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    Healthcare Plan Information

    2016 Plan Information for Pennsylvania

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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 $118.33
    Aetna Direct N62 Non-Postal CDHP Self & Family Monthly $298.42
    Aetna Direct N63 Non-Postal CDHP Self Plus One Monthly $259.50
    Aetna HealthFund CDHP and Value Plan H41 Non-Postal CDHP Self Monthly $215.17
    Aetna HealthFund CDHP and Value Plan H42 Non-Postal CDHP Self & Family Monthly $485.89
    Aetna HealthFund CDHP and Value Plan H43 Non-Postal CDHP Self Plus One Monthly $530.14
    Aetna HealthFund CDHP and Value Plan H44 Non-Postal Basic Self Monthly $134.18
    Aetna HealthFund CDHP and Value Plan H45 Non-Postal Basic Self & Family Monthly $307.96
    Aetna HealthFund CDHP and Value Plan H46 Non-Postal Basic Self Plus One Monthly $301.92
    Aetna HealthFund HDHP 224 Non-Postal HDHP Self Monthly $130.08
    Aetna HealthFund HDHP 225 Non-Postal HDHP Self & Family Monthly $286.94
    Aetna HealthFund HDHP 226 Non-Postal HDHP Self Plus One Monthly $281.31
    Aetna Open Access P31 Non-Postal High Self Monthly $905.41
    Aetna Open Access P32 Non-Postal High Self & Family Monthly $2257.60
    Aetna Open Access P33 Non-Postal High Self Plus One Monthly $2284.31
    Aetna Open Access P34 Non-Postal Basic Self Monthly $639.28
    Aetna Open Access P35 Non-Postal Basic Self & Family Monthly $1498.40
    Aetna Open Access P36 Non-Postal Basic Self Plus One Monthly $1532.63
    Aetna Open Access YE1 Non-Postal High Self Monthly $247.54
    Aetna Open Access YE2 Non-Postal High Self & Family Monthly $723.99
    Aetna Open Access YE3 Non-Postal High Self Plus One Monthly $765.91
    Geisinger Health Plan GG4 Non-Postal Standard Self Monthly $186.08
    Geisinger Health Plan GG5 Non-Postal Standard Self & Family Monthly $432.88
    Geisinger Health Plan GG6 Non-Postal Standard Self Plus One Monthly $492.42
    Keystone Health Plan West NP1 Non-Postal High Self Monthly $136.62
    Keystone Health Plan West NP2 Non-Postal High Self & Family Monthly $309.92
    Keystone Health Plan West NP3 Non-Postal High Self Plus One Monthly $257.12
    UPMC Health Plan 8W1 Non-Postal High Self Monthly $309.79
    UPMC Health Plan 8W2 Non-Postal High Self & Family Monthly $755.93
    UPMC Health Plan 8W3 Non-Postal High Self Plus One Monthly $738.31
    UPMC Health Plan 8W4 Non-Postal HDHP Self Monthly $128.25
    UPMC Health Plan 8W5 Non-Postal HDHP Self & Family Monthly $295.65
    UPMC Health Plan 8W6 Non-Postal HDHP Self Plus One Monthly $284.30
    UPMC Health Plan UW4 Non-Postal Standard Self Monthly $144.89
    UPMC Health Plan UW5 Non-Postal Standard Self & Family Monthly $340.48
    UPMC Health Plan UW6 Non-Postal Standard Self Plus One Monthly $326.00
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