2021 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 | 262.6 |
Aetna Direct | 225 | Non-Postal | HDHP Self & Family | Monthly | 515.62 |
Aetna Direct | 226 | Non-Postal | HDHP Self Plus One | Monthly | 578.72 |
Aetna Direct | N61 | Non-Postal | CDHP Self | Monthly | 153.96 |
Aetna Direct | N62 | Non-Postal | CDHP Self & Family | Monthly | 388.27 |
Aetna Direct | N63 | Non-Postal | CDHP Self Plus One | Monthly | 337.64 |
Aetna Direct | Z24 | Non-Postal | Advantage Self | Monthly | 125 |
Aetna Direct | Z25 | Non-Postal | Advantage Self & Family | Monthly | 331.25 |
Aetna Direct | Z26 | Non-Postal | Advantage Self Plus One | Monthly | 275 |
Aetna HealthFund CDHP and Aetna Value Plan | JS1 | Non-Postal | CDHP Self | Monthly | 486.51 |
Aetna HealthFund CDHP and Aetna Value Plan | JS2 | Non-Postal | CDHP Self & Family | Monthly | 1083.94 |
Aetna HealthFund CDHP and Aetna Value Plan | JS3 | Non-Postal | CDHP Self Plus One | Monthly | 1158.17 |
Aetna HealthFund CDHP and Aetna Value Plan | JS4 | Non-Postal | Value Self | Monthly | 571.16 |
Aetna HealthFund CDHP and Aetna Value Plan | JS5 | Non-Postal | Value Self & Family | Monthly | 1280.59 |
Aetna HealthFund CDHP and Aetna Value Plan | JS6 | Non-Postal | Value Self Plus One | Monthly | 1352.91 |
Dean Health Plan | AG1 | Non-Postal | Basic Self | Monthly | 113.77 |
Dean Health Plan | AG2 | Non-Postal | Basic Self & Family | Monthly | 255.97 |
Dean Health Plan | AG3 | Non-Postal | Basic Self Plus One | Monthly | 238.91 |
Dean Health Plan | WD1 | Non-Postal | High Self | Monthly | 737.45 |
Dean Health Plan | WD2 | Non-Postal | High Self & Family | Monthly | 1681.83 |
Dean Health Plan | WD3 | Non-Postal | High Self Plus One | Monthly | 1526.7 |
Dean Health Plan | WD4 | Non-Postal | Standard Self | Monthly | 171.28 |
Dean Health Plan | WD5 | Non-Postal | Standard Self & Family | Monthly | 426.05 |
Dean Health Plan | WD6 | Non-Postal | Standard Self Plus One | Monthly | 386.1 |
Group Health Cooperative | WJ1 | Non-Postal | High Self | Monthly | 365.61 |
Group Health Cooperative | WJ2 | Non-Postal | High Self & Family | Monthly | 1093.3 |
Group Health Cooperative | WJ3 | Non-Postal | High Self Plus One | Monthly | 834.73 |
Group Health Cooperative | WJ4 | Non-Postal | Standard Self | Monthly | 154.71 |
Group Health Cooperative | WJ5 | Non-Postal | Standard Self & Family | Monthly | 402.25 |
Group Health Cooperative | WJ6 | Non-Postal | Standard Self Plus One | Monthly | 340.37 |
HealthPartners | V31 | Non-Postal | High Self | Monthly | 167.02 |
HealthPartners | V32 | Non-Postal | High Self & Family | Monthly | 409.17 |
HealthPartners | V33 | Non-Postal | High Self Plus One | Monthly | 369.1 |
HealthPartners | V34 | Non-Postal | Standard Self | Monthly | 127.35 |
HealthPartners | V35 | Non-Postal | Standard Self & Family | Monthly | 310.23 |
HealthPartners | V36 | Non-Postal | Standard Self Plus One | Monthly | 281.45 |
Quartz Health Benefit Plans Corporation | TF1 | Non-Postal | High Self | Monthly | 580.39 |
Quartz Health Benefit Plans Corporation | TF2 | Non-Postal | High Self & Family | Monthly | 1430.97 |
Quartz Health Benefit Plans Corporation | TF3 | Non-Postal | High Self Plus One | Monthly | 1362.47 |
Quartz Health Benefit Plans Corporation | TF4 | Non-Postal | Standard Self | Monthly | 160.1 |
Quartz Health Benefit Plans Corporation | TF5 | Non-Postal | Standard Self & Family | Monthly | 384.24 |
Quartz Health Benefit Plans Corporation | TF6 | Non-Postal | Standard Self Plus One | Monthly | 352.21 |
UnitedHealthcare Advantage Plan | Y51 | Non-Postal | High Self | Monthly | 102.93 |
UnitedHealthcare Advantage Plan | Y52 | Non-Postal | High Self & Family | Monthly | 272.77 |
UnitedHealthcare Advantage Plan | Y53 | Non-Postal | High Self Plus One | Monthly | 226.45 |