2023 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 | 269.92 |
| Aetna Direct | 225 | Non-Postal | HDHP Self & Family | Monthly | 511.92 |
| Aetna Direct | 226 | Non-Postal | HDHP Self Plus One | Monthly | 586.26 |
| Aetna Direct | N61 | Non-Postal | CDHP Self | Monthly | 160.35 |
| Aetna Direct | N62 | Non-Postal | CDHP Self & Family | Monthly | 404.39 |
| Aetna Direct | N63 | Non-Postal | CDHP Self Plus One | Monthly | 351.67 |
| 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 | 603.67 |
| Aetna HealthFund CDHP and Aetna Value Plan | JS2 | Non-Postal | CDHP Self & Family | Monthly | 1334.15 |
| Aetna HealthFund CDHP and Aetna Value Plan | JS3 | Non-Postal | CDHP Self Plus One | Monthly | 1418.08 |
| Aetna HealthFund CDHP and Aetna Value Plan | JS4 | Non-Postal | Value Self | Monthly | 544.24 |
| Aetna HealthFund CDHP and Aetna Value Plan | JS5 | Non-Postal | Value Self & Family | Monthly | 1202.31 |
| Aetna HealthFund CDHP and Aetna Value Plan | JS6 | Non-Postal | Value Self Plus One | Monthly | 1287.61 |
| 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 | 804.98 |
| Dean Health Plan | WD2 | Non-Postal | High Self & Family | Monthly | 1821.02 |
| Dean Health Plan | WD3 | Non-Postal | High Self Plus One | Monthly | 1657.76 |
| Dean Health Plan | WD4 | Non-Postal | Standard Self | Monthly | 184.63 |
| Dean Health Plan | WD5 | Non-Postal | Standard Self & Family | Monthly | 447.7 |
| Dean Health Plan | WD6 | Non-Postal | Standard Self Plus One | Monthly | 410.28 |
| Group Health Cooperative | WJ1 | Non-Postal | High Self | Monthly | 550.74 |
| Group Health Cooperative | WJ2 | Non-Postal | High Self & Family | Monthly | 1570.4 |
| Group Health Cooperative | WJ3 | Non-Postal | High Self Plus One | Monthly | 1235.26 |
| Group Health Cooperative | WJ4 | Non-Postal | Standard Self | Monthly | 160.26 |
| Group Health Cooperative | WJ5 | Non-Postal | Standard Self & Family | Monthly | 416.69 |
| Group Health Cooperative | WJ6 | Non-Postal | Standard Self Plus One | Monthly | 352.58 |
| HealthPartners | V31 | Non-Postal | High Self | Monthly | 184.29 |
| HealthPartners | V32 | Non-Postal | High Self & Family | Monthly | 470.99 |
| HealthPartners | V33 | Non-Postal | High Self Plus One | Monthly | 414.66 |
| 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 |