Form Number: et-2169pr
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.
|Access Plan by Dean Health Plan1||$941.18||$2,320.04|
|Aspirus Health Plan||$952.32||$2,347.86|
|Common Ground Healthcare Cooperative||$889.16||$2,189.96|
|Dean Health Plan||
|Dean Health Plan - Prevea360 East||$709.34||$1,740.42|
|Dean Health Plan - Prevea360 West and Mayo Clinic Health System||$811.20||$1,995.06|
|GHC of Eau Claire Greater Wisconsin||$706.78||$1,734.02|
|GHC of Eau Claire River Region||$917.52||$2,260.86|
|GHC of South Central Wisconsin||$603.56||$1,475.96|
|HealthPartners Health Plan Southeast||$966.24||$2,382.66|
|HealthPartners Health Plan West||$938.48||$2,313.26|
|Medical Associates Health Plan||$641.20||$1,570.06|
|MercyCare Health Plan||$636.94||$1,559.42|
|Quartz - UW Health||$671.12||$1,644.86|
|Robin with HealthPartners Health Plan||$1,084.10||$2,677.32|
|Security Health Plan||$996.72||$2,458.86|
|State Maintenance Plan (SMP)1 - Dean Health Plan||$748.10||$1,837.34|
1 Members with the Access Plan or SMP coverage who enroll in Medicare Parts A and B will automatically be moved to the Medicare Plus plan. All other non-Medicare family members will remain covered under the Access Plan or SMP.