At Least 50% Time or Greater The premiums in this chart apply to full-time employees in these appointment types: 1) Unclassified employees; 2) Classified employees represented by a Bargaining Unit with a settled contract—see chart below; 3) Non-represented Classified employees which include project employees, LTEs and Craftworker LTEs.
Bargaining Units With Settled Contracts
IMPORTANT: The 3-Tier model and actual contributions are subject to collective bargaining, non-represented pay plans and unclassified pay plans.
| HEALTH PLAN | TIER | SINGLE | FAMILY | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| STATE SHARE | REG CODE | EMPLOYEE SHARE | EC CODE | TOTAL PREMIUM | STATE SHARE |
REG CODE | EMPLOYEE SHARE | EC CODE | TOTAL PREMIUM | |||
| STANDARD PLAN | 3 | 708.50 | 4AO | 100.00 | 4AE | 808.50 | 1767.70 | 4AO | 250.00 | 4AE | 2017.70 | |
| STANDARD PLAN OUT-OF-STATE | 2 | 758.50 | 4AO | 50.00 | 4AE | 808.50 | 1892.70 | 4AO | 125.00 | 4AE | 2017.70 | |
| STATE MAINTENANCE PLAN* | 1 | 489.30 | 4AR | 22.00 | 4AA | 511.30 | 1220.00 | 4AR | 55.00 | 4AA | 1275.00 | |
| COMPCAREBLUE - AURORA/FAMILY | 1 | 473.60 | 4HK | 22.00 | 4HJ | 495.60 | 1180.60 | 4HK | 55.00 | 4HJ | 1235.60 | |
| COMPCAREBLUE NORTHWEST | 2 | 511.10 | 4DE | 50.00 | 4DD | 561.10 | 1274.40 | 4DE | 125.00 | 4DD | 1399.40 | |
| COMPCAREBLUE SOUTHEAST | 2 | 536.40 | 4EN | 50.00 | 4EM | 586.40 | 1337.60 | 4EN | 125.00 | 4EM | 1462.60 | |
| DEAN HEALTH PLAN | 1 | 415.60 | 4CP | 22.00 | 4CO | 437.60 | 1035.60 | 4CP | 55.00 | 4CO | 1090.60 | |
| GHC-EAU CLAIRE | 1 | 503.00 | 4DN | 22.00 | 4DM | 525.00 | 1254.10 | 4DN | 55.00 | 4DM | 1309.10 | |
| GHC-SOUTH CENTRAL | 1 | 408.20 | 4DB | 22.00 | 4DA | 430.20 | 1017.10 | 4DB | 55.00 | 4DA | 1072.10 | |
| GUNDERSEN LUTHERAN | 1 | 510.40 | 4BN | 22.00 | 4BM | 532.40 | 1272.60 | 4BN | 55.00 | 4BM | 1327.60 | |
| HEALTH TRADITION | 1 | 513.20 | 4CW | 22.00 | 4CV | 535.20 | 1279.60 | 4CW | 55.00 | 4CV | 1334.60 | |
| HUMANA-EASTERN | 1 | 549.60 | 4EQ | 22.00 | 4EP | 571.60 | 1370.60 | 4EQ | 55.00 | 4EP | 1425.60 | |
| HUMANA-WESTERN | 2 | 521.50 | 4BW | 50.00 | 4BV | 571.50 | 1300.40 | 4BW | 125.00 | 4BV | 1425.40 | |
| MEDICAL ASSOCIATES HMO | 1 | 421.40 | 4DP | 22.00 | 4DQ | 443.40 | 1050.10 | 4DP | 55.00 | 4DQ | 1105.10 | |
| MERCYCARE HEALTH PLAN | 1 | 380.80 | 4GN | 22.00 | 4GM | 402.80 | 948.60 | 4GN | 55.00 | 4GM | 1003.60 | |
| NETWORK HEALTH PLAN | 1 | 443.40 | 4GB | 22.00 | 4GA | 465.40 | 1105.10 | 4GB | 55.00 | 4GA | 1160.10 | |
| PHYSICIANS PLUS | 1 | 417.30 | 4CM | 22.00 | 4CL | 439.30 | 1039.90 | 4CM | 55.00 | 4CL | 1094.90 | |
| UNITED HEALTHCARE NE | 1 | 426.60 | 4DH | 22.00 | 4DG | 448.60 | 1063.10 | 4DH | 55.00 | 4DG | 1118.10 | |
| UNITED HEALTHCARE SE | 1 | 509.20 | 4HX | 22.00 | 4HW | 531.20 | 1269.60 | 4HX | 55.00 | 4HW | 1324.60 | |
| UNITY-COMMUNITY | 1 | 524.40 | 4CH | 22.00 | 4CG | 546.40 | 1307.60 | 4CH | 55.00 | 4CG | 1362.60 | |
| UNITY-UW HEALTH | 1 | 413.30 | 4BE | 22.00 | 4BD | 435.30 | 1029.90 | 4BE | 55.00 | 4BD | 1084.90 | |
WPS PATIENT CHOICE 1 |
1 | 533.00 | 4HR | 22.00 | 4HQ | 555.00 | 1329.10 | 4HR | 55.00 | 4HQ | 1384.10 | |
| WPS PATIENT CHOICE 2 | 2 | 551.50 | 4HU | 50.00 | 4HT | 601.50 | 1375.40 | 4HU | 125.00 | 4HT | 1500.40 | |
| WPS PREVEA HEALTH PLAN | 1 | 490.60 | 4BH | 22.00 | 4BG | 512.60 | 1223.10 | 4BH | 55.00 | 4BG | 1278.10 | |
*Only available to employees living in SMP counties
File last updated: March 19, 2007
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© 2006 Board of Regents of the University of Wisconsin System
UW1332 10/05