Form Number: et-2156pr
The non-Medicare retiree health plan rates reflect the total monthly premium rates for each health plan.
Uniform Dental premiums are added to your medical premiums if you choose coverage. Prices are shown with and without Uniform Dental.
| Health Plan | Individual with / without dental |
Family with / without dental |
|---|---|---|
| Access Plan1 by Dean Health Plan | $2,027.94 / $1,995.86 | $5,032.58 / $4,952.38 |
| Aspirus Health Plan | $2,011.96 / $1,979.88 | $4,992.62 / $4,912.42 |
| Common Ground Healthcare Cooperative | $1,895.58 / $1,863.50 | $4,701.66 / $4,621.46 |
| Dean Health Plan | $1,638.10 / $1,606.02 | $4,057.96 / $3,977.76 |
| Dean Health Plan - Prevea360 East | $1,576.30 / $1,544.22 | $3,903.46 / $3,823.26 |
| Dean Health Plan - Prevea360 West and Mayo Clinic Health System | $1,800.06 / $1,767.98 | $4,462.86 / $4,382.66 |
| GHC of Eau Claire Greater WI | $1,804.66 / $1,772.58 | $4,474.36 / $4,394.16 |
| GHC of Eau Claire River Region | $1,927.38 / $1,895.30 | $4,781.16 / $4,700.96 |
| GHC-SCW Dane Choice | $1,349.92 / $1,317.84 | $3,337.52 / $3,257.32 |
| GHC-SCW Neighbors | $1,486.12 / $1,454.04 | $3,678.02 / $3,597.82 |
| HealthPartners Southeast | $2,127.76 / $2,095.68 | $5,282.12 / $5,201.92 |
| HealthPartners West | $2,145.36 / $2,113.28 | $5,326.12 / $5,245.92 |
| Medical Associates Health Plan | $1,319.46 / $1,287.38 | $3,261.36 / $3,181.16 |
| MercyCare Health Plan | $1,405.62 / $1,373.54 | $3,476.76 / $3,396.56 |
| Network Health | $1,658.16 / $1,626.08 | $4,108.12 / $4,027.92 |
| Quartz Central | $2,132.96 / $2,100.88 | $5,295.12 / $5,214.92 |
| Quartz UW Health | $1,464.60 / $1,432.52 | $3,624.22 / $3,544.02 |
| Quartz West | $1,427.38 / $1,395.30 | $3,531.16 / $3,450.96 |
| Robin with HealthPartners | $2,225.02 / $2,192.94 | $5,525.26 / $5,445.06 |
| Security Health Plan | $2,113.62 / $2,081.54 | $5,246.76 / $5,166.56 |
| State Maintenance Plan (SMP)1 - Dean Health Plan | $1,592.84 / $1,560.76 | $3,944.82 / $3,864.62 |
1Members with 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 Access Plan or SMP.