2016 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 | 130.08 |
| Aetna Direct | 225 | Non-Postal | HDHP Self & Family | Monthly | 286.94 |
| Aetna Direct | 226 | Non-Postal | HDHP Self Plus One | Monthly | 281.31 |
| Aetna Direct | N61 | Non-Postal | CDHP Self | Monthly | 118.33 |
| Aetna Direct | N62 | Non-Postal | CDHP Self & Family | Monthly | 298.42 |
| Aetna Direct | N63 | Non-Postal | CDHP Self Plus One | Monthly | 259.5 |
| Aetna HealthFund CDHP and Aetna Value Plan | JS1 | Non-Postal | CDHP Self | Monthly | 412.06 |
| Aetna HealthFund CDHP and Aetna Value Plan | JS2 | Non-Postal | CDHP Self & Family | Monthly | 934.7 |
| Aetna HealthFund CDHP and Aetna Value Plan | JS3 | Non-Postal | CDHP Self Plus One | Monthly | 974.5 |
| Aetna HealthFund CDHP and Aetna Value Plan | JS4 | Non-Postal | Basic Self | Monthly | 190.54 |
| Aetna HealthFund CDHP and Aetna Value Plan | JS5 | Non-Postal | Basic Self & Family | Monthly | 431.94 |
| Aetna HealthFund CDHP and Aetna Value Plan | JS6 | Non-Postal | Basic Self Plus One | Monthly | 476.71 |
| Aetna Whole Health | F71 | Non-Postal | Basic Self | Monthly | 114.64 |
| Aetna Whole Health | F72 | Non-Postal | Basic Self & Family | Monthly | 317.2 |
| Aetna Whole Health | F73 | Non-Postal | Basic Self Plus One | Monthly | 314.07 |
| Dean Health Plan | WD1 | Non-Postal | High Self | Monthly | 380.14 |
| Dean Health Plan | WD2 | Non-Postal | High Self & Family | Monthly | 879.25 |
| Dean Health Plan | WD3 | Non-Postal | High Self Plus One | Monthly | 770.31 |
| Dean Health Plan | WD4 | Non-Postal | Standard Self | Monthly | 146.41 |
| Dean Health Plan | WD5 | Non-Postal | Standard Self & Family | Monthly | 351.38 |
| Dean Health Plan | WD6 | Non-Postal | Standard Self Plus One | Monthly | 322.1 |
| Group Health Cooperative | WJ1 | Non-Postal | High Self | Monthly | 178.77 |
| Group Health Cooperative | WJ2 | Non-Postal | High Self & Family | Monthly | 852 |
| Group Health Cooperative | WJ3 | Non-Postal | High Self Plus One | Monthly | 317.33 |
| HealthPartners | V31 | Non-Postal | High Self | Monthly | 221.5 |
| HealthPartners | V32 | Non-Postal | High Self & Family | Monthly | 607.29 |
| HealthPartners | V33 | Non-Postal | High Self Plus One | Monthly | 512.31 |
| HealthPartners | V34 | Non-Postal | Standard Self | Monthly | 97.08 |
| HealthPartners | V35 | Non-Postal | Standard Self & Family | Monthly | 236.5 |
| HealthPartners | V36 | Non-Postal | Standard Self Plus One | Monthly | 214.55 |
| MercyCare Health Plans | EY1 | Non-Postal | High Self | Monthly | 199.86 |
| MercyCare Health Plans | EY2 | Non-Postal | High Self & Family | Monthly | 928.07 |
| MercyCare Health Plans | EY3 | Non-Postal | High Self Plus One | Monthly | 331.08 |
| Physicians Plus | LW1 | Non-Postal | High Self | Monthly | 194.63 |
| Physicians Plus | LW2 | Non-Postal | High Self & Family | Monthly | 615.5 |
| Physicians Plus | LW3 | Non-Postal | High Self Plus One | Monthly | 572.19 |
| Physicians Plus | LW4 | Non-Postal | Standard Self | Monthly | 145.52 |
| Physicians Plus | LW5 | Non-Postal | Standard Self & Family | Monthly | 424.77 |
| Physicians Plus | LW6 | Non-Postal | Standard Self Plus One | Monthly | 393.16 |