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| HMO Plans |
|
2000 Total Biweekly
Premium |
2001 Biweekly premium rates |
2000 Total Monthly
Premium |
2001 Monthly premium rates |
| Location - Plan
- Option - |
|
Total
Premium |
Gov't
Pays |
Empl.
Pays |
Change in employee payment |
Total
Premium |
Gov't
Pays |
Empl.
Pays |
Change in employee payment |
| Enrollment Code |
|
| PA Aetna U.S. Healthcare |
|
|
|
|
|
|
High Self |
KL1 |
|
90.94 |
91.56 |
68.67 |
22.89 |
0.16 |
|
197.04 |
198.38 |
148.79 |
49.59 |
0.33 |
|
|
High Family |
KL2 |
|
242.04 |
242.29 |
181.72 |
60.57 |
-5.50 |
|
524.42 |
524.96 |
393.72 |
131.24 |
-11.91 |
|
|
Standard Self |
KL4 |
|
76.41 |
79.51 |
59.63 |
19.88 |
0.78 |
|
165.56 |
172.27 |
129.20 |
43.07 |
1.68 |
|
|
Standard Family |
KL5 |
|
203.80 |
211.53 |
158.65 |
52.88 |
1.93 |
|
441.57 |
458.32 |
343.74 |
114.58 |
4.19 |
|
| PA Aetna U.S. Healthcare |
|
|
|
|
|
|
High Self |
SU1 |
|
115.81 |
122.88 |
86.59 |
36.29 |
-0.69 |
|
250.92 |
266.24 |
187.61 |
78.63 |
-1.49 |
|
|
High Family |
SU2 |
|
295.84 |
315.11 |
195.82 |
119.29 |
-0.58 |
|
640.99 |
682.74 |
424.28 |
258.46 |
-1.26 |
|
|
Standard Self |
SU4 |
|
98.98 |
107.99 |
80.99 |
27.00 |
2.26 |
|
214.46 |
233.98 |
175.49 |
58.49 |
4.88 |
|
|
Standard Family |
SU5 |
|
255.61 |
278.77 |
195.82 |
82.95 |
3.31 |
|
553.82 |
604.00 |
424.28 |
179.72 |
7.17 |
|
| PA First Priority Hlth |
|
|
|
|
|
|
|
High Self |
C81 |
|
96.26 |
140.49 |
86.59 |
53.90 |
29.84 |
|
208.56 |
304.40 |
187.61 |
116.79 |
64.65 |
|
|
High Family |
C82 |
|
248.14 |
362.17 |
195.82 |
166.35 |
94.18 |
|
537.64 |
784.70 |
424.28 |
360.42 |
204.05 |
|
| PA Free State Health Plan |
|
|
|
|
|
|
High Self |
LD1 |
|
124.90 |
119.38 |
86.59 |
32.79 |
-13.28 |
|
270.62 |
258.66 |
187.61 |
71.05 |
-28.77 |
|
|
High Family |
LD2 |
|
284.79 |
272.14 |
195.82 |
76.32 |
-32.50 |
|
617.05 |
589.64 |
424.28 |
165.36 |
-70.42 |
|
| PA Geisinger Health Plan |
|
|
|
|
|
|
High Self |
N91 |
|
65.34 |
91.07 |
68.30 |
22.77 |
6.44 |
|
141.57 |
197.32 |
147.99 |
49.33 |
13.94 |
|
|
High Family |
N92 |
|
199.31 |
271.37 |
195.82 |
75.55 |
25.72 |
|
431.84 |
587.97 |
424.28 |
163.69 |
55.73 |
|
| PA HealthAmerica Pennsylvania |
|
|
|
|
|
|
High Self |
261 |
|
87.62 |
92.94 |
69.71 |
23.23 |
1.33 |
|
189.84 |
201.37 |
151.03 |
50.34 |
2.88 |
|
|
High Family |
262 |
|
227.81 |
241.66 |
181.25 |
60.41 |
3.46 |
|
493.59 |
523.60 |
392.70 |
130.90 |
7.50 |
|
| PA HealthAmerica Pennsylvania |
|
|
|
|
|
|
High Self |
SW1 |
|
94.55 |
99.27 |
74.45 |
24.82 |
1.18 |
|
204.86 |
215.09 |
161.32 |
53.77 |
2.56 |
|
|
High Family |
SW2 |
|
245.82 |
258.08 |
193.56 |
64.52 |
-5.33 |
|
532.61 |
559.17 |
419.38 |
139.79 |
-11.55 |
|
| PA HealthGuard |
|
|
|
|
|
|
|
High Self |
NQ1 |
|
83.28 |
92.31 |
69.23 |
23.08 |
2.26 |
|
180.44 |
200.01 |
150.01 |
50.00 |
4.89 |
|
|
High Family |
NQ2 |
|
217.01 |
240.73 |
180.55 |
60.18 |
5.93 |
|
470.19 |
521.58 |
391.19 |
130.39 |
12.84 |
|
| PA Keystone Health Plan Central |
|
|
|
|
|
|
High Self |
S41 |
|
108.30 |
115.94 |
86.59 |
29.35 |
-0.12 |
|
234.65 |
251.20 |
187.61 |
63.59 |
-0.26 |
|
|
High Family |
S42 |
|
262.29 |
280.60 |
195.82 |
84.78 |
-1.54 |
|
568.30 |
607.97 |
424.28 |
183.69 |
-3.34 |
|
| PA Keystone Health Plan East |
|
|
|
|
|
|
High Self |
ED1 |
|
93.16 |
107.01 |
80.26 |
26.75 |
3.46 |
|
201.85 |
231.86 |
173.90 |
57.96 |
7.50 |
|
|
High Family |
ED2 |
|
245.72 |
282.00 |
195.82 |
86.18 |
16.43 |
|
532.39 |
611.00 |
424.28 |
186.72 |
35.60 |
|
| PA KeystoneBlue |
|
|
|
|
|
|
|
High Self |
EF1 |
|
96.38 |
110.84 |
83.13 |
27.71 |
3.62 |
|
208.82 |
240.15 |
180.11 |
60.04 |
7.84 |
|
|
High Family |
EF2 |
|
285.93 |
328.82 |
195.82 |
133.00 |
23.04 |
|
619.52 |
712.44 |
424.28 |
288.16 |
49.91 |
|
| PA QualMed Plans for Health |
|
|
|
|
|
|
High Self |
271 |
|
123.29 |
140.20 |
86.59 |
53.61 |
9.15 |
|
267.13 |
303.77 |
187.61 |
116.16 |
19.83 |
|
|
High Family |
272 |
|
286.63 |
325.94 |
195.82 |
130.12 |
19.46 |
|
621.03 |
706.20 |
424.28 |
281.92 |
42.16 |
|
| PA QualMed Plans for Health |
|
|
|
|
|
|
High Self |
2K1 |
|
88.04 |
116.28 |
86.59 |
29.69 |
7.68 |
|
190.75 |
251.94 |
187.61 |
64.33 |
16.64 |
|
|
High Family |
2K2 |
|
213.75 |
282.32 |
195.82 |
86.50 |
33.06 |
|
463.13 |
611.69 |
424.28 |
187.41 |
71.63 |
|
| PA UPMC Health Plan |
|
|
|
|
|
|
|
High Self |
8W1 |
|
72.53 |
81.32 |
60.99 |
20.33 |
2.20 |
|
157.15 |
176.19 |
132.14 |
44.05 |
4.76 |
|
|
High Family |
8W2 |
|
214.95 |
207.44 |
155.58 |
51.86 |
-1.88 |
|
465.73 |
449.45 |
337.09 |
112.36 |
-4.07 |
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