Form Number: et-2168pr
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 | $1,191.14 | $2,940.58 |
| Aspirus Health Plan | $1,181.68 | $2,916.92 |
| Common Ground Healthcare Cooperative | $1,112.82 | $2,744.76 |
| Dean Health Plan | $960.46 | $2,363.86 |
| Dean Health Plan - Prevea360 East | $923.90 | $2,272.46 |
| Dean Health Plan - Prevea360 West and Mayo Clinic Health System | $1,056.30 | $2,603.46 |
| GHC of Eau Claire Greater WI | $1,059.02 | $2,610.26 |
| GHC of Eau Claire River Region | $1,131.64 | $2,791.82 |
| GHC-SCW Dane Choice | $789.94 | $1,937.56 |
| GHC-SCW Neighbors | $870.54 | $2,139.06 |
| HealthPartners Health Plan Southeast | $1,250.20 | $3,088.22 |
| HealthPartners Health Plan West | $1,260.62 | $3,114.26 |
| Medical Associates Health Plan | $771.92 | $1,892.52 |
| MercyCare Health Plan | $822.90 | $2,019.96 |
| Network Health | $972.34 | $2,393.56 |
| Quartz Central | $1,253.28 | $3,095.92 |
| Quartz - UW Health | $857.80 | $2,107.22 |
| Quartz West | $835.78 | $2,052.16 |
| Robin with HealthPartners Health Plan | $1,307.76 | $3,232.12 |
| Security Health Plan | $1,241.84 | $3,067.32 |
| State Maintenance Plan (SMP)1 by Dean Health Plan | $933.68 | $2,296.92 |
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.