Form Number: et-2168pr
The employee and non-Medicare retiree health plan rates reflect total monthly premium rates for each health plan.
Members of new participating employers may have a surcharge added to their rates. Your employer will inform you. Contact your payroll office with questions.
| Health Plan | Individual | Family |
|---|---|---|
| Access Plan1 by Dean | $1,095.42 | $2,705.62 |
| Aspirus Health Plan | $1,108.36 | $2,737.96 |
| Common Ground Healthcare Cooperative | $1,035.06 | $2,554.70 |
| Dean Health Plan | $814.76 | $2,003.96 |
| Dean Health Plan - Prevea360 East | $826.38 | $2,033.00 |
| Dean Health Plan - Prevea360 West and Mayo Clinic Health System | $944.60 | $2,328.56 |
| GHC of Eau Claire Greater Wisconsin | $823.42 | $2,025.60 |
| GHC of Eau Claire River Region | $1,067.98 | $2,637.00 |
| GHC of South Central Wisconsin | $703.62 | $1,726.10 |
| HealthPartners Health Plan Southeast | $1,124.52 | $2,778.36 |
| HealthPartners Health Plan West | $1,092.30 | $2,697.80 |
| Medical Associates Health Plan | $747.32 | $1,835.36 |
| MercyCare Health Plan | $742.36 | $1,822.96 |
| Network Health | $876.94 | $2,159.40 |
| Quartz Central | $1,170.64 | $2,893.66 |
| Quartz - UW Health | $782.04 | $1,922.16 |
| Quartz West | $930.62 | $2,293.60 |
| Robin with HealthPartners Health Plan | $1,261.28 | $3,120.26 |
| Security Health Plan | $1,159.90 | $2,866.80 |
| State Maintenance Plan (SMP)1 by Dean Health Plan | $855.68 | $2,106.26 |
1Members with Local Access Plan or SMP coverage who enroll 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 Local Access Plan or SMP.