Healthcare
2021 Plan Information for Pennsylvania
Choose a Location, Employee Type, & Payment Period
Click to view Plan Information for this state
Location Specific Rates
| Contract | Enrollment Code | Enrollment Type | Option/Enrollment Type | Payment Period | Employee Payment |
|---|---|---|---|---|---|
| Aetna Direct | 224 | Non-Postal | HDHP Self | Monthly | 262.6 |
| Aetna Direct | 225 | Non-Postal | HDHP Self & Family | Monthly | 515.62 |
| Aetna Direct | 226 | Non-Postal | HDHP Self Plus One | Monthly | 578.72 |
| Aetna Direct | N61 | Non-Postal | CDHP Self | Monthly | 153.96 |
| Aetna Direct | N62 | Non-Postal | CDHP Self & Family | Monthly | 388.27 |
| Aetna Direct | N63 | Non-Postal | CDHP Self Plus One | Monthly | 337.64 |
| 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 | H41 | Non-Postal | CDHP Self | Monthly | 303.42 |
| Aetna HealthFund CDHP and Aetna Value Plan | H42 | Non-Postal | CDHP Self & Family | Monthly | 666.53 |
| Aetna HealthFund CDHP and Aetna Value Plan | H43 | Non-Postal | CDHP Self Plus One | Monthly | 745.27 |
| Aetna HealthFund CDHP and Aetna Value Plan | H44 | Non-Postal | Value Self | Monthly | 294.06 |
| Aetna HealthFund CDHP and Aetna Value Plan | H45 | Non-Postal | Value Self & Family | Monthly | 657.95 |
| Aetna HealthFund CDHP and Aetna Value Plan | H46 | Non-Postal | Value Self Plus One | Monthly | 718.23 |
| Aetna Open Access | P31 | Non-Postal | High Self | Monthly | 1064.81 |
| Aetna Open Access | P32 | Non-Postal | High Self & Family | Monthly | 2632.5 |
| Aetna Open Access | P33 | Non-Postal | High Self Plus One | Monthly | 2691.42 |
| Aetna Open Access | P34 | Non-Postal | Basic Self | Monthly | 982.11 |
| Aetna Open Access | P35 | Non-Postal | Basic Self & Family | Monthly | 2276.13 |
| Aetna Open Access | P36 | Non-Postal | Basic Self Plus One | Monthly | 2338.57 |
| Aetna Open Access | YE1 | Non-Postal | High Self | Monthly | 683.13 |
| Aetna Open Access | YE2 | Non-Postal | High Self & Family | Monthly | 1811.42 |
| Aetna Open Access | YE3 | Non-Postal | High Self Plus One | Monthly | 1878.48 |
| Geisinger Health Plan | AJ1 | Non-Postal | Basic Self | Monthly | 278.64 |
| Geisinger Health Plan | AJ2 | Non-Postal | Basic Self & Family | Monthly | 618.11 |
| Geisinger Health Plan | AJ3 | Non-Postal | Basic Self Plus One | Monthly | 611.83 |
| Geisinger Health Plan | GG4 | Non-Postal | Standard Self | Monthly | 389.27 |
| Geisinger Health Plan | GG5 | Non-Postal | Standard Self & Family | Monthly | 871.41 |
| Geisinger Health Plan | GG6 | Non-Postal | Standard Self Plus One | Monthly | 850.92 |
| UnitedHealthcare Advantage Plan | Y51 | Non-Postal | High Self | Monthly | 102.93 |
| UnitedHealthcare Advantage Plan | Y52 | Non-Postal | High Self & Family | Monthly | 272.77 |
| UnitedHealthcare Advantage Plan | Y53 | Non-Postal | High Self Plus One | Monthly | 226.45 |
| UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA)) | V41 | Non-Postal | HDHP Self | Monthly | 129.98 |
| UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA)) | V42 | Non-Postal | HDHP Self & Family | Monthly | 298.95 |
| UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA)) | V43 | Non-Postal | HDHP Self Plus One | Monthly | 279.45 |
| UnitedHealthcare Insurance Company, Inc. (Choice Open Access) | LR1 | Non-Postal | High Self | Monthly | 246.98 |
| UnitedHealthcare Insurance Company, Inc. (Choice Open Access) | LR2 | Non-Postal | High Self & Family | Monthly | 607.62 |
| UnitedHealthcare Insurance Company, Inc. (Choice Open Access) | LR3 | Non-Postal | High Self Plus One | Monthly | 535.17 |
| UnitedHealthcare Insurance Company, Inc. Choice Plus Primary | AS1 | Non-Postal | High Self | Monthly | 149.87 |
| UnitedHealthcare Insurance Company, Inc. Choice Plus Primary | AS2 | Non-Postal | High Self & Family | Monthly | 354.44 |
| UnitedHealthcare Insurance Company, Inc. Choice Plus Primary | AS3 | Non-Postal | High Self Plus One | Monthly | 322.22 |
| UnitedHealthcare Insurance Company, Inc. Choice Primary | Y81 | Non-Postal | High Self | Monthly | 144.18 |
| UnitedHealthcare Insurance Company, Inc. Choice Primary | Y82 | Non-Postal | High Self & Family | Monthly | 340.98 |
| UnitedHealthcare Insurance Company, Inc. Choice Primary | Y83 | Non-Postal | High Self Plus One | Monthly | 309.98 |
| UPMC Health Plan | 8W4 | Non-Postal | HDHP Self | Monthly | 160.41 |
| UPMC Health Plan | 8W5 | Non-Postal | HDHP Self & Family | Monthly | 369.22 |
| UPMC Health Plan | 8W6 | Non-Postal | HDHP Self Plus One | Monthly | 355.18 |
| UPMC Health Plan | UW4 | Non-Postal | Standard Self | Monthly | 170.55 |
| UPMC Health Plan | UW5 | Non-Postal | Standard Self & Family | Monthly | 400.31 |
| UPMC Health Plan | UW6 | Non-Postal | Standard Self Plus One | Monthly | 412.58 |
| UPMC Health Plan | YS4 | Non-Postal | HDHP Self | Monthly | 285.03 |
| UPMC Health Plan | YS5 | Non-Postal | HDHP Self & Family | Monthly | 649.7 |
| UPMC Health Plan | YS6 | Non-Postal | HDHP Self Plus One | Monthly | 674.14 |
| UPMC Health Plan | YT4 | Non-Postal | Standard Self | Monthly | 442.89 |
| UPMC Health Plan | YT5 | Non-Postal | Standard Self & Family | Monthly | 1050.42 |
| UPMC Health Plan | YT6 | Non-Postal | Standard Self Plus One | Monthly | 1051.62 |