Basic Self | Monthly | 709.23 |
| Aetna Open Access | P35 | Non-Postal | Basic Self & Family | Monthly | 1666.24 |
| Aetna Open Access | P36 | Non-Postal | Basic Self Plus One | Monthly | 1702.65 |
| Aetna Open Access | YE1 | Non-Postal | High Self | Monthly | 329.98 |
| Aetna Open Access | YE2 | Non-Postal | High Self & Family | Monthly | 939.99 |
| Aetna Open Access | YE3 | Non-Postal | High Self Plus One | Monthly | 983.58 |
| Geisinger Health Plan | GG4 | Non-Postal | Standard Self | Monthly | 184.27 |
| Geisinger Health Plan | GG5 | Non-Postal | Standard Self & Family | Monthly | 426.88 |
| Geisinger Health Plan | GG6 | Non-Postal | Standard Self Plus One | Monthly | 405.04 |
| Highmark Choice Company | NP1 | Non-Postal | High Self | Monthly | 154.8 |
| Highmark Choice Company | NP2 | Non-Postal | High Self & Family | Monthly | 351.09 |
| Highmark Choice Company | NP3 | Non-Postal | High Self Plus One | Monthly | 291.34 |
| UPMC Health Plan | 8W1 | Non-Postal | High Self | Monthly | 289.44 |
| UPMC Health Plan | 8W2 | Non-Postal | High Self & Family | Monthly | 714.16 |
| UPMC Health Plan | 8W3 | Non-Postal | High Self Plus One | Monthly | 701 |
| UPMC Health Plan | 8W4 | Non-Postal | HDHP Self | Monthly | 127.99 |
| UPMC Health Plan | 8W5 | Non-Postal | HDHP Self & Family | Monthly | 293.18 |
| UPMC Health Plan | 8W6 | Non-Postal | HDHP Self Plus One | Monthly | 282.34 |
| UPMC Health Plan | UW4 | Non-Postal | Standard Self | Monthly | 149.95 |
| UPMC Health Plan | UW5 | Non-Postal | Standard Self & Family | Monthly | 352.38 |
| UPMC Health Plan | UW6 | Non-Postal | Standard Self Plus One | Monthly | 337.4 |