2022 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 | 293.78 |
Aetna Direct | 225 | Non-Postal | HDHP Self & Family | Monthly | 574.3 |
Aetna Direct | 226 | Non-Postal | HDHP Self Plus One | Monthly | 645.93 |
Aetna Direct | N61 | Non-Postal | CDHP Self | Monthly | 157.07 |
Aetna Direct | N62 | Non-Postal | CDHP Self & Family | Monthly | 396.12 |
Aetna Direct | N63 | Non-Postal | CDHP Self Plus One | Monthly | 344.47 |
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 | 506.81 |
Aetna HealthFund CDHP and Aetna Value Plan | JS2 | Non-Postal | CDHP Self & Family | Monthly | 1120.71 |
Aetna HealthFund CDHP and Aetna Value Plan | JS3 | Non-Postal | CDHP Self Plus One | Monthly | 1204.54 |
Aetna HealthFund CDHP and Aetna Value Plan | JS4 | Non-Postal | Value Self | Monthly | 563.98 |
Aetna HealthFund CDHP and Aetna Value Plan | JS5 | Non-Postal | Value Self & Family | Monthly | 1254.69 |
Aetna HealthFund CDHP and Aetna Value Plan | JS6 | Non-Postal | Value Self Plus One | Monthly | 1337.24 |
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 | 754.04 |
Dean Health Plan | WD2 | Non-Postal | High Self & Family | Monthly | 1710.58 |
Dean Health Plan | WD3 | Non-Postal | High Self Plus One | Monthly | 1560.91 |
Dean Health Plan | WD4 | Non-Postal | Standard Self | Monthly | 181.89 |
Dean Health Plan | WD5 | Non-Postal | Standard Self & Family | Monthly | 465.85 |
Dean Health Plan | WD6 | Non-Postal | Standard Self Plus One | Monthly | 430.62 |
Group Health Cooperative | WJ1 | Non-Postal | High Self | Monthly | 558.5 |
Group Health Cooperative | WJ2 | Non-Postal | High Self & Family | Monthly | 1587.67 |
Group Health Cooperative | WJ3 | Non-Postal | High Self Plus One | Monthly | 1259.24 |
Group Health Cooperative | WJ4 | Non-Postal | Standard Self | Monthly | 146.86 |
Group Health Cooperative | WJ5 | Non-Postal | Standard Self & Family | Monthly | 381.86 |
Group Health Cooperative | WJ6 | Non-Postal | Standard Self Plus One | Monthly | 323.11 |
HealthPartners | V31 | Non-Postal | High Self | Monthly | 173.03 |
HealthPartners | V32 | Non-Postal | High Self & Family | Monthly | 442.06 |
HealthPartners | V33 | Non-Postal | High Self Plus One | Monthly | 392.88 |
HealthPartners | V34 | Non-Postal | Standard Self | Monthly | 138.32 |
HealthPartners | V35 | Non-Postal | Standard Self & Family | Monthly | 336.96 |
HealthPartners | V36 | Non-Postal | Standard Self Plus One | Monthly | 305.69 |