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University of Wisconsin
Health Insurance Premium
Employee Contribution for the 2010 Plan Year
Tier 1 : Health Maintenance Organizations (HMOs)
Out-of-state residents assigned to work out of state receive
Tier 2 :
the Standard Plan, Preferred Provider Plan (PPP), at Tier 2 rates.
Tier 3 : Standard Plan, Preferred Provider Plan (PPP)
Coverage Level : Single or Family
2010 Monthly Employee Contribution for
Non-Represented Classified and Unclassified Employees
Single Family
Tier 1 $34.00 $85.00
Tier 2 $75.00 $188.00
Tier 3 $179.00 $448.00
Current Monthly Employee Contribution* for
Represented Classified Employees
(excluding Represented SEA Employees)
Single Family
Tier 1 $31.00 $78.00
Tier 2 $69.00 $173.00
Tier 3 $164.00 $412.00
Current Monthly Employee Contribution* for
Represented SEA Employees
Single Family
Tier 1 $27.00 $68.00
Tier 2 $60.00 $150.00
Tier 3 $143.00 $358.00
*Monthly employee contributions for represented employees are subject to collective bargaining
and could change before or during the calendar year.
Rev. 11/09
University of Wisconsin
Health Insurance Premium
Employee Contribution for the 2010 Plan Year
Tier 1 : Health Maintenance Organizations (HMOs)
Out-of-state residents assigned to work out of state receive
Tier 2 :
the Standard Plan, Preferred Provider Plan (PPP), at Tier 2 rates.
Tier 3 : Standard Plan, Preferred Provider Plan (PPP)
Coverage Level : Single or Family
2010 Monthly Premium for
Crafts Employees
Plan Name Tier Single Family
Anthem Blue Northeast 1 $615.50 $1,535.00
Anthem Blue Northwest 1 $599.70 $1,495.50
Anthem Blue Southeast 1 $724.50 $1,807.50
Arise Health Plan 1 $672.40 $1,677.30
Dean Health Plan 1 $574.70 $1,433.00
GHC of Eau Claire 1 $766.70 $1,913.00
GHC of South Central Wisconsin 1 $569.10 $1,419.00
Gundersen Lutheran Health Plan 1 $685.90 $1,711.00
HealthPartners 1 $689.00 $1,718.80
Health Tradition Health Plan 1 $720.10 $1,796.50
Humana Eastern 1 $727.00 $1,813.80
Humana Western 1 $700.20 $1,746.80
Medical Associates Health Plan 1 $564.50 $1,407.50
MercyCare Health Plan 1 $564.10 $1,406.50
Network Health Plan 1 $645.50 $1,610.00
Physicians Plus 1 $575.10 $1,434.00
Security Health Plan 1 $743.00 $1,853.80
Standard Plan (PPP) 2 or 3 $1,074.00 $2,681.60
State Maintenance Plan (SMP) 1 $664.60 $1,657.70
UnitedHealthcare Northeast 1 $653.40 $1,629.80
UnitedHealthcare Southeast 1 $672.90 $1,678.50
Unity - Community 1 $626.40 $1,562.30
Unity - UW Health 1 $576.10 $1,436.50
WPS MetroChoice 1 $675.10 $1,684.00
Rev. 11/09
University of Wisconsin
Health Insurance Premium
Employee Contribution for the 2010 Plan Year
Tier 1 : Health Maintenance Organizations (HMOs)
Out-of-state residents assigned to work out of state receive
Tier 2 :
the Standard Plan, Preferred Provider Plan (PPP), at Tier 2 rates.
Tier 3 : Standard Plan, Preferred Provider Plan (PPP)
Coverage Level : Single or Family
2010 Monthly Employee Contribution for
Non-Represented and Represented Employees
employed less than half-time
Plan Name Tier Single Family
Anthem Blue Northeast 1 $307.75 $767.50
Anthem Blue Northwest 1 $299.85 $747.75
Anthem Blue Southeast 1 $362.25 $903.75
Arise Health Plan 1 $336.20 $838.65
Dean Health Plan 1 $287.35 $716.50
GHC of Eau Claire 1 $383.35 $956.50
GHC of South Central Wisconsin 1 $284.55 $709.50
Gundersen Lutheran Health Plan 1 $342.95 $855.50
HealthPartners 1 $344.50 $859.40
Health Tradition Health Plan 1 $360.05 $898.25
Humana Eastern 1 $363.50 $906.90
Humana Western 1 $350.10 $873.40
Medical Associates Health Plan 1 $282.25 $703.75
MercyCare Health Plan 1 $282.05 $703.25
Network Health Plan 1 $322.75 $805.00
Physicians Plus 1 $287.55 $717.00
Security Health Plan 1 $371.50 $926.90
Standard Plan (PPP) 2 or 3 $537.00 $1,340.80
State Maintenance Plan (SMP) 1 $332.30 $828.85
UnitedHealthcare Northeast 1 $326.70 $814.90
UnitedHealthcare Southeast 1 $336.45 $839.25
Unity - Community 1 $313.20 $781.15
Unity - UW Health 1 $288.05 $718.25
WPS MetroChoice 1 $337.55 $842.00
Rev. 11/09
University of Wisconsin
Health Insurance Premium
Employee Contribution for the 2010 Plan Year
Tier 1 : Health Maintenance Organizations (HMOs)
Out-of-state residents assigned to work out of state receive
Tier 2 :
the Standard Plan, Preferred Provider Plan (PPP), at Tier 2 rates.
Tier 3 : Standard Plan, Preferred Provider Plan (PPP)
Coverage Level : Single or Family
UW Graduate Assistants
2010 Appointee Monthly Contribution for
Non-Represented UW Graduate Assistants
Single Family
Tier 1 $17.00 $42.50
Tier 2 $37.50 $94.00
Tier 3 $89.50 $224.00
Current Appointee Monthly Contribution* for
Represented UW-Madison Graduate Assistants
and
Represented UW-Milwaukee Graduate Assistants
Single Family
Tier 1 $15.50 $39.00
Tier 2 $34.50 $86.50
Tier 3 $82.00 $206.00
*Monthly employee contributions for represented employees are subject to collective bargaining
and could change before or during the calendar year.
Rev. 11/09
