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Wisconsin Department of Employee Trust Funds header image It's Your Choice 2017 Local High Deductible Health Plan Insurance Program
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2017 It's Your Choice - Local High Deductible Health Plan Insurance for Employees and Retirees
Wisconsin Department Of Employee Trust Funds It's Your Choice 2017


Local High Deductible Health Plan
Insurance for Employees
and Retirees
(PO7, PO17)


Health Plan 2017 Premium Rates

Form Number: et-2169pr

Employee and Non-Medicare Retiree Rates

The employee and non-Medicare Retiree1 health plan rates reflect total monthly premium rates for each health plan.

  Medical with Dental Medical without Dental
Health Plan Name Individual Family Individual Family
Anthem Blue Preferred Northeast          625.96      1,540.72          598.12      1,471.10
Arise Health Plan          921.86      2,280.42          894.02      2,210.80
Dean Health Insurance          654.06      1,610.92          626.22      1,541.30
Dean Health Insurance-Prevea360          633.66      1,559.92          605.82      1,490.30
GHC of Eau Claire          792.16      1,956.22          764.32      1,886.60
GHC of South Central Wisconsin          579.06      1,423.42          551.22      1,353.80
Gundersen Health Plan          578.96      1,423.22          551.12      1,353.60
Health Tradition Health Plan          587.96      1,445.72          560.12      1,376.10
HealthPartners Health Plan          739.96      1,825.72          712.12      1,756.10
Humana-Eastern          937.76      2,320.22          909.92      2,250.60
Humana-Western      1,077.16      2,668.72      1,049.32      2,599.10
IYC Access Health Plan - Balance of State5 and IYC Medicare Plus4      1,073.42      2,677.54      1,045.58      2,607.92
IYC Access Health Plan- Dane6 and IYC Medicare Plus4          994.78      2,480.96          966.94      2,411.34
IYC Access Health Plan- Milwaukee7 and IYC Medicare Plus4      1,161.72      2,898.24      1,133.88      2,828.62
IYC Access Health Plan- Waukesha8 and IYC Medicare Plus4      1,073.42      2,677.54      1,045.58      2,607.92
Medical Associates Health Plans          540.56      1,327.22          512.72      1,257.60
MercyCare Health Plans          610.26      1,501.42          582.42      1,431.80
Network Health - Northeast          652.26      1,606.42          624.42      1,536.80
Network Health - Southeast          661.86      1,630.42          634.02      1,560.80
Physicians Plus          631.16      1,553.72          603.32      1,484.10
Security Health Plan - Central          923.26      2,283.92          895.42      2,214.30
Security Health Plan - Valley          923.26      2,283.92          895.42      2,214.30
State Maintenance Plan (SMP)          735.50      1,830.56          707.66      1,760.94
UnitedHealthcare of Wisconsin          790.76      1,952.72          762.92      1,883.10
Unity Health Insurance-Community          581.26      1,428.92          553.42      1,359.30
Unity Health Insurance-UW Health          523.36      1,284.22          495.52      1,214.60
WEA Trust-East          727.96      1,795.72          700.12      1,726.10
WEA Trust-Northwest Chippewa Valley          919.26      2,273.92          891.42      2,204.30
WEA Trust-Northwest Mayo Clinic Hlth. Sys.          919.26      2,273.92          891.42      2,204.30

NA = not applicable
1 Members of new participating employers may have a surcharge added to their rates. Your employer will inform you. Contact your payroll office with questions.
2 Medicare 1 = Family coverage with at least one insured family member enrolled in Medicare Parts A, B and D.
3 Medicare 2 = Family coverage with all insured family members enrolled in Medicare Parts A, B and D.
4 Members with IYC Access Health Plan or SMP coverage who become enrolled in Medicare Parts A and B will automatically be moved to the IYC Medicare Plus plan. All other non-Medicare family members remain covered under the IYC Access Health Plan or SMP. IYC Access Health Plan rates are determined by the employer county or the retiree county of residence. Counties are divided into the following rate categories:
5 Balance of State: All other Wisconsin counties not listed below. (Code A4)
6 Dane: Dane, Grant, Jefferson, La Crosse, Polk and St. Croix. (A1)
7 Milwaukee: Milwaukee County. Also applies to retirees and continuants living out of state. (A2)
8 Waukesha: Kenosha, Ozaukee, Racine, Washington and Waukesha. (A3)

Disclaimer:
Every effort has been made to ensure that this information is accurate, but may be subject to change. Please note revision dates located at the bottom of each page. In the event of conflicting information, federal law, state statute, state health contracts and/or policies and provisions established by the State of Wisconsin Group Insurance Board shall be followed.

This page was last modified on: 11/1/2016 1:08:13 PM