2018 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 | 151.86 |
| Aetna Direct | 225 | Non-Postal | HDHP Self & Family | Monthly | 334.98 |
| Aetna Direct | 226 | Non-Postal | HDHP Self Plus One | Monthly | 328.41 |
| Aetna Direct | N61 | Non-Postal | CDHP Self | Monthly | 131.92 |
| Aetna Direct | N62 | Non-Postal | CDHP Self & Family | Monthly | 332.67 |
| Aetna Direct | N63 | Non-Postal | CDHP Self Plus One | Monthly | 289.29 |
| Aetna HealthFund CDHP and Aetna Value Plan | H41 | Non-Postal | CDHP Self | Monthly | 326.13 |
| Aetna HealthFund CDHP and Aetna Value Plan | H42 | Non-Postal | CDHP Self & Family | Monthly | 745.55 |
| Aetna HealthFund CDHP and Aetna Value Plan | H43 | Non-Postal | CDHP Self Plus One | Monthly | 793.24 |
| Aetna HealthFund CDHP and Aetna Value Plan | H44 | Non-Postal | Value Self | Monthly | 143.93 |
| Aetna HealthFund CDHP and Aetna Value Plan | H45 | Non-Postal | Value Self & Family | Monthly | 330.34 |
| Aetna HealthFund CDHP and Aetna Value Plan | H46 | Non-Postal | Value Self Plus One | Monthly | 323.86 |
| Aetna Open Access | P31 | Non-Postal | High Self | Monthly | 1075.71 |
| Aetna Open Access | P32 | Non-Postal | High Self & Family | Monthly | 2682.25 |
| Aetna Open Access | P33 | Non-Postal | High Self Plus One | Monthly | 2710.74 |
| Aetna Open Access | P34 | Non-Postal | Basic Self | Monthly | 851.37 |
| Aetna Open Access | P35 | Non-Postal | Basic Self & Family | Monthly | 1998.79 |
| Aetna Open Access | P36 | Non-Postal | Basic Self Plus One | Monthly | 2034.07 |
| Aetna Open Access | YE1 | Non-Postal | High Self | Monthly | 423.39 |
| Aetna Open Access | YE2 | Non-Postal | High Self & Family | Monthly | 1180.29 |
| Aetna Open Access | YE3 | Non-Postal | High Self Plus One | Monthly | 1223.67 |
| Geisinger Health Plan | GG4 | Non-Postal | Standard Self | Monthly | 187.37 |
| Geisinger Health Plan | GG5 | Non-Postal | Standard Self & Family | Monthly | 436.11 |
| Geisinger Health Plan | GG6 | Non-Postal | Standard Self Plus One | Monthly | 414.27 |
| Highmark Choice Company | NP1 | Non-Postal | High Self | Monthly | 193.05 |
| Highmark Choice Company | NP2 | Non-Postal | High Self & Family | Monthly | 438.1 |
| Highmark Choice Company | NP3 | Non-Postal | High Self Plus One | Monthly | 347.29 |
| UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA)) | V41 | Non-Postal | HDHP Self | Monthly | 141.74 |
| UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA)) | V42 | Non-Postal | HDHP Self & Family | Monthly | 354.37 |
| UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA)) | V43 | Non-Postal | HDHP Self Plus One | Monthly | 304.75 |
| UnitedHealthcare Insurance Company, Inc. (Choice Open Access) | LR1 | Non-Postal | High Self | Monthly | 152 |
| UnitedHealthcare Insurance Company, Inc. (Choice Open Access) | LR2 | Non-Postal | High Self & Family | Monthly | 389.91 |
| UnitedHealthcare Insurance Company, Inc. (Choice Open Access) | LR3 | Non-Postal | High Self Plus One | Monthly | 326.8 |
| UPMC Health Plan | 8W1 | Non-Postal | High Self | Monthly | 367.68 |
| UPMC Health Plan | 8W2 | Non-Postal | High Self & Family | Monthly | 901.23 |
| UPMC Health Plan | 8W3 | Non-Postal | High Self Plus One | Monthly | 881.12 |
| UPMC Health Plan | 8W4 | Non-Postal | HDHP Self | Monthly | 134.9 |
| UPMC Health Plan | 8W5 | Non-Postal | HDHP Self & Family | Monthly | 309.39 |
| UPMC Health Plan | 8W6 | Non-Postal | HDHP Self Plus One | Monthly | 297.86 |
| UPMC Health Plan | UW4 | Non-Postal | Standard Self | Monthly | 156.12 |
| UPMC Health Plan | UW5 | Non-Postal | Standard Self & Family | Monthly | 366.88 |
| UPMC Health Plan | UW6 | Non-Postal | Standard Self Plus One | Monthly | 351.28 |