2020 Plan Information for Wisconsin
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 | 217.96 |
| Aetna Direct | 225 | Non-Postal | HDHP Self & Family | Monthly | 423.58 |
| Aetna Direct | 226 | Non-Postal | HDHP Self Plus One | Monthly | 483.84 |
| Aetna Direct | N61 | Non-Postal | CDHP Self | Monthly | 153.16 |
| Aetna Direct | N62 | Non-Postal | CDHP Self & Family | Monthly | 386.25 |
| Aetna Direct | N63 | Non-Postal | CDHP Self Plus One | Monthly | 335.89 |
| Aetna Direct | Z24 | Non-Postal | Advantage Self | Monthly | 115.96 |
| Aetna Direct | Z25 | Non-Postal | Advantage Self & Family | Monthly | 307.29 |
| Aetna Direct | Z26 | Non-Postal | Advantage Self Plus One | Monthly | 255.11 |
| Aetna HealthFund CDHP and Aetna Value Plan | JS1 | Non-Postal | CDHP Self | Monthly | 493.15 |
| Aetna HealthFund CDHP and Aetna Value Plan | JS2 | Non-Postal | CDHP Self & Family | Monthly | 1104.63 |
| Aetna HealthFund CDHP and Aetna Value Plan | JS3 | Non-Postal | CDHP Self Plus One | Monthly | 1173.73 |
| Aetna HealthFund CDHP and Aetna Value Plan | JS4 | Non-Postal | Value Self | Monthly | 562.64 |
| Aetna HealthFund CDHP and Aetna Value Plan | JS5 | Non-Postal | Value Self & Family | Monthly | 1266.57 |
| Aetna HealthFund CDHP and Aetna Value Plan | JS6 | Non-Postal | Value Self Plus One | Monthly | 1334.06 |
| Dean Health Plan | WD1 | Non-Postal | High Self | Monthly | 636.24 |
| Dean Health Plan | WD2 | Non-Postal | High Self & Family | Monthly | 1454.24 |
| Dean Health Plan | WD3 | Non-Postal | High Self Plus One | Monthly | 1316.6 |
| Dean Health Plan | WD4 | Non-Postal | Standard Self | Monthly | 170.73 |
| Dean Health Plan | WD5 | Non-Postal | Standard Self & Family | Monthly | 451.75 |
| Dean Health Plan | WD6 | Non-Postal | Standard Self Plus One | Monthly | 407.2 |
| Group Health Cooperative | WJ1 | Non-Postal | High Self | Monthly | 347.12 |
| Group Health Cooperative | WJ2 | Non-Postal | High Self & Family | Monthly | 1046.74 |
| Group Health Cooperative | WJ3 | Non-Postal | High Self Plus One | Monthly | 795.3 |
| HealthPartners | V31 | Non-Postal | High Self | Monthly | 201.47 |
| HealthPartners | V32 | Non-Postal | High Self & Family | Monthly | 551.18 |
| HealthPartners | V33 | Non-Postal | High Self Plus One | Monthly | 481.95 |
| HealthPartners | V34 | Non-Postal | Standard Self | Monthly | 114.98 |
| HealthPartners | V35 | Non-Postal | Standard Self & Family | Monthly | 280.1 |
| HealthPartners | V36 | Non-Postal | Standard Self Plus One | Monthly | 254.11 |
| MercyCare Health Plans | EY1 | Non-Postal | High Self | Monthly | 275.08 |
| MercyCare Health Plans | EY2 | Non-Postal | High Self & Family | Monthly | 866.97 |
| MercyCare Health Plans | EY3 | Non-Postal | High Self Plus One | Monthly | 597.52 |
| MercyCare Health Plans | EY4 | Non-Postal | Standard Self | Monthly | 152.4 |
| MercyCare Health Plans | EY5 | Non-Postal | Standard Self & Family | Monthly | 406.83 |
| MercyCare Health Plans | EY6 | Non-Postal | Standard Self Plus One | Monthly | 327.67 |
| Quartz Health Benefit Plans Corporation | TF1 | Non-Postal | High Self | Monthly | 499.52 |
| Quartz Health Benefit Plans Corporation | TF2 | Non-Postal | High Self & Family | Monthly | 1240.87 |
| Quartz Health Benefit Plans Corporation | TF3 | Non-Postal | High Self Plus One | Monthly | 1181.09 |
| Quartz Health Benefit Plans Corporation | TF4 | Non-Postal | Standard Self | Monthly | 153.57 |
| Quartz Health Benefit Plans Corporation | TF5 | Non-Postal | Standard Self & Family | Monthly | 368.57 |
| Quartz Health Benefit Plans Corporation | TF6 | Non-Postal | Standard Self Plus One | Monthly | 337.86 |