2017 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 | 138.7 |
| Aetna Direct | 225 | Non-Postal | HDHP Self & Family | Monthly | 305.95 |
| Aetna Direct | 226 | Non-Postal | HDHP Self Plus One | Monthly | 299.95 |
| 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 Aetna Value Plan | JS1 | Non-Postal | CDHP Self | Monthly | 485.2 |
| Aetna HealthFund CDHP and Aetna Value Plan | JS2 | Non-Postal | CDHP Self & Family | Monthly | 1106.22 |
| Aetna HealthFund CDHP and Aetna Value Plan | JS3 | Non-Postal | CDHP Self Plus One | Monthly | 1148.2 |
| Aetna HealthFund CDHP and Aetna Value Plan | JS4 | Non-Postal | Value Self | Monthly | 218.24 |
| Aetna HealthFund CDHP and Aetna Value Plan | JS5 | Non-Postal | Value Self & Family | Monthly | 500.05 |
| Aetna HealthFund CDHP and Aetna Value Plan | JS6 | Non-Postal | Value Self Plus One | Monthly | 548.01 |
| Aetna Whole Health | F71 | Non-Postal | Basic Self | Monthly | 130.44 |
| Aetna Whole Health | F72 | Non-Postal | Basic Self & Family | Monthly | 360.92 |
| Aetna Whole Health | F73 | Non-Postal | Basic Self Plus One | Monthly | 398.51 |
| 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 |
| Group Health Cooperative | WJ1 | Non-Postal | High Self | Monthly | 193.33 |
| Group Health Cooperative | WJ2 | Non-Postal | High Self & Family | Monthly | 912.76 |
| Group Health Cooperative | WJ3 | Non-Postal | High Self Plus One | Monthly | 333.45 |
| HealthPartners | V31 | Non-Postal | High Self | Monthly | 233.43 |
| HealthPartners | V32 | Non-Postal | High Self & Family | Monthly | 643.98 |
| HealthPartners | V33 | Non-Postal | High Self Plus One | Monthly | 546.43 |
| HealthPartners | V34 | Non-Postal | Standard Self | Monthly | 106.52 |
| HealthPartners | V35 | Non-Postal | Standard Self & Family | Monthly | 259.5 |
| HealthPartners | V36 | Non-Postal | Standard Self Plus One | Monthly | 235.43 |
| MercyCare Health Plans | EY1 | Non-Postal | High Self | Monthly | 247.39 |
| MercyCare Health Plans | EY2 | Non-Postal | High Self & Family | Monthly | 797.36 |
| MercyCare Health Plans | EY3 | Non-Postal | High Self Plus One | Monthly | 533.63 |
| Physicians Plus | LW1 | Non-Postal | High Self | Monthly | 172.46 |
| Physicians Plus | LW2 | Non-Postal | High Self & Family | Monthly | 641.64 |
| Physicians Plus | LW3 | Non-Postal | High Self Plus One | Monthly | 600.97 |
| Physicians Plus | LW4 | Non-Postal | Standard Self | Monthly | 146.58 |
| Physicians Plus | LW5 | Non-Postal | Standard Self & Family | Monthly | 465.04 |
| Physicians Plus | LW6 | Non-Postal | Standard Self Plus One | Monthly | 434.98 |