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    Healthcare Plan Information

    2017 Plan Information for Illinois

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    State Specific Rates
    Contract Enrollment Code Employee Type Option/Enrollment Type Payment Period Employee Payment
    Aetna Direct N61 Non-Postal CDHP Self Monthly $120.05
    Aetna Direct N62 Non-Postal CDHP Self & Family Monthly $302.77
    Aetna Direct N63 Non-Postal CDHP Self Plus One Monthly $263.29
    Aetna HealthFund CDHP and Value Plan H41 Non-Postal CDHP Self Monthly $271.91
    Aetna HealthFund CDHP and Value Plan H42 Non-Postal CDHP Self & Family Monthly $620.04
    Aetna HealthFund CDHP and Value Plan H43 Non-Postal CDHP Self Plus One Monthly $666.83
    Aetna HealthFund CDHP and Value Plan H44 Non-Postal Value Self Monthly $139.55
    Aetna HealthFund CDHP and Value Plan H45 Non-Postal Value Self & Family Monthly $320.28
    Aetna HealthFund CDHP and Value Plan H46 Non-Postal Value Self Plus One Monthly $314.00
    Aetna HealthFund HDHP 224 Non-Postal HDHP Self Monthly $138.70
    Aetna HealthFund HDHP 225 Non-Postal HDHP Self & Family Monthly $305.95
    Aetna HealthFund HDHP 226 Non-Postal HDHP Self Plus One Monthly $299.95
    Blue Cross and Blue Shield of Illinois A21 Non-Postal High Self Monthly $276.96
    Blue Cross and Blue Shield of Illinois A22 Non-Postal High Self & Family Monthly $772.75
    Blue Cross and Blue Shield of Illinois A23 Non-Postal High Self Plus One Monthly $597.20
    Blue Preferred Plus POS 9G1 Non-Postal High Self Monthly $218.20
    Blue Preferred Plus POS 9G2 Non-Postal High Self & Family Monthly $417.61
    Blue Preferred Plus POS 9G3 Non-Postal High Self Plus One Monthly $380.10
    Blue Preferred Plus POS 9G4 Non-Postal Standard Self Monthly $129.78
    Blue Preferred Plus POS 9G5 Non-Postal Standard Self & Family Monthly $374.51
    Blue Preferred Plus POS 9G6 Non-Postal Standard Self Plus One Monthly $337.44
    Dean Health Plan WD1 Non-Postal High Self Monthly $426.98
    Dean Health Plan WD2 Non-Postal High Self & Family Monthly $992.06
    Dean Health Plan WD3 Non-Postal High Self Plus One Monthly $874.36
    Dean Health Plan WD4 Non-Postal Standard Self Monthly $150.07
    Dean Health Plan WD5 Non-Postal Standard Self & Family Monthly $360.16
    Dean Health Plan WD6 Non-Postal Standard Self Plus One Monthly $330.15
    Health Alliance HMO K84 Non-Postal Standard Self Monthly $151.54
    Health Alliance HMO K85 Non-Postal Standard Self & Family Monthly $587.45
    Health Alliance HMO K86 Non-Postal Standard Self Plus One Monthly $318.24
    Humana CoverageFirst and Value Plan GB1 Non-Postal CDHP Self Monthly $239.13
    Humana CoverageFirst and Value Plan GB2 Non-Postal CDHP Self & Family Monthly $524.06
    Humana CoverageFirst and Value Plan GB3 Non-Postal CDHP Self Plus One Monthly $515.88
    Humana CoverageFirst and Value Plan GB4 Non-Postal Value Self Monthly $116.33
    Humana CoverageFirst and Value Plan GB5 Non-Postal Value Self & Family Monthly $261.73
    Humana CoverageFirst and Value Plan GB6 Non-Postal Value Self Plus One Monthly $250.10
    Humana CoverageFirst and Value Plan MW1 Non-Postal CDHP Self Monthly $217.94
    Humana CoverageFirst and Value Plan MW2 Non-Postal CDHP Self & Family Monthly $476.39
    Humana CoverageFirst and Value Plan MW3 Non-Postal CDHP Self Plus One Monthly $470.32
    Humana CoverageFirst and Value Plan MW4 Non-Postal Value Self Monthly $122.14
    Humana CoverageFirst and Value Plan MW5 Non-Postal Value Self & Family Monthly $274.82
    Humana CoverageFirst and Value Plan MW6 Non-Postal Value Self Plus One Monthly $262.61
    Humana Health Plan, Inc. 751 Non-Postal High Self Monthly $777.53
    Humana Health Plan, Inc. 752 Non-Postal High Self & Family Monthly $1735.42
    Humana Health Plan, Inc. 753 Non-Postal High Self Plus One Monthly $1673.38
    Humana Health Plan, Inc. 754 Non-Postal Standard Self Monthly $399.40
    Humana Health Plan, Inc. 755 Non-Postal Standard Self & Family Monthly $884.65
    Humana Health Plan, Inc. 756 Non-Postal Standard Self Plus One Monthly $860.43
    Humana Health Plan, Inc. 9F1 Non-Postal High Self Monthly $1059.30
    Humana Health Plan, Inc. 9F2 Non-Postal High Self & Family Monthly $2369.45
    Humana Health Plan, Inc. 9F3 Non-Postal High Self Plus One Monthly $2279.25
    Humana Health Plan, Inc. AB4 Non-Postal Standard Self Monthly $464.79
    Humana Health Plan, Inc. AB5 Non-Postal Standard Self & Family Monthly $1031.73
    Humana Health Plan, Inc. AB6 Non-Postal Standard Self Plus One Monthly $1001.00
    MercyCare HMO EY1 Non-Postal High Self Monthly $247.39
    MercyCare HMO EY2 Non-Postal High Self & Family Monthly $797.36
    MercyCare HMO EY3 Non-Postal High Self Plus One Monthly $533.63
    Union Health Service 761 Non-Postal High Self Monthly $156.46
    Union Health Service 762 Non-Postal High Self & Family Monthly $460.68
    Union Health Service 763 Non-Postal High Self Plus One Monthly $342.17
    UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced L91 Non-Postal Value Self Monthly $108.27
    UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced L92 Non-Postal Value Self & Family Monthly $303.59
    UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced L93 Non-Postal Value Self Plus One Monthly $211.44
    UnitedHealthcare Plan of the River Valley Inc. YH1 Non-Postal High Self Monthly $162.30
    UnitedHealthcare Plan of the River Valley Inc. YH2 Non-Postal High Self & Family Monthly $707.14
    UnitedHealthcare Plan of the River Valley Inc. YH3 Non-Postal High Self Plus One Monthly $313.74
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