2019 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 | 164.93 |
| Aetna Direct | 225 | Non-Postal | HDHP Self & Family | Monthly | 363.8 |
| Aetna Direct | 226 | Non-Postal | HDHP Self Plus One | Monthly | 360.1 |
| Aetna Direct | N61 | Non-Postal | CDHP Self | Monthly | 139.33 |
| Aetna Direct | N62 | Non-Postal | CDHP Self & Family | Monthly | 351.38 |
| Aetna Direct | N63 | Non-Postal | CDHP Self Plus One | Monthly | 305.56 |
| Aetna HealthFund CDHP and Aetna Value Plan | H41 | Non-Postal | CDHP Self | Monthly | 330.14 |
| Aetna HealthFund CDHP and Aetna Value Plan | H42 | Non-Postal | CDHP Self & Family | Monthly | 751.19 |
| Aetna HealthFund CDHP and Aetna Value Plan | H43 | Non-Postal | CDHP Self Plus One | Monthly | 804.09 |
| Aetna HealthFund CDHP and Aetna Value Plan | H44 | Non-Postal | Value Self | Monthly | 154.13 |
| Aetna HealthFund CDHP and Aetna Value Plan | H45 | Non-Postal | Value Self & Family | Monthly | 353.75 |
| Aetna HealthFund CDHP and Aetna Value Plan | H46 | Non-Postal | Value Self Plus One | Monthly | 346.81 |
| Aetna Open Access | P31 | Non-Postal | High Self | Monthly | 986.49 |
| Aetna Open Access | P32 | Non-Postal | High Self & Family | Monthly | 2462.72 |
| Aetna Open Access | P33 | Non-Postal | High Self Plus One | Monthly | 2498.66 |
| Aetna Open Access | P34 | Non-Postal | Basic Self | Monthly | 799.74 |
| Aetna Open Access | P35 | Non-Postal | Basic Self & Family | Monthly | 1875.56 |
| Aetna Open Access | P36 | Non-Postal | Basic Self Plus One | Monthly | 1917.3 |
| Aetna Open Access | YE1 | Non-Postal | High Self | Monthly | 439.4 |
| Aetna Open Access | YE2 | Non-Postal | High Self & Family | Monthly | 1217.43 |
| Aetna Open Access | YE3 | Non-Postal | High Self Plus One | Monthly | 1265.7 |
| Geisinger Health Plan | GG4 | Non-Postal | Standard Self | Monthly | 230.45 |
| Geisinger Health Plan | GG5 | Non-Postal | Standard Self & Family | Monthly | 531.27 |
| Geisinger Health Plan | GG6 | Non-Postal | Standard Self Plus One | Monthly | 508.95 |
| Highmark Choice Company | NP1 | Non-Postal | High Self | Monthly | 279.01 |
| Highmark Choice Company | NP2 | Non-Postal | High Self & Family | Monthly | 629.59 |
| Highmark Choice Company | NP3 | Non-Postal | High Self Plus One | Monthly | 497.4 |
| UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA)) | V41 | Non-Postal | HDHP Self | Monthly | 123.92 |
| UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA)) | V42 | Non-Postal | HDHP Self & Family | Monthly | 285.01 |
| UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA)) | V43 | Non-Postal | HDHP Self Plus One | Monthly | 266.43 |
| UnitedHealthcare Insurance Company, Inc. (Choice Open Access) | LR1 | Non-Postal | High Self | Monthly | 169.22 |
| UnitedHealthcare Insurance Company, Inc. (Choice Open Access) | LR2 | Non-Postal | High Self & Family | Monthly | 444.8 |
| UnitedHealthcare Insurance Company, Inc. (Choice Open Access) | LR3 | Non-Postal | High Self Plus One | Monthly | 369.46 |
| UPMC Health Plan | 8W1 | Non-Postal | High Self | Monthly | 374.06 |
| UPMC Health Plan | 8W2 | Non-Postal | High Self & Family | Monthly | 913.12 |
| UPMC Health Plan | 8W3 | Non-Postal | High Self Plus One | Monthly | 897.54 |
| UPMC Health Plan | 8W4 | Non-Postal | HDHP Self | Monthly | 143.39 |
| UPMC Health Plan | 8W5 | Non-Postal | HDHP Self & Family | Monthly | 329.4 |
| UPMC Health Plan | 8W6 | Non-Postal | HDHP Self Plus One | Monthly | 317.01 |
| UPMC Health Plan | UW4 | Non-Postal | Standard Self | Monthly | 162.96 |
| UPMC Health Plan | UW5 | Non-Postal | Standard Self & Family | Monthly | 385.61 |
| UPMC Health Plan | UW6 | Non-Postal | Standard Self Plus One | Monthly | 392.68 |