Healthcare
2022 Plan Information for Pennsylvania
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 | 293.78 |
| Aetna Direct | 225 | Non-Postal | HDHP Self & Family | Monthly | 574.3 |
| Aetna Direct | 226 | Non-Postal | HDHP Self Plus One | Monthly | 645.93 |
| Aetna Direct | N61 | Non-Postal | CDHP Self | Monthly | 157.07 |
| Aetna Direct | N62 | Non-Postal | CDHP Self & Family | Monthly | 396.12 |
| Aetna Direct | N63 | Non-Postal | CDHP Self Plus One | Monthly | 344.47 |
| 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 | 295.66 |
| Aetna HealthFund CDHP and Aetna Value Plan | H42 | Non-Postal | CDHP Self & Family | Monthly | 639.27 |
| Aetna HealthFund CDHP and Aetna Value Plan | H43 | Non-Postal | CDHP Self Plus One | Monthly | 728.26 |
| Aetna HealthFund CDHP and Aetna Value Plan | H44 | Non-Postal | Value Self | Monthly | 303.2 |
| Aetna HealthFund CDHP and Aetna Value Plan | H45 | Non-Postal | Value Self & Family | Monthly | 669.5 |
| Aetna HealthFund CDHP and Aetna Value Plan | H46 | Non-Postal | Value Self Plus One | Monthly | 739.24 |
| Aetna Open Access | P31 | Non-Postal | High Self | Monthly | 1232.01 |
| Aetna Open Access | P32 | Non-Postal | High Self & Family | Monthly | 3029.32 |
| Aetna Open Access | P33 | Non-Postal | High Self Plus One | Monthly | 3094.28 |
| Aetna Open Access | P34 | Non-Postal | Basic Self | Monthly | 1191.23 |
| Aetna Open Access | P35 | Non-Postal | Basic Self & Family | Monthly | 2752.34 |
| Aetna Open Access | P36 | Non-Postal | Basic Self Plus One | Monthly | 2820 |
| Aetna Open Access | YE1 | Non-Postal | High Self | Monthly | 651.15 |
| Aetna Open Access | YE2 | Non-Postal | High Self & Family | Monthly | 1723.24 |
| Aetna Open Access | YE3 | Non-Postal | High Self Plus One | Monthly | 1801.13 |
| Geisinger Health Plan | AJ1 | Non-Postal | Basic Self | Monthly | 360.47 |
| Geisinger Health Plan | AJ2 | Non-Postal | Basic Self & Family | Monthly | 796.01 |
| Geisinger Health Plan | AJ3 | Non-Postal | Basic Self Plus One | Monthly | 788.51 |
| Geisinger Health Plan | GG4 | Non-Postal | Standard Self | Monthly | 462 |
| Geisinger Health Plan | GG5 | Non-Postal | Standard Self & Family | Monthly | 1028.47 |
| Geisinger Health Plan | GG6 | Non-Postal | Standard Self Plus One | Monthly | 1007.87 |
| UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA)) | V41 | Non-Postal | HDHP Self | Monthly | 165.45 |
| UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA)) | V42 | Non-Postal | HDHP Self & Family | Monthly | 378.55 |
| UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA)) | V43 | Non-Postal | HDHP Self Plus One | Monthly | 355.73 |
| UnitedHealthcare Insurance Company, Inc. (Choice Open Access) | LR1 | Non-Postal | High Self | Monthly | 291.63 |
| UnitedHealthcare Insurance Company, Inc. (Choice Open Access) | LR2 | Non-Postal | High Self & Family | Monthly | 704.6 |
| UnitedHealthcare Insurance Company, Inc. (Choice Open Access) | LR3 | Non-Postal | High Self Plus One | Monthly | 630.98 |
| UnitedHealthcare Insurance Company, Inc. Choice Plus Primary | AS1 | Non-Postal | High Self | Monthly | 162.73 |
| UnitedHealthcare Insurance Company, Inc. Choice Plus Primary | AS2 | Non-Postal | High Self & Family | Monthly | 384.86 |
| UnitedHealthcare Insurance Company, Inc. Choice Plus Primary | AS3 | Non-Postal | High Self Plus One | Monthly | 349.87 |
| UnitedHealthcare Insurance Company, Inc. Choice Primary | Y81 | Non-Postal | High Self | Monthly | 145.31 |
| UnitedHealthcare Insurance Company, Inc. Choice Primary | Y82 | Non-Postal | High Self & Family | Monthly | 343.67 |
| UnitedHealthcare Insurance Company, Inc. Choice Primary | Y83 | Non-Postal | High Self Plus One | Monthly | 312.43 |
| UPMC Health Plan | 8W4 | Non-Postal | HDHP Self | Monthly | 166.99 |
| UPMC Health Plan | 8W5 | Non-Postal | HDHP Self & Family | Monthly | 384.8 |
| UPMC Health Plan | 8W6 | Non-Postal | HDHP Self Plus One | Monthly | 369.87 |
| UPMC Health Plan | UW4 | Non-Postal | Standard Self | Monthly | 192.68 |
| UPMC Health Plan | UW5 | Non-Postal | Standard Self & Family | Monthly | 454.96 |
| UPMC Health Plan | UW6 | Non-Postal | Standard Self Plus One | Monthly | 489.49 |