Form Number: et-2107prtg
| Health Plan | Individual with / without dental |
Family with / without dental |
|---|---|---|
| Access Plan by Dean | $1,147.88 / $1,115.80 | $2,832.44 / $2,752.24 |
| Aspirus Health Plan | $748.88 / $716.80 | $1,834.92 / $1,754.72 |
| Common Ground Healthcare Cooperative | $751.40 / $719.32 | $1,841.22 / $1,761.02 |
| Dean Health Plan | $633.40 / $601.32 | $1,546.22 / $1,466.02 |
| Dean Health Plan - Prevea360 East | $730.56 / $698.48 | $1,789.12 / $1,708.92 |
| Dean Health Plan - Prevea360 West and Mayo Clinic Health System | $808.84 / $776.76 | $1,984.82 / $1,904.62 |
| GHC of Eau Claire Greater WI | $744.22 / $712.14 | $1,823.26 / $1,743.06 |
| GHC of Eau Claire River Region | $828.00 / $795.92 | $2,032.72 / $1,952.52 |
| GHC-SCW Dane Choice | $634.52 / $602.44 | $1,549.02 / $1,468.82 |
| GHC-SCW Neighbors | $628.32 / $596.24 | $1,533.52 / $1,453.32 |
| HealthPartners Health Plan Southeast | $745.80 / $713.72 | $1,827.22 / $1,747.02 |
| HealthPartners Health Plan West | $743.58 / $711.50 | $1,821.66 / $1,741.46 |
| Medical Associates Health Plan | $645.48 / $613.40 | $1,576.42 / $1,496.22 |
| MercyCare Health Plan | $537.96 / $505.88 | $1,307.62 / $1,227.42 |
| Network Health | $763.98 / $731.90 | $1,872.66 / $1,792.46 |
| Quartz Central | $746.82 / $714.74 | $1,829.76 / $1,749.56 |
| Quartz - UW Health | $649.22 / $617.14 | $1,585.76 / $1,505.56 |
| Quartz West | $726.66 / $694.58 | $1,779.36 / $1,699.16 |
| Robin with HealthPartners Health Plan | $794.92 / $762.84 | $1,950.02 / $1,869.82 |
| Security Health Plan | $788.76 / $756.68 | $1,934.62 / $1,854.42 |
| State Maintenance Plan (SMP) by Dean Health Plan | $891.96 / $859.88 | $2,192.64 / $2,112.44 |