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Healthcare Plan Information

2021 Plan Information for Pennsylvania

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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 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
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