Form Number: et-2158pr
The employee and non-Medicare Retiree health plan rates reflect the 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 Health Plan | $1,169.18 | $2,885.68 |
| Aspirus Health Plan | $1,159.92 | $2,862.52 |
| Common Ground Healthcare Cooperative | $1,092.52 | $2,694.02 |
| Dean Health Plan | $943.40 | $2,321.22 |
| Dean Health Plan - Prevea360 East | $907.64 | $2,231.82 |
| Dean Health Plan - Prevea360 West and Mayo Clinic Health System | $1,037.20 | $2,555.72 |
| GHC of Eau Claire Greater WI | $1,039.88 | $2,562.42 |
| GHC of Eau Claire River Region | $1,110.96 | $2,740.12 |
| GHC-SCW Dane Choice | $776.52 | $1,904.02 |
| GHC-SCW Neighbors | $855.40 | $2,101.22 |
| HealthPartners Health Plan Southeast | $1,226.98 | $3,030.16 |
| HealthPartners Health Plan West | $1,237.18 | $3,055.66 |
| Medical Associates Health Plan | $758.86 | $1,859.86 |
| MercyCare Health Plan | $808.76 | $1,984.62 |
| Network Health | $955.04 | $2,350.32 |
| Quartz Central | $1,230.00 | $3,037.72 |
| Quartz - UW Health | $842.94 | $2,070.06 |
| Quartz West | $821.38 | $2,016.16 |
| Robin with HealthPartners Health Plan | $1,283.32 | $3,171.02 |
| Security Health Plan | $1,218.80 | $3,009.72 |
| State Maintenance Plan (SMP)1 by Dean Health Plan | $950.52 | $2,339.04 |
1Members with Local 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 remain covered under the Local Access Plan or SMP.